Cancer Causes & Control

, Volume 7, Issue 5, pp 497–506 | Cite as

Smoking habits and risk of cancers other than lung cancer: 28 years' follow-up of 26,000 Norwegian men and women

  • Anders Engeland
  • Aage Andersen
  • Tor Haldorsen
  • Steinar Tretli
Research Papers

The impact of tobacco smoking on lung cancer risk has been investigated thoroughly since the 1950s, but other types of cancer also have been associated with smoking. In the present study, the aim was to explore the variation in risk connected with cigarette, cigar, and pipe smoking of suspected smoking-associated cancers other than lung cancer. Data were obtained from a survey of a random sample of the Norwegian population. A self-administered mailed questionnaire, which included questions about smoking habits, was completed by 26,000 men and women in 1965 (response rate: 76 percent). The cohort was followed from 1966 through 1993, including registration of all incident cancer cases. A dose-response relationship of cigarette smoking to the risk of urinary bladder cancer and cancers of the upper digestive and respiratory tract was observed. For the latter forms of cancer, a dose-response relationship of pipe smoking also was observed. In cancer of the pancreas, a stronger association between cigarette smoking and cancer risk was observed when the analysis was confined to histologically confirmed cases only. Current cigarette smokers at baseline had a significantly higher risk of cervical cancer than those who never smoked cigarettes. In cancers of the stomach, colon, rectum, breast, corpus uteri, ovary, and prostate, and in leukemia, no association between smoking and cancer risk was observed.

