Lung cancer and smoking: A case-control study in Buenos Aires, Argentina
Introduction
In Argentina, as in many industrially developing countries, vascular and neoplastic diseases are now the chief causes of premature death. Cancer is the second cause of death, and lung cancer is the first neoplastic cause of death among males, with an age-adjusted mortality rate of 39.0/100 000 for the period 1989–1992. The rate for females, 6.1/100 000 for the same period, is still low compared to the rates in developed countries [14].
Very few data are available regarding incidence. In the city of La Plata province of Buenos Aires, data from 1980 showed an annual age standardized lung cancer incidence rate of 40.3/100 000 among males [1]. More recent figures in the country are available only from the population-based Tumor Registry of the Department of Concordia, Entre Rios. The rates were 55.8 /100 000 for males and 8.3 for females, for the period 1990–1994 [19].
Tobacco smoking is the major cause of lung cancer world-wide [10], while 85% of lung cancer cases in males have been attributed to tobacco smoking [16].
In less developed countries, where lung cancer is already a major cause of adult male mortality, tobacco will become in a few decades one of the most important causes of death, as in developed countries 15, 17. In this context, it becomes important to measure the effect of tobacco and of the factors that may modify those effects in those countries where the tobacco-related lung cancer epidemics is still in its early phases in males and very early phases in females [4].
The present paper is the first study on lung cancer and tobacco smoke conducted so far in Argentina. Results are reported from a hospital-based case-control study performed in Buenos Aires on males. The purpose of this study was to evaluate the risks associated with lifestyle characteristics of smoking and type of tobacco.
Section snippets
Patients and methods
During the study period, March 1994–March 1996, all incident male lung cancer cases, residents in the city or in the Province of Buenos Aires, who where admitted for treatment in four hospitals of Buenos Aires city, were considered eligible for the present study. In total, 216 lung cancer cases were identified in the participant hospitals. Fifteen patients were too ill or mentally incapable of being interviewed and one patient refused to be interviewed, leaving 200 patients, who were included
Results
Selected characteristics of cases and controls are reported in Table 2. No differences between cases and controls were observed in the age distribution, educational level or lifetime residence in urban or rural areas. The analysis of smoking habits was restricted to cigarette smokers because only five men smoked pipes or cigars only. Eleven cases were non-smokers and all of them were histologically verified. Among ever smokers, and during the majority of their lifetime smoking, 30% of the cases
Discussion
The prevalence of non-smokers, ex-smokers and current smokers observed in this study among the controls was close to the prevalence observed in a survey held in Buenos Aires in 1995. In that study, conducted on 1152 men aged 35 and over, a third of the interviewees had never smoked and a third were current smokers, almost exclusively of cigarettes [13].
We found, consistently with studies from other countries, that tobacco smoking is an important risk factor of lung cancer [10], with former
Acknowledgements
The authors are grateful to the following physicians for their contributions: British Hospital: G. Angaramo, M. Blasco, D.J. Chimondeguy, T.M. Angelillo McKinley, J.D. Emery; Italian Hospital: J. Lastiri, G. Pallotta, M. Varela; Roffo Institute: R. del Aguila, A. Gonzalez, R. Kirchuck, C. Spector; Tornú Hospital: C. Bagnes, M. Elffman, H. Vicente. We are also indebted to Natalie Rivera, MIRT fellow from the University of Washington, Seattle, WA, who worked in Buenos Aires with the database and
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