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Smoking and risk of glioma: a meta-analysis

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Abstract

Objective

Although causal relationships between smoking and cancer risk have been established for many sites, most studies of brain cancer have not supported an association. However, two recent cohort studies showed increased risks of glioma among smokers. We quantified the association between smoking and glioma through a meta-analysis of the literature.

Methods

Of 20 eligible studies, 17 (6 cohort and 11 case–control) were included in an analysis of ever versus never smoking. Multivariate-adjusted risk estimates in the papers were pooled to calculate cumulative risk.

Results

The cumulative estimated risk associated with ever smoking was 1.06 (95% CI: 0.97–1.15), for all, 1.10 (95% CI: 1.01–1.20) for cohort, and 1.00 (95% CI: 0.88–1.15) for case–control studies. A significantly increased risk associated with past smoking was noted for cohort studies, OR = 1.16 (p = 0.007), while an increased risk of borderline significance was seen for all studies, OR = 1.10 (p = 0.08). In general, dose–response analysis did not support an association and was limited because very few studies included these variables and could be pooled.

Conclusion

Overall, results of pooling of all studies suggested that smoking is not associated with risk of glioma. However, the small but significant increased risk seen for cohort studies remains to be clarified.

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References

  1. Centers for Disease Control and Prevention (2004) Surgeon general’s report: the health consequences of smoking. Atlanta, GA: Centers for Disease Control and Prevention 2004. Available from, http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2004/00_pdfs/chapter2.pdf

  2. Baldwin RT, Preston-Martin S (2004) Epidemiology of brain tumors in childhood—a review. Toxicol Appl Pharmacol 199:118–131

    Article  CAS  PubMed  Google Scholar 

  3. Dietrich M, Block G, Pogoda JM, Buffler P, Hecht S, Preston-Martin S (2005) A review: dietary and endogenously formed N-nitroso compounds and risk of childhood brain tumors. Cancer Causes Control 16:619–635

    Article  PubMed  Google Scholar 

  4. Efird JT, Friedman GD, Sidney S et al (2004) The risk for malignant primary adult-onset glioma in a large, multiethnic, managed-care cohort: cigarette smoking and other lifestyle behaviors. J Neurooncol 68:57–69

    Article  PubMed  Google Scholar 

  5. Navarro Silvera SA, Miller AB, Rohan TE (2006) Cigarette smoking and risk of glioma: a prospective cohort study. Int J Cancer 118:1848–1851

    Article  CAS  Google Scholar 

  6. Holick CN, Giovannucci EL, Rosner B, Stampfer MJ, Michaud DS (2007) Prospective study of cigarette smoking and adult glioma: dosage, duration, and latency. Neuro Oncol 9:326–334

    Article  PubMed  Google Scholar 

  7. Benson VS, Pirie K, Green J, Casabonne D, Beral V, Million Women Study Collaborators (2008) Lifestyle factors and primary glioma and meningioma tumours in the Million Women Study cohort. Br J Cancer 99:185–190

    Article  CAS  PubMed  Google Scholar 

  8. Zheng T, Cantor KP, Zhang Y, Chiu BCH, Lynch CF (2001) Risk of brain glioma not associated with cigarette smoking or use of other tobacco products in Iowa. Cancer Epidemol Biomarkers Prev 10:413–414

    CAS  Google Scholar 

  9. Hu J, Johnson KC, Mao Y et al (1998) Risk factors for glioma in adults: a case–control study in Northeast China. Cancer Detect Prev 22(2):100–108

    Article  CAS  PubMed  Google Scholar 

  10. McLaughlin JK, Hrubec Z, Blot WJ, Fraumeni JF (1995) Smoking and cancer mortality among US veterans: a 26-year follow-up. Int J Cancer 60:190–193

    Article  CAS  PubMed  Google Scholar 

  11. Mills PK, Preston-Martin S, Annegers JF, Beeson WL, Phillips RL, Fraser GE (1989) Risk factors for tumors of the brain and cranial meninges in Seventh-Day Adventists. Neuroepidemiology 8:266–275

    Article  CAS  PubMed  Google Scholar 

  12. Blowers L, Preston-Martin S, Mack WJ (1997) Dietary and other lifestyle factors of women with brain gliomas in Los Angeles county (California, USA). Cancer Causes Control 8:5–12

