Risk of major cancers associated with various forms of tobacco use in India: a systematic review and meta-analysis
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Several studies have established the association of various cancers with tobacco consumption. However, hardly any attempt has been made to examine the combined effect of various forms of tobacco consumption. Hence, the present study was undertaken to measure the overall risk of different cancer sites associated with various forms of tobacco used individually or in combination, and to investigate the risk variation within each site by different forms of use.
Meta-analysis was carried out on the findings of 22 published studies of samples exposed to tobacco use and control groups that were not exposed to tobacco. The pooled odds ratios (ORs) for each cancer for different combinations of forms of tobacco were calculated using a random effects model.
Smoking was found to be associated with a 5-fold higher risk of oropharynx, larynx, and lung, a 3-fold higher risk of hypopharynx, and esophagus, and a 2-fold higher risk of oral cancer. Esophagus (OR = 3.5) and oral cancer were the only sites significantly associated with tobacco chewing. The OR associated with bidi smoking was highest for lung (6-fold) followed by esophagus (3.5-fold) and oral cancer (3-fold). Lung cancer was also significantly associated with cigarette smoking.
The present study reported pooled ORs for different tobacco-related cancers associated with various forms of tobacco use, both individually as well as in various combinations. Collecting data on the consumption of tobacco is a complex exercise. Pooled ORs reported in this study will be useful in working out the quantum of diverse tobacco-related cancers attributable to different forms of tobacco consumption, both individually as well as in combination.
KeywordsBidi Cigarette Smoking Chewing Cancer Meta-analysis India
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Ethical approval and consent to participate
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Availability of supporting data
This meta-analysis study was based on secondary data sources (published studies).
The authors declare that they have no conflict of interest.
- Balaram P, Sridhar H, Rajkumar T, Vaccarella S, Herrero R, Nandakumar A, Ravichandran K, Ramdas K, Sankaranarayanan R, Gajalakshmi V (2002) Oral cancer in southern India: the influence of smoking, drinking, paan-chewing and oral hygiene. Int J Cancer 98(3):440–445PubMedCrossRefPubMedCentralGoogle Scholar
- Bhojani U, Chander S, Devadasan N (2009) Tobacco use and related factors among pre-university students in a college in Bangalore, India. Accessed 2 Dec 2017Google Scholar
- Chaudhry K, Prabhakar A, Prabhakaran P, Prasad A, Singh K, Singh A (2001) Prevalence of tobacco use in Karnataka and Uttar Pradesh in India. Final report of the study by the Indian Council of Medical Research and the WHO South East Asian Regional Office, New Delhi. Accessed 20 Dec 2017Google Scholar
- IARC (1986) Tobacco smoking. IARC Monogr Eval Carcinog Risk Chem Hum 38:35–394Google Scholar
- Ihsan R, Chauhan PS, Mishra AK, Singh L, Sharma JD, Zomawia E, Verma Y, Kapur S, Saxena S (2014) Copy number polymorphism of glutathione-S-transferase genes (GSTM1 & GSTT1) in susceptibility to lung cancer in a high-risk population from north-east India. Indian J Med Res 139(5):720PubMedPubMedCentralGoogle Scholar
- Jayanta K, Notani P, Sanghvi L (1983) Health consequences of smoking in two socioeconomic classes in Bombay, India. In: Proceedings of 5th World Conference on Smoking and Health, 1983, pp 149–156Google Scholar
- National Cancer Registry Programme (NCRP) (2016) Three-year report of the population based cancer registries: 2012–2014, Indian Council of Medical Research, New Delhi, India. Accessed 16 Feb 2017Google Scholar
- Parkin D, Whelan S, Ferlay J, Raymond L, Young J (1997) Cancer incidence in five continents, Vol VII. IARC Scientific Publications, Lyon. Accessed 20 Jan 2017Google Scholar
- Parkin D, Whelan S, Ferlay J, Teppo L, Thomas D (2002) Cancer incidence in five continents, Vol. VIII. IARC Scientific Publications, Lyon. Accessed 20 Jan 2017Google Scholar
- Phukan RK, Borah PK, Saikia BJ, Das M, Sekhon GS, Mahanta J (2014) Interaction of tobacco smoking and chewing with angiotensin converting enzyme (insertion/deletion) gene polymorphisms and risk of lung cancer in a high risk area from Northeast India. Asian Pac J Cancer Prev 15(24):10691–10695PubMedCrossRefPubMedCentralGoogle Scholar
- WHO (2011) Global status report on noncommunicable diseases 2010. World Health Organization, Geneva. Accessed 18 Jan 2017Google Scholar