Active and passive smoking and risk of breast cancer: a meta-analysis
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Studies on active and passive tobacco smoking and breast cancer have found inconsistent results. A meta-analysis of observational studies on tobacco smoking and breast cancer occurrence was conducted based on systematic searches for studies with retrospective (case–control) and prospective (cohort) designs. Eligible studies were identified, and relative risk measurements were extracted for active and passive tobacco exposures. Random-effects meta-analyses were used to compute summary relative risks (SRR). Heterogeneity of results between studies was evaluated using the (I 2) statistics. For ever active smoking, in 27 prospective studies, the SRR for breast cancer was 1.10 (95 % CI [1.09–1.12]) with no heterogeneity (I 2 = 0 %). In 44 retrospective studies, the SRR was 1.08 (95 % CI [1.02–1.14]) with high heterogeneity (I 2 = 59 %). SRRs for current active smoking were 1.13 (95 % CI [1.09–1.17]) in 27 prospective studies and 1.08 (95 % CI [0.97–1.20]) in 22 retrospective studies. The results were stable across different subgroup analyses, notably pre/post-menopause, alcohol consumption adjustments, including/excluding passive smokers from the referent group. For ever passive smoking, in 11 prospective studies, the SRR for breast cancer was 1.07 (95 % CI [1.02–1.13]) with no heterogeneity (I 2 = 1 %). In 20 retrospective studies, the SRR was 1.30 (95 % CI [1.10–1.54]) with high heterogeneity (I 2 = 74 %). Too few prospective studies were available for meaningful subgroup analyses. There is consistent evidence for a moderate increase in the risk of breast cancer in women who smoke tobacco. The evidence for a moderate increase in risk with passive smoking is more substantial than a few years ago.
KeywordsBreast cancer Environmental tobacco smoke Smoking Meta-analysis
The authors thank Magali Boniol for the data extraction verifications.
A.M. and P.B. designed the study. A.M. did the literature search, extracted and analysed the data. All authors interpreted the results. A.M. wrote the report. All authors reviewed, revised and edited the report.
This work was founded by the International Prevention Research Institute.
Compliance with ethical standards
Conflict of interests
The authors declare that they have no conflict of interest.
- 2.Aune D, Greenwood DC, Chan DS, Vieira R, Vieira AR, Navarro Rosenblatt DA, Cade JE, Burley VJ, Norat T (2012) Body mass index, abdominal fatness and pancreatic cancer risk: a systematic review and non-linear dose–response meta-analysis of prospective studies. Ann Oncol 23:843–852. doi: 10.1093/annonc/mdr398 CrossRefPubMedGoogle Scholar
- 4.Bjerkaas E, Parajuli R, Weiderpass E, Engeland A, Maskarinec G, Selmer R, Gram IT (2013) Smoking duration before first childbirth: an emerging risk factor for breast cancer? Results from 302,865 Norwegian women. Cancer Causes Control 24:1347–1356. doi: 10.1007/s10552-013-0213-1 PubMedCentralCrossRefPubMedGoogle Scholar
- 6.Brown LM, Gridley G, Wu AH, Falk RT, Hauptmann M, Kolonel LN, West DW, Nomura AM, Pike MC, Hoover RN, Ziegler RG (2010) Low level alcohol intake, cigarette smoking and risk of breast cancer in Asian–American women. Breast Cancer Res Treat 120:203–210. doi: 10.1007/s10549-009-0464-4 PubMedCentralCrossRefPubMedGoogle Scholar
- 9.Collishaw NE, Boyd NF, Cantor KP, Hammond SK, Johnson KC, MIllar J, Miller AB, MIller M, Palmer JR, Salmon AG, Turcotte F (2009) Canadian expert panel on tobacco smoke and breast cancer risk., OTRU special report seriesOntario Tobacco Research Unit, TorontoGoogle Scholar
- 10.Cox DG, Dostal L, Hunter DJ, Le Marchand L, Hoover R, Ziegler RG, Thun MJ, Breast Prostate Cancer, Cohort C (2011) N-acetyltransferase 2 polymorphisms, tobacco smoking, and breast cancer risk in the breast and prostate cancer cohort consortium. Am J Epidemiol 174:1316–1322. doi: 10.1093/aje/kwr257 PubMedCentralCrossRefPubMedGoogle Scholar
- 11.Danaei G, Vander Hoorn S, Lopez AD, Murray CJ, Ezzati M, Comparative Risk Assessment collaborating (2005) Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors. Lancet 366:1784–1793. doi: 10.1016/S0140-6736(05)67725-2 CrossRefPubMedGoogle Scholar
