Steven Stellman - Risk of squamous cell carcinoma and adenocarcinoma of the lung in relation to lifetime filter cigarette smoking

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      Stellman, S. D., Muscat, J. E., Thompson, S., Hoffmann, D.,   Wynder, E. L. 80 (3) 382-8-

      Abstract: BACKGROUND: Over the past few decades,   the incidence of adenocarcinoma (AC) of the lung increased much   more rapidly than that of squamous cell carcinoma (SCC) in men   and women. During this time period, filter cigarettes with   substantially reduced "tar" and nicotine yields in the smoke came   to dominate the market. METHODS: The risk of SCC and AC in   lifelong smokers of filter cigarettes relative to lifelong   nonfilter cigarette smokers was assessed in a case-control study   performed between 1977 and 1995 with 2292 lung carcinoma patients   and 1343 hospital controls who were current smokers. RESULTS:   Odds ratios (OR) for SCC in male and female subjects who had   smoked filter cigarettes exclusively during their lives were   slightly reduced relative to lifetime nonfilter cigarette smokers   in men (OR = 0.8; 95% confidence interval [CI], 0.5-1.2), and   significantly reduced in women (OR = 0.4; 95% CI, 0.2-0.8). No   reduction in risk was observed for AC of the lung in men or   women. CONCLUSIONS: Evidence that the increasing predominance of   AC over SCC may be due in part to the reduced risk of SCC (but   not AC) associated with lifelong filter cigarette smoking is   strongest in women; for men, further studies that include larger   numbers of lifetime filter smokers are needed to confirm this   finding. A lack of protection against AC from low yield filter   cigarettes may result from smokers' "compensating" with deeper   and more frequent inhalation, thereby increasing delivery of   carcinogens to the peripheral lung. The smoke of modern   cigarettes also contains higher concentrations of nitrosamines   that primarily produce AC.

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