Key words

Cancer incidence cohort study Norway smoking 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    International Agency for Research on Cancer. Tobacco Smoking. Lyon, France: IARC, 1986; IARC Monogr Eval Carcinog Risk Chem Hum, Vol. 38.Google Scholar
  2. 2.
    Siegel M. Smoking and leukemia: evaluation of a causal hypothesis. Am J Epidemiol 1993; 138: 1–9.Google Scholar
  3. 3.
    Kune GA, Kune S, Vitetta L, Watson LF. Smoking and colorectal cancer risk: data from the Melbourne Colorectal Cancer Study and brief review of literature. Int J Cancer 1992; 50: 369–72.Google Scholar
  4. 4.
    Palmer JR, Rosenberg L. Cigarette smoking and the risk of breast cancer. Epidemiol Rev 1993; 15: 145–56.Google Scholar
  5. 5.
    Whittemore AS, Wu ML, Paffenbarger RSJr, et al. Personal and environmental characteristics related to epithelial ovarian cancer. II. Exposures to talcum powder, tobacco, alcohol, and coffee. Am J Epidemiol 1988; 128: 1228–40.Google Scholar
  6. 6.
    Nomura AMY, Kolonel LN. Prostate cancer: a current perspective. Epidemiol Rev 1991; 13: 200–27.Google Scholar
  7. 7.
    Mørck HI, Linde J, Agner E, Hein HO, Gyntelberg F, Nielsen PE. Tobaksforbrug og rygevaner i Norden 1920–1980. [Tobacco consumption and smoking habits in the Nordic countries 1920–1980] Nordisk Medicin 1982; 97: 134–46. (In Danish)Google Scholar
  8. 8.
    Engeland A, Haldorsen T, Andersen A, Tretli S. The impact of smoking habits on lung cancer risk: 28 years' observation of 26,000 Norwegian men and women. Cancer Causes Control 1996; 7: 366–76.Google Scholar
  9. 9.
    Reid DD. Studies of disease among migrants and native populations in Great Britain, Norway and the United States. I. Background and design. In: Haenszel W, ed. Epidemiological Study of Cancer and Other Chronic Diseases. Washington DC: US Dept of Health Education and Welfare, Public Health Service, 1966; 287–90.Google Scholar
  10. 10.
    Haenszel W, Hougen A. Proportion of respiratory symptoms in Norway. J Chron Dis 1972; 25: 519–44.Google Scholar
  11. 11.
    World Health Organization. International Classification of Diseases, Seventh Revision. Geneva, Switzerland: WHO, 1957.Google Scholar
  12. 12.
    Halpern MT, Gillespie BW, Warner KE. Patterns of absolute risk of lung cancer mortality in former smokers. JNCI 1993; 85: 457–64.Google Scholar
  13. 13.
    Preston DL, Lubin JH, Pierce DA. EPICURE. User's Guide. Seattle, WA (USA): Hirosoft International Corporation, 1988–93.Google Scholar
  14. 14.
    Cox DR, Oakes D. Analysis of Survival Data. London, UK: Chapmann and Hall Ltd, 1984.Google Scholar
  15. 15.
    Patrick DL, Cheadle A, Thompson DC, Diehr P, Koepsell T, Kinne S. The validity of self-reported smoking: a review and meta-analysis. Am J Public Health 1994; 84: 1086–93.Google Scholar
  16. 16.
    Klesges RC, Debon M, Ray JW. Are self-reports of smoking rate biased? Evidence from the second national health and nutrition examination survey. J Clin Epidemiol 1995; 48: 1225–33.Google Scholar
  17. 17.
    Rønneberg A, Lund KE, Hafstad A. Lifetime smoking habits among Norwegian men and women born between 1890 and 1974. Int J Epidemiol 1994; 23: 267–76.Google Scholar
  18. 18.
    Lund E, Zeiner-Henriksen T. Røking som risikofaktor for ulike kreftformer blant 26 000 norske menn og kvinner. [Smoking as risk factor for cancer among 26,000 Norwegian males and females.] Tidsskr Nor Laegeforen 1981; 101: 1937–40. (In Norwegian)Google Scholar
  19. 19.
    US Department of Health and Human Services. Reducing the health consequences of smoking: 25 years of progress. A report of the Surgeon General. Washington DC: DHHS, 1989.Google Scholar
  20. 20.
    Burch JD, Rohan TE, Howe GR, et al. Risk of bladder cancer by source and type of tobacco exposure: a case-control study. Int J Cancer 1989; 44: 622–8.Google Scholar
  21. 21.
    Momas I, Daures JP, Festy B, Bontoux J, Gremy F. Bladder cancer and black tobacco cigarette smoking. Some results from a French case-control study. Eur J Epidemiol 1994; 10: 599–604.Google Scholar
  22. 22.
    Tomatis L, Aitio A, Day NE, et al. Cancer: Causes, Occurrence and Control. Lyon, France: International Agency for Research on Cancer, 1990; IARC Sci. Pub. No. 100.Google Scholar
  23. 23.
    Mellemgaard A, Engholm G, McLaughlin JK, Olsen JH. Risk factors for renal cell carcinoma in Denmark. I. Role of socioeconomic status, tobacco use, beverages, and family history. Cancer Causes Control 1994; 5: 105–13.Google Scholar
  24. 24.
    Heuch I, Kvåle G, Jacobsen BK, Bjelke E. Use of alcohol, tobacco and coffee, and risk of pancreatic cancer. Br J Cancer 1983; 48: 637–43.Google Scholar
  25. 25.
    Gram IT, Austin H, Stalsberg H. Cigarette smoking and the incidence of cervical intraepithelial neoplasia, grade III, and cancer of the cervix uteri. Am J Epidemiol 1992; 135: 341–6.Google Scholar
  26. 26.
    Sood AK. Cigarette smoking and cervical cancer: meta-analysis and critical review of recent studies. Am J Prev Med 1991; 7: 208–13.Google Scholar
  27. 27.
    Licciardone JC, Brownson RC, Chang JC, WilkinsIII JR. Uterine cervical cancer risk in cigarette smokers: a meta-analytic study. Am J Prev Med 1990; 6: 274–81.Google Scholar
  28. 28.
    Winkelstein WJr. Smoking and cervical cancer-current status: a review. Am J Epidemiol 1990; 131: 945–57.Google Scholar
  29. 29.
    Phillips AN, Smith GD. Cigarette smoking as a potential cause of cervical cancer: has confounding been controlled? Int J Epidemiol 1994; 23: 42–9.Google Scholar
  30. 30.
    Doll R, Peto R. The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. JNCI 1981; 66: 1191–308.Google Scholar
  31. 31.
    Forman D. The Etiology of Gastric Cancer. Lyon, France: International Agency for Research on Cancer, 1991; IARC Sci. Pub. No. 105: 22–32.Google Scholar
  32. 32.
    Baron JA. Smoking and estrogen-related disease. Am J Epidemiol 1984; 119: 9–22.Google Scholar
  33. 33.
    Brinton LA, Barrett RJ, Berman ML, Mortel R, Twiggs LB, Wilbanks GD. Cigarette smoking and the risk of endometrial cancer. Am J Epidemiol 1993; 137: 281–91.Google Scholar
  34. 34.
    Shu XO, Brinton LA, Zheng W, Gao YT, Fan J, Fraumeni JFJr. A population-based case-control study of endometrial cancer in Shanghai, China. Int J Cancer 1991; 49: 38–43.Google Scholar
  35. 35.
    Franceschi S, La Vecchia C, Booth M et al. Pooled analysis of 3 European case-control studies of ovarian cancer: II. Age at menarche and at menopause. Int J Cancer 1991; 49: 57–60.Google Scholar
  36. 36.
    Sandler DP. Recent studies in leukemia epidemiology. Curr Opin Oncol 1995; 7: 12–8.Google Scholar
  37. 37.
    Brownson RC, Novotny TE, Perry MC. Cigarette smoking and adult leukemia. A meta-analysis. Arch Intern Med 1993; 153: 469–75.Google Scholar

Copyright information

© Rapid Science Publishers 1996

Authors and Affiliations

  • Anders Engeland
  • Aage Andersen
  • Tor Haldorsen
  • Steinar Tretli

There are no affiliations available

Personalised recommendations