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Elsevier Seiena Publishera B.V: (Biomedioa! Diuisidn)' and health 19'$7: M. Aoki et al, editors 483 RELATIONSHIP R'iTW'N SNiO1CINi". AND F4MA'LR Li1NG CANCER YS G?!NG',7.'.H.L1A'NG ,A'•Y.ZHANG',G.L»Mi1 a+tment of gpidemiology,Tianj'in Medical Co1!lege,Tianjin(P.R.China) re is still controversy irbout the relationship betxeen cigarettee and femele lung cancer.The mortality rate of'femalei lung ean- TihnSiin is the: highest in China(28,3/185)•The female smoking in Tianjin is also the highest in China.Therefore we )x4d conr a cese--control study of female- lung cancer to illustrate it. No conducted a 1i:1 pair matched case-control study. ;1~.Casesr157 female•lung cancer cases all! residen't in Tianjin more _then 110 yeaTar. Squamous cell carcinoma 35(22•3%) :Smgll ce1'1 carcinoma .3't(1'9.7%) ;Adenocarcinoma 58(36,.9g:).Large ce1!1 carcinoma ,4(2.5%) ;Cell type unknown 29(t8.5%)• Cases were diagnosed:133('84.7R) histosogical- f{'• ly or cytologi.cally;1'7(110.8%) by CT;7'(41.5%) clinically or by X-ray. + " 2.Controls:157,matched xith sex,race,age(l-2'years)and marital ata- °:`'' . RRSnLTS, 1.Thei case.group is a quite representative o'f' the Tian3in, female lhtng cancer. The age group structnre and d3stribution of residents of t1i6 lung cancer group is quite similar with t'hose• of 1983 Tian jini fe- male liung, cancer. Smoking rate of the control Proup(40.t3 a) is quite similar with that' of the Tianjin adult female: population,('39.5gt &38 0) . 2.The age,educati'on.occupation,race,marital status,birth place.resi- dent place of'the case and control' groupsi have no significant dif- ference(P>0»05).. 3'»Female lung cancer and active smoking, . OR of active smoking is 3.0'5,FAR% is 57.4% (Table 1). F.xposure rat'e of'casea: - 4 + =65.6% 157 .656(3.05 -1). FAR9=•656('3.0'5r1)+1 =57.4g6'. s:.0R=3•05. 9SS6CT=7.77-5•30 relationship between lung ct;ncer i:Adjested OR-2.6r95% CI=7.4-41.6, risk and number of cigaratt~e ses smoked FP<G.009 per day and year of amoking(Table 2).

OR is higher of those smoking deeper than those smoke superiicial'l,jr.%~! .,,3 or non-smoking ('Tgb1e 3). OR is higher among those start smoking ear- 0' TABLE 2.LUNG' CANCER RISK AND' N0.0'F' TABLE 3. OR AND DD DRGRRW OF IN-d:r+ CIGARETTES AND YEAR OF SMOKING HALATION(M-H MSTHOD) No.off -c iga- rettes/da 1 t- 1'.81 1.40-2.33 11'- 3',.27 2.28-4.68 21 - 5.90 3.79-9, 18 Y!esr of smoking 0 1 1'- S. 73 1I. 38'-2'.18 20- 3•00 2.17-4.16 40- 5.20 3.4!4-7'.75 TABLF' 4. OR' AND: AGE ONSET OF SMf?KING (M-H M?7HOD) Age Group Nonrsmoking 21 16-20 15 P Case 54 37 66. Control 98' 33 26 ,:•;; k 0 01 14 3 15 5 7 2'. > 0.05 10.01 <0.01 <D . 01 OR' 1 1.59 3.10 6.3 <0.01 4.Female. lung canceT- and passive smoking. <44! Case 8 1 3 Control 12 0 1 45-Case 16 8 17. Control 29 9 14 55-Case 24 13 13 Control 35 118 6 65-Case 6. 6 6 Controti 17 4 2 ther and colileagues,onTy that from husbarnd'is quite significant. The non-smoking female cases and' controls with smoking or non-smok- ing husband' is as tahle 5. The OR is 2.$6 (,P<0.05)'. -* we: naa calculaoea Lne vn oz pauzive' smoxiing i1rom nusoana,iazner,mo- .,. TABLE 5• OR OF SMOKING HUSBAND TO NION-SMOKING' WI'F8 Husband Smoker Non-smoker Case 34 20 Control 41 52'. OR=2.1i6.9'5% CI=t.03-4.53. p<m.o5 Exposure rate of cases _ ~ PAR%=,6-11312 3'(2.1661 +1 °42L29L. OR of female lung cancer i'n- ~ creases rit'h the- number of cigar-,.y, ettes smoked per day by her hus-,,.jA' 2.03 4L61-A

