Cancer Causes & Control

, Volume 23, Issue 10, pp 1729–1737

Lifetime risk for cancer death by sex and smoking status: the lifetime risk pooling project

  • Andrew Gawron
  • Lifang Hou
  • Hongyan Ning
  • Jarett D. Berry
  • Donald M. Lloyd-Jones
Original paper

DOI: 10.1007/s10552-012-9959-0

Cite this article as:
Gawron, A., Hou, L., Ning, H. et al. Cancer Causes Control (2012) 23: 1729. doi:10.1007/s10552-012-9959-0



Understanding how sex and tobacco exposure may modify lifetime risks for cancer mortality is important for effective communication of risk in targeted public health messages.


To determine lifetime risk estimates for cancer death associated with sex and smoking status in the United States.


A pooled cohort design using ten well-defined epidemiologic cohorts including middle-aged and older individuals was used to estimate the lifetime risk for cancer death at selected index ages, with death from non-cancer causes as the competing risk, by sex and smoking status.


There were a total of 11,317 cancer-related deaths. At age 45 years, the lifetime risk of cancer death for male smokers is 27.7 % (95 % CI 24.0–31.4 %) compared to 15.8 % (95 % CI 12.7–18.9 %) for male non-smokers. At age 45 years, the lifetime risk of cancer death for female smokers is 21.7 % (95 % CI 18.8–24.6 %) compared to 13.2 % (95 % CI 11.0–15.4 %) for female non-smokers. Remaining lifetime risk for cancer death declined with age, and men have a greater risk for cancer death compared to women. Adjustment for competing risk of death, particularly representing cardiovascular mortality, yielded a greater change in lifetime risk estimates for men and smokers compared to women and non-smokers.


At the population level, the lifetime risk for cancer death remains significantly higher for smokers compared to non-smokers, regardless of sex. These estimates may provide clinicians with useful information for counseling individual patients and highlight the need for continued public health efforts related to smoking cessation.


Tobacco Smoking Cancer Lifetime risk Cancer mortality Sex 



Lifetime risk


Kaplan–Meier cumulative incidence


Cardiovascular disease


Surveillance, epidemiology, and end results

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Andrew Gawron
    • 1
  • Lifang Hou
    • 2
    • 3
  • Hongyan Ning
    • 2
  • Jarett D. Berry
    • 4
  • Donald M. Lloyd-Jones
    • 2
    • 5
  1. 1.Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  2. 2.Department of Preventive Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  3. 3.Robert H. Lurie Comprehensive Cancer Center, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  4. 4.Department of Internal MedicineUniversity of Texas Southwestern Medical CenterDallasUSA
  5. 5.Department of Medicine, Feinberg School of Medicine, The Bluhm Cardiovascular InstituteNorthwestern UniversityChicagoUSA

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