Tobacco smoking and esophageal and gastric cardia adenocarcinoma: a meta-analysis

Epidemiology. 2011 May;22(3):344-9. doi: 10.1097/EDE.0b013e31821092cd.

Abstract

Background: Smoking has been related to esophageal and gastric cardia adenocarcinoma, but the magnitude of the association is uncertain.

Methods: We conducted a meta-analysis of 33 studies published up to January 2010. We derived summary estimates using random-effects models.

Results: Compared with never-smokers, the pooled relative risk (RR) was 1.76 (95% confidence interval = 1.54-2.01) for ever-smokers, 2.32 (1.96-2.75) for current smokers, and 1.62 (1.40-1.87) for ex-smokers. There was no important difference between esophageal (RR = 1.85 for ever- vs. never-smokers) and gastric cardia (RR = 1.76) adenocarcinoma. We found a direct association with dose (RR = 2.48 [2.14-2.86] for ≥ 20 cigarettes/d) and duration (RR = 2.32 [1.92-2.82] for ≥ 40 years) of cigarette consumption.

Conclusions: This meta-analysis estimates the excess of esophageal and gastric cardia adenocarcinoma risk for smokers. This risk was similar for the 2 cancer sites.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy
  • Adult
  • Aged
  • Cardia / pathology*
  • Case-Control Studies
  • Cohort Studies
  • Comorbidity
  • Esophageal Neoplasms / epidemiology*
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / therapy
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prognosis
  • Risk Assessment
  • Smoking / adverse effects
  • Smoking / epidemiology*
  • Stomach Neoplasms / epidemiology*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / therapy
  • Survival Analysis