    Article  CAS  PubMed  Google Scholar 

  13. Lee M, Wrensch M, Miike R (1997) Dietary and tobacco risk factors for adult onset glioma in the San Francisco Bay area (California, USA). Cancer Causes Control 8:13–24

    Article  CAS  PubMed  Google Scholar 

  14. Hurley SF, McNeil JJ, Donnan GA, Forbes A, Salzberg M, Giles GG (1996) Tobacco consumption and alcohol consumption as risk factors for glioma: a case–control study in Melbourne, Australia. J Epidemiol Community Health 50:442–446

    Article  CAS  PubMed  Google Scholar 

  15. Ryan P, Lee MW, North B, McMichael AJ (1992) Risk factors for tumors of the brain and meninges: results from the adelaide adult brain tumor study. Int J Cancer 51:20–27

    Article  CAS  PubMed  Google Scholar 

  16. Schlehofer B, Kunze S, Sachsenheimer W, Blettner M, Niehoff D, Wahrendor J (1990) Occupational risk factors for brain tumors: results from a population-based case–control study in Germany. Cancer Causes Control 1990(1):209–215

    Article  Google Scholar 

  17. Brownson RC, Reif JS, Chang JC, Davis JR (1990) An analysis of occupational risks for brain cancer. Am J Public Health 80(2):169–172

    Article  CAS  PubMed  Google Scholar 

  18. Preston-Martin S, Mack W, Henderson BE (1989) Risk factors for gliomas and meningiomas in males in Los Angeles county. Cancer Res 49:6137–6143

    CAS  PubMed  Google Scholar 

  19. Burch JD, Craib KJP, Choi BCK, Miller AB, Tisch HA, Howe GR (1987) An exploratory case–control study of brain tumors in adults. JNCI 78(1):601–609

    CAS  PubMed  Google Scholar 

  20. Carpenter AV, Flanders WD, Frome EL, Cole P, Fry SA (1987) Brain cancer and nonoccupational risk factors: a case–control study among workers at two nuclear facilities. Am J Public Health 77:1180–1182

    Article  CAS  PubMed  Google Scholar 

  21. Musicco M, Filippini G, Bordo BM, Melotto A, Morello G, Berrino F (1982) Gliomas and occupational exposure to carcinogens: case–control study. Am J Epidemiol 116(5):782–790

    CAS  PubMed  Google Scholar 

  22. Ahlbom A, Lindberg Navier I, Norell S, Olin R, Spannare B (1986) Nonoccupational risk indicators for astrocytomas in adults. Am J Epidemiol 124(2):334–337

    CAS  PubMed  Google Scholar 

  23. Hochberg F, Toniolo P, Cole P (1990) Nonoccupational risk indicators of glioblastoma in adults. J Neurooncol 8:55–60

    Article  CAS  PubMed  Google Scholar 

  24. Zampieri P, Meneghini F, Grigoletto F et al (1994) Risk factors for cerebral glioma in adults: a case–control study in an Italian population. J Neurooncol 19:61–67

    Article  CAS  PubMed  Google Scholar 

  25. Giles GG, McNeil JJ, Donnan G et al (1994) Dietary factors and the risk of glioma in adults: results of a case–control study in Melbourne, Australia. Int J Cancer 59:357–362

    Article  CAS  PubMed  Google Scholar 

  26. Choi NW, Schuman LM, Gullen WH (1970) Epidemiology of primary central nervous system neoplasms. II: case–control study. Am J Epidemiol 91(5):467–485

    CAS  PubMed  Google Scholar 

  27. StataCorp (2007) Stata statistical software: release 10. StataCorp LP, College Station

    Google Scholar 

  28. Normand ST (1999) Tutorial in biostatistics-meta-analysis: formulating, evaluating, combining, and reporting. Statist Med 18:321–359

    Article  CAS  Google Scholar 

  29. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Controlled Clin Trials 7:177–188

    Article  CAS  PubMed  Google Scholar 

  30. Greenland S, Longnecker MP (1992) Methods for trend estimation from summarized dose-response data, with application to meta-analysis. Am J Epidemiol 135(11):1301–1309

