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Cancer Prevention Research
Cancer Prevention Research
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Research Article

Association between Cigar or Pipe Smoking and Cancer Risk in Men: A Pooled Analysis of Five Cohort Studies

Jyoti Malhotra, Claire Borron, Neal D. Freedman, Christian C. Abnet, Piet A. van den Brandt, Emily White, Roger L. Milne, Graham G. Giles and Paolo Boffetta
Jyoti Malhotra
1Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey.
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  • For correspondence: Jyoti.malhotra@rutgers.edu
Claire Borron
2Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
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Neal D. Freedman
3Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
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Christian C. Abnet
3Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
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Piet A. van den Brandt
4Department of Epidemiology, Maastricht University Medical Center, Maastricht, the Netherlands.
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Emily White
5Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington.
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Roger L. Milne
6Cancer Epidemiology Center, Cancer Council Victoria, Melbourne, Australia.
7School of Population and Global Health, University of Melbourne, Melbourne, Australia.
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Graham G. Giles
6Cancer Epidemiology Center, Cancer Council Victoria, Melbourne, Australia.
7School of Population and Global Health, University of Melbourne, Melbourne, Australia.
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Paolo Boffetta
2Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
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DOI: 10.1158/1940-6207.CAPR-17-0084 Published December 2017
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Abstract

Introduction: Use of non-cigarette tobacco products such as cigars and pipe has been increasing, even though these products entail exposure to similar carcinogens to those in cigarettes. More research is needed to explore the risk of these products to guide cancer prevention efforts.

Methods: To measure the association between cigars and/or pipe smoking, and cancer incidence in men, we performed meta-analyses of data from five prospective cohorts. Cox regression was used to evaluate the association between different aspects of cigars and pipe smoking and risk of each smoking-related cancer (head and neck, esophagus, lung, stomach, liver, pancreas, kidney, and bladder) for each study. Adjusted HRs were combined using random-effects models.

Results: Cigars and/or pipe smokers were at increased risk for head and neck [HR, 1.51; 95% confidence interval (CI), 1.22–1.87], lung (HR, 2.04; 95% CI, 1.68–2.47), and liver cancers (HR, 1.56; 95% CI, 1.08–2.26). Ever-smokers of cigars and/or pipe had an increased risk of developing a smoking-related cancer when compared with never smokers of any tobacco product (overall HR, 1.07; 95% CI, 1.03–1.12). The risk for smoking-related cancers was also increased in mixed smokers who smoked cigars or pipe as well as cigarettes, even when they were smoking predominantly pipe or cigars.

Discussion: This pooled analysis highlights the increased risk for smoking-related cancers, particularly for lung and head and neck cancers in exclusive and predominant smokers (former and current) of cigars and pipe. Tobacco prevention efforts should include these products in addition to cigarettes. Cancer Prev Res; 10(12); 704–9. ©2017 AACR.

  • Received March 21, 2017.
  • Revision received August 4, 2017.
  • Accepted September 21, 2017.
  • ©2017 American Association for Cancer Research.
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Cancer Prevention Research: 10 (12)
December 2017
Volume 10, Issue 12
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Association between Cigar or Pipe Smoking and Cancer Risk in Men: A Pooled Analysis of Five Cohort Studies
Jyoti Malhotra, Claire Borron, Neal D. Freedman, Christian C. Abnet, Piet A. van den Brandt, Emily White, Roger L. Milne, Graham G. Giles and Paolo Boffetta
Cancer Prev Res December 1 2017 (10) (12) 704-709; DOI: 10.1158/1940-6207.CAPR-17-0084

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Association between Cigar or Pipe Smoking and Cancer Risk in Men: A Pooled Analysis of Five Cohort Studies
Jyoti Malhotra, Claire Borron, Neal D. Freedman, Christian C. Abnet, Piet A. van den Brandt, Emily White, Roger L. Milne, Graham G. Giles and Paolo Boffetta
Cancer Prev Res December 1 2017 (10) (12) 704-709; DOI: 10.1158/1940-6207.CAPR-17-0084
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