Impact of cigarette smoking on cancer risk in the European prospective investigation into cancer and nutrition study

Antonio Agudo, Catalina Bonet, Noémie Travier, Carlos A. González, Paolo Vineis, H. Bas Bueno-de-Mesquita, Dimitrios Trichopoulos, Paolo Boffetta, Françoise Clavel-Chapelon, Marie Christine Boutron-Ruault, Rudolf Kaaks, Annekatrin Lukanova, Madlen Schuẗze, Heiner Boeing, Anne Tjonneland, Jytte Halkjaer, Kim Overvad, Christina C. Dahm, J. Ramon Quirós, María José SánchezNerea Larrañaga, Carmen Navarro, Eva Ardanaz, Kay Tee Khaw, Nicholas J. Wareham, Timothy J. Key, Naomi E. Allen, Antonia Trichopoulou, Pagona Lagiou, Domenico Palli, Sabina Sieri, Rosario Tumino, Salvatore Panico, Hendriek Boshuizen, Frederike L. Büchner, Petra H M Peeters, Signe Borgquist, Martin Almquist, Göran Hallmans, Ingegerd Johansson, Inger T. Gram, Eiliv Lund, Elisabete Weiderpass, Isabelle Romieu, Elio Riboli

Research output: Contribution to journalArticlepeer-review


Purpose: Our aim was to assess the impact of cigarette smoking on the risk of the tumors classified by the International Agency for Research on Cancer as causally associated with smoking, referred to as tobacco-related cancers (TRC). Methods: The study population included 441,211 participants (133,018 men and 308,193 women) from the European Prospective Investigation Into Cancer and Nutrition. We investigated 14,563 participants who developed a TRC during an average follow-up of 11 years. The impact of smoking cigarettes on cancer risk was assessed by the population attributable fraction (AFp), calculated using the adjusted hazard ratios and 95% CI for current and former smokers, plus either the prevalence of smoking among cancer cases or estimates from surveys in representative samples of the population in each country. Results: The proportion of all TRC attributable to cigarette smoking was 34.9% (95% CI, 32.5 to 37.4) using the smoking prevalence among cases and 36.2% (95% CI, 33.7 to 38.6) using the smoking prevalence from the population. The AF p were above 80% for cancers of the lung and larynx, between 20% and 50% for most respiratory and digestive cancers and tumors from the lower urinary tract, and below 20% for the remaining TRC. Conclusion: Using data on cancer incidence for 2008 and our AFp estimates, about 270,000 new cancer diagnoses per year can be considered attributable to cigarette smoking in the eight European countries with available data for both men and women (Italy, Spain, United Kingdom, the Netherlands, Greece, Germany, Sweden, Denmark).

Original languageEnglish
Pages (from-to)4550-4557
Number of pages8
JournalJournal of Clinical Oncology
Issue number36
Publication statusPublished - Dec 20 2012

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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