    CAS  PubMed  Google Scholar 

  31. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101

    Article  CAS  PubMed  Google Scholar 

  32. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple graphical test. BMJ 315:629–634

    CAS  PubMed  Google Scholar 

  33. SEER Stat Fact Sheets (2009) Cancer of the brain and other nervous system. Available from http://www.seer.cancer.gov/statfacts/html/brain.html (accessed 2 June, 2009)

  34. Sadetzki S, Zach L, Chetrit A et al (2008) Epidemiology of gliomas in Israel: a nationwide study. Neuroepidemiology 31(4):254–269

    Article  Google Scholar 

  35. Gordis L (1996) Epidemiology. W.B. Saunders Company, Philadelphia, p 176

    Google Scholar 

  36. Vrijheid M, DeHour I, Krewski D, Sanchez M, Cardis E (2006) The effects of recall errors and of selection bias in epidemiologic studies of mobile phone use and cancer risk. J Expo Sci Environ Epidemiol 16:371–384

    Article  PubMed  Google Scholar 

  37. Passaro KT, Noss J, Savitz DA, Little RE, The ALSPAC Study Team (1997) Agreement between self and partner reports of paternal drinking and smoking. Int J Cancer 26(2):315–320

    CAS  Google Scholar 

  38. Hatch MC, Misra D, Kabat GC, Kartzmer S (1991) Proxy respondents in reproductive research: a comparison of self- and partner reported data. Am J Epidemiol 133(8):826–831

    CAS  PubMed  Google Scholar 

  39. Preston-Martin S (1996) Epidemiology of primary CNS neoplasms. Neurol Clin 14(2):273–290

    Article  CAS  PubMed  Google Scholar 

  40. Wrensch M, Minn Y, Chew T, Bondy M, Berger MS (2002) Epidemiology of primary brain tumors: current concepts and review of the literature. Neuro Oncol 4:278–299

    Article  PubMed  Google Scholar 

  41. Ohgaki H, Kleihues P (2005) Epidemiology and etiology of gliomas. Acta Neuropathol 109(1):93–108

    Article  PubMed  Google Scholar 

  42. Schwartzbaum JA, Fisher JL, Aldape KD, Wrensch M (2005) Epidemiology and molecular pathology of glioma. Nat Clin Pract Neurol 2(9):494–503

    Article  Google Scholar 

  43. Ryan P, Lee MW, North B, McMichael AJ (1992) Amalgam fillings, diagnostic dental X-rays, and tumors of the brain and meninges. Eur J Cancer B Oral Oncol 28B(2):91–95

    Article  CAS  PubMed  Google Scholar 

  44. Wrensch M, Miike R, Lee M, Neuhaus J (2000) Are prior head injuries or diagnostic X-rays associated with glioma in adults? The effects of control selection bias. Neuroepidemiology 19:234–244

    Article  CAS  PubMed  Google Scholar 

  45. Blettner M, Schlehofer B, Samkange-Zeeb F, Berg G, Schlaefer K, Schuz J (2007) Medical exposure to ionizing radiation and the risk of brain tumors: Interphone Study Group, Germany. Eur J Cancer 43:1990–1998

    Article  PubMed  Google Scholar 

  46. Karlsson P, Holmberg E, Lundell M, Mattsson A, Holm L-E, Wallgren A (1998) Intracranial tumors after exposure to ionizing radiation during infancy: a pooled analysis of two Swedish cohorts of 28, 008 infants with skin hemangioma. Radiat Res 150:357–364

    Article  CAS  PubMed  Google Scholar 

  47. Shore RE, Moseson M, Harley N, Pasternack BS (2003) Tumors and other diseases following childhood X-ray treatment for ringworm of the scalp (tinea capitis). Health Phys 85:404–408

    Article  CAS  PubMed  Google Scholar 

  48. Sadetzki S, Chetrit A, Freedman L, Stovall M, Modan B, Novikov I (2005) Long-term follow-up for brain tumor development after childhood exposure to ionizing radiation for tinea capitis. Radiat Res 163:424–432

    Article  CAS  PubMed  Google Scholar 

  49. Neglia JP, Robison LL, Stovall M et al (2006) New primary neoplasms of the central nervous system in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Natl Cancer Inst 98:1528–1537