- 12.Dossus L, Boutron-Ruault MC, Kaaks R, Gram IT, Vilier A, Fervers B, Manjer J, Tjonneland A, Olsen A, Overvad K, Chang-Claude J, Boeing H, Steffen A, Trichopoulou A, Lagiou P, Sarantopoulou M, Palli D, Berrino F, Tumino R, Vineis P, Mattiello A, Bueno-de-Mesquita HB, van Duijnhoven FJ, Bakker MF, Peeters PH, Weiderpass E, Bjerkaas E, Braaten T, Menendez V, Agudo A, Sanchez MJ, Amiano P, Tormo MJ, Barricarte A, Butt S, Khaw KT, Wareham N, Key TJ, Travis RC, Rinaldi S, McCormack V, Romieu I, Cox DG, Norat T, Riboli E, Clavel-Chapelon F (2014) Active and passive cigarette smoking and breast cancer risk: results from the EPIC cohort. Int J Cancer 134:1871–1888. doi: 10.1002/ijc.28508 CrossRefPubMedGoogle Scholar
- 15.Ferlay J, Soerjomataram I, Ervik M, Dikshit RP, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2012) GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 In: International Agency for Research on Cancer, Lyon, FranceGoogle Scholar
- 18.Hamajima N, Hirose K, Tajima K, Rohan T, Calle EE, Heath CW Jr, Coates RJ, Liff JM, Talamini R, Chantarakul N, Koetsawang S, Rachawat D, Morabia A, Schuman L, Stewart W, Szklo M, Bain C, Schofield F, Siskind V, Band P, Coldman AJ, Gallagher RP, Hislop TG, Yang P, Kolonel LM, Nomura AM, Hu J, Johnson KC, Mao Y, De Sanjose S, Lee N, Marchbanks P, Ory HW, Peterson HB, Wilson HG, Wingo PA, Ebeling K, Kunde D, Nishan P, Hopper JL, Colditz G, Gajalanski V, Martin N, Pardthaisong T, Silpisornkosol S, Theetranont C, Boosiri B, Chutivongse S, Jimakorn P, Virutamasen P, Wongsrichanalai C, Ewertz M, Adami HO, Bergkvist L, Magnusson C, Persson I, Chang-Claude J, Paul C, Skegg DC, Spears GF, Boyle P, Evstifeeva T, Daling JR, Hutchinson WB, Malone K, Noonan EA, Stanford JL, Thomas DB, Weiss NS, White E, Andrieu N, Bremond A, Clavel F, Gairard B, Lansac J, Piana L, Renaud R, Izquierdo A, Viladiu P, Cuevas HR, Ontiveros P, Palet A, Salazar SB, Aristizabel N, Cuadros A, Tryggvadottir L, Tulinius H, Bachelot A, Le MG, Peto J, Franceschi S, Lubin F, Modan B, Ron E, Wax Y, Friedman GD, Hiatt RA, Levi F, Bishop T, Kosmelj K et al (2002) Alcohol, tobacco and breast cancer–collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer 87:1234–1245. doi: 10.1038/sj.bjc.6600596 CrossRefPubMedGoogle Scholar
- 21.IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (2004) IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, vol 83., Tobacco smoke and involuntary smokingWorld Health Organization, International Agency for Research on Cancer, LyonGoogle Scholar
- 22.International Agency for Research on Cancer (2009) A review of human carcinogens. Part E: Personal habits and indoor combustions. Lyon, FranceGoogle Scholar
- 27.Land SR, Liu Q, Wickerham DL, Costantino JP, Ganz PA (2014) Cigarette smoking, physical activity, and alcohol consumption as predictors of cancer incidence among women at high risk of breast cancer in the NSABP P-1 trial. Cancer Epidemiol Biomarkers Prev 23:823–832. doi: 10.1158/1055-9965.EPI-13-1105-T PubMedCentralCrossRefPubMedGoogle Scholar
- 28.Liu L, Wu K, Lin X, Yin W, Zheng X, Tang X, Mu L, Hu Z, Wang J (2000) Passive smoking and other factors at different periods of life and breast cancer risk in chinese women who have never smoked—a case–control study in Chongqing, People’s Republic of China. Asian Pac J Cancer Prev 1:131–137PubMedGoogle Scholar
- 29.Luo J, Margolis KL, Wactawski-Wende J, Horn K, Messina C, Stefanick ML, Tindle HA, Tong E, Rohan TE (2011) Association of active and passive smoking with risk of breast cancer among postmenopausal women: a prospective cohort study. BMJ 342:d1016. doi: 10.1136/bmj.d1016 PubMedCentralCrossRefPubMedGoogle Scholar
- 32.Miller MD, Marty MA, Broadwin R, Johnson KC, Salmon AG, Winder B, Steinmaus C, California Environmental Protection A (2007) The association between exposure to environmental tobacco smoke and breast cancer: a review by the California Environmental Protection Agency. Prev Med 44:93–106. doi: 10.1016/j.ypmed.2006.08.015 CrossRefPubMedGoogle Scholar
- 38.Reynolds P, Hurley S, Goldberg DE, Anton-Culver H, Bernstein L, Deapen D, Horn-Ross PL, Peel D, Pinder R, Ross RK, West D, Wright WE, Ziogas A (2004) active smoking, household passive smoking, and breast cancer: evidence from the California Teachers Study. JNCI J Natl Cancer Inst 96:29–37. doi: 10.1093/jnci/djh002 CrossRefPubMedGoogle Scholar
- 39.Roddam AW, Pirie K, Pike MC, Chilvers C, Crossley B, Hermon C, McPherson K, Peto J, Vessey M, Beral V (2007) Active and passive smoking and the risk of breast cancer in women aged 36–45 years: a population based case–control study in the UK. Br J Cancer 97:434–439. doi: 10.1038/sj.bjc.6603859 PubMedCentralCrossRefPubMedGoogle Scholar
- 42.Surgeon General (2014) Cancer. In: The health consequences of smoking—50 years of progressGoogle Scholar