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

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background 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. Objective To determine lifetime risk estimates for cancer death associated with sex and smoking status in the United States. Methods 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. Results 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 nonsmokers. 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. Conclusions 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.

Original languageEnglish (US)
Pages (from-to)1729-1737
Number of pages9
JournalCancer Causes and Control
Volume23
Issue number10
DOIs
StatePublished - Oct 2012

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Smoking
Neoplasms
Public Health
Risk Adjustment
Mortality
Smoking Cessation
Tobacco
Counseling
Communication
Population

Keywords

  • Cancer
  • Cancer mortality
  • Lifetime risk
  • Sex
  • Smoking
  • Tobacco

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Lifetime risk for cancer death by sex and smoking status : The lifetime risk pooling project. / Gawron, Andrew; Hou, Lifang; Ning, Hongyan; Berry, Jarett D.; Lloyd-Jones, Donald M.

In: Cancer Causes and Control, Vol. 23, No. 10, 10.2012, p. 1729-1737.

Research output: Contribution to journalArticle

Gawron, Andrew ; Hou, Lifang ; Ning, Hongyan ; Berry, Jarett D. ; Lloyd-Jones, Donald M. / Lifetime risk for cancer death by sex and smoking status : The lifetime risk pooling project. In: Cancer Causes and Control. 2012 ; Vol. 23, No. 10. pp. 1729-1737.
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abstract = "Background 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. Objective To determine lifetime risk estimates for cancer death associated with sex and smoking status in the United States. Methods 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. Results 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 nonsmokers. 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. Conclusions 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.",
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N2 - Background 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. Objective To determine lifetime risk estimates for cancer death associated with sex and smoking status in the United States. Methods 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. Results 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 nonsmokers. 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. Conclusions 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.

AB - Background 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. Objective To determine lifetime risk estimates for cancer death associated with sex and smoking status in the United States. Methods 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. Results 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 nonsmokers. 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. Conclusions 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.

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