    Article  PubMed  Google Scholar 

  50. Wynder EL, Muscat JE (1995) The changing epidemiology of smoking and lung cancer histology. Environ Health Perspect 103(Suppl 8):143–148

    Article  PubMed  Google Scholar 

  51. Hoffmann D, Hoffmann I, El-Bayoumy K (2001) The less harmful cigarette: a controversial issue. A tribute to Ernst L. Wynder. 14(7):767–790

    CAS  Google Scholar 

  52. Zang EA, Wynder EL (1996) Differences in lung cancer risk between men and women: examination of the evidence. J Natl Cancer Inst 88(3/4):183–192

    Article  CAS  PubMed  Google Scholar 

  53. Siegfried JM (2001) Women and lung cancer: does oestrogen play a role? Lancet Oncol 2(8):506–513

    Article  CAS  PubMed  Google Scholar 

  54. Wei Q, Cheng L, Amos CI et al (2000) Repair of tobacco carcinogen-induced DNA adducts and lung cancer risk: a molecular epidemiologic study. J Natl Cancer Inst 92(21):1764–1772

    Article  CAS  PubMed  Google Scholar 

  55. Kure EH, Ryberg D, Hewer A et al (1996) p53 mutations in lung tumors: relationship to gender and lung DNA adduct levels. Carcinogenesis 17(10):2201–2205

    Article  CAS  PubMed  Google Scholar 

  56. Wakelee HA, Gomez SL, Chang ET (2008) Sex differences in lung-cancer susceptibility: a smoke screen? Lancet Oncol 9(7):609–610

    Article  PubMed  Google Scholar 

  57. Liu X, Chen C, Smith BJ (2008) Progress in brain penetration evaluation in drug discovery and development. J Pharmacol Exp Ther 325(2):349–356

    Article  CAS  PubMed  Google Scholar 

  58. Banks WA (2008) Delivery of peptides to the brain: emphasis on therapeutic development. Biopolymers 90(5):589–594

    Article  CAS  PubMed  Google Scholar 

  59. Czeisler BM, Janigro D (2006) Reading and writing the blood-brain barrier: relevance to therapeutics. Recent Patents CNS Drug Discov 1(2):157–173

    Article  CAS  Google Scholar 

  60. Ohtsuki S, Terasaki T (2007) Contribution of carrier-mediated transport systems to the blood-brain barrier as a supporting and protecting interface for the brain: importance for CNS drug discovery and development. Pharm Res 24(9):1745–1758

    Article  CAS  PubMed  Google Scholar 

  61. Hawkins BT, Abbruscato TJ, Egleton RD et al (2004) Nicotine increases in vivo blood-brain barrier permeability and alters cerebral microvascular tight junction protein distribution. Brain Res 1027:48–58

    Article  CAS  PubMed  Google Scholar 

  62. Berleur MP, Cordier S (1996) The role of chemical, physical, or viral exposures and health factors in neurocarcinogenesis: implications for epidemiologic studies of brain tumors. Cancer Causes Control 6:240–256

    Article  Google Scholar 

  63. Hawkins BT, Davis TP (2005) The blood-brain barrier/neurovascular unit in health and disease. Pharmacol Rev 57:173–185

    Article  CAS  PubMed  Google Scholar 

  64. Hashizume R, Ozawa T, Gryaznov SM, Bollen AW, Lamborn KR, Frey WH 2nd, Deen DF (2008) New therapeutic approach for brain tumors: intranasal delivery of telomerase inhibitor GRN163. Neuro Oncol 10(2):112–120

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Cancer and Radiation Epidemiology Unit, Gertner Institute of Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel

    Lori Mandelzweig & Siegal Sadetzki

  2. Biostatistics Unit, Gertner Institute of Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel

    Ilya Novikov

  3. Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Siegal Sadetzki

Authors
  1. Lori Mandelzweig
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  2. Ilya Novikov
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  3. Siegal Sadetzki
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Correspondence to Siegal Sadetzki.

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Mandelzweig, L., Novikov, I. & Sadetzki, S. Smoking and risk of glioma: a meta-analysis. Cancer Causes Control 20, 1927–1938 (2009). https://doi.org/10.1007/s10552-009-9386-z

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