Elsevier

Lung Cancer

Volume 21, Issue 3, 1 September 1998, Pages 155-163
Lung Cancer

Lung cancer and smoking: A case-control study in Buenos Aires, Argentina

https://doi.org/10.1016/S0169-5002(98)00055-5Get rights and content

Abstract

The objective of this study was to examine the risks for lung cancer associated with lifestyle characteristics of smoking in a developing country where lung cancer is the first cause of mortality by cancer in men, tobacco propaganda is freely allowed, and there are no restrictions operating for smoking. The design was a case-control and hospital-based study. Two hundred men with lung cancer and 397 hospital controls were interviewed. Odds ratio (OR) for current smokers was 8.5, whereas former smokers displayed an OR of 5.3. The risk increased with duration of smoking and with the number of cigarettes smoked per day. The attributable risk for smoking was 85%. Smokers of black tobacco and more than 24 cigarettes/day showed a risk of 12.9 regarding non-smokers, and of 15.5 for 40 or more years duration of smoking. The proportion of cases diagnosed as adenocarcinoma was higher than the proportion of squamous cell carcinoma.

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

References (22)

  • E Benhamou et al.

    Black (air-cured) and blond (flue-cured) tobacco and cancer risk. VI. Lung cancer

    Eur J Cancer

    (1993)
  • Alvarez Gelves JC, Perez Arias E. Provincial cancer registry, La Plata, In: Parkin DM, editor. Cancer Ocurrence in...
  • S Benhamou et al.

    Differential effects of tar content, type of tobacco and use of filter on lung cancer risk in male cigarette smokers

    Int J Epidemiol

    (1994)
  • P Boffetta et al.

    Mortality patterns and trends for lung cancer and other related cancers in the Americas, 1955-1989

    Int J Epidemiol

    (1993)
  • Breslow NE, Day NE. Statistical methods in cancer research. The analysis of case-control studies. IARC Sci Publ 32....
  • Cámara de la Industria del Tabaco. Compendio estadı́stico 1960–1985. Buenos Aires: Cámara de la Industria del Tabaco,...
  • A Charloux et al.

    The increase of lung adenocarcinoma: reality or artefact? A review of the epidemiology of lung adenocarcinoma

    Int J Epidemiol

    (1997)
  • E De Stefani et al.

    Dietary nitrosodimethylamine and the risk of lung cancer: a case-control study from Uruguay

    Cancer Epidemiol Biomarkers Prev

    (1996)
  • E De Stefani et al.

    Black (air-cured) and blond (flue-cured) tobacco and cancer risk. VI. Lung cancer

    Eur J Cancer

    (1993)
  • IARC Monographs on the evaluation of carcinogenic risks to humans, vol. 38. Tobacco smoking. Lyon: IARC,...
  • O.G Joly et al.

    Dark tobacco and lung cancer in Cuba

    J Natl Cancer Inst

    (1983)
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