485 bmad and the+ duretion, of exposure to her husband's smoking(Table 6). !; -`5" OR of either active or passive and, combination of active and pas- 'eive smoking is as tablie 7. 4v' TABLB 6.©R'OF FEMAL?'LUNG' , ; OAHCBR 0'F SMOKING HUSBAND QIGAR?iTTTi' PBR DAY 0 1 1- 1.40 1.12-?.76' 10- y.97 1.42-2.72 20- 2.76 1.85'-4.10 -YRARS OF EXPO.°+tDR4' 0... .1 1- 1.49 1.r5-1.94 20- 2.23 1.54-3,.22 .'40- 3.32 2'.it.-5.22 TABLS 7.OR OP AOTI1VR AND PASSI'Vs SMOKING FROMi RTrSBAND AOTIV^•. SMOKING(wIV?5) NO YZ'S ^ H[ISBI4ND N0 1.0. 2. 61 (1 . 4-4I.6 ) SMOKING YrS 1.86(1.04'- 4,.90(1.8-9.5)' 3•5) If a smoking,woman with smoking hus- band,the OR of lung cancer is 41.9.expo- sure rate is 81% (83/103). PriR° .8n 144--1 +1 `T5»959~.. A non-smoking woman with smoking husband,the OR of lung cancer is 1I.86',exposure rate is 63% (134/'54). 63' (1'.86; -1 ) ~ %,. PAR16=.63'('1 .86-1 +t 3'S • 1 , Ac&ordi'ng to 103 smoking female lunw cancer cases about 78. 23 (1'03 X' '•.7595) are- due+ to smoking,,xhil!c the 54 non-smoking female lung cancer, ..Casee about 18.95( 54 X.3'51) are due to passive sr^okin,~ ^'ro- h•+r h^ia_ "band. OR of'1'ung cancerr and cooking with coal is shown in table 8.. tribute to active smoking,andipassive smoking from their husbands. 6'. OR od female lung cancer due to other causes. Occupational exposurc: Textile workers,xorkers expose•to asb:atos, benzene,etc. 0R=3.1,95% OI=1.58-6.02'. OR of'history of'lung diseases ('incliu•!e pulmonary TBO,chronic bron- c}titis,pulimonary Lnfectilon,etc. )is 2.64.Ad3usted' with conditi;onal re- gression model',OR.=2.12,95mC:I of OR;=1.23-3.63• ThaE is 78,2 +18•95_61.C,10,6 of female lung,cance'r in Tianjin may at- 7. Joint Rffect of the;-Ri3k Factors. . xultifactor analysis by conditional regression method'demonstrate t{;that:tha combination of active smoking,passive smoking from husbands,. 4 occupational exposure.history of lung diseases and•4 X10 hours cook- Lng with coali makes the ©R'be'i'ng, 'abou't' 50 in comparison aith those

without the above- risk factors and h'ours. 95% CI of'0R=13'.7-185•3• TAFILT3 8. OR OF LUNG CANC'RR ANO' COOKING WITH COAL' DURATION OF CDOKING(hrs) OR 13C10~ (1.5 hr/day,20 yrs) 1.54 2X104(1..5 hr/day,40 yrs) 2.36 3X104(2 hrs/day,4'2 yrs) 3.62 4X$04(3' hrsJ'aey,37' yrs) 5.56 9'5% CI of OR 1.20-1.96 1.66-3.34 2.36-5-55 3 . 40-9 .10 V A+l~ V 1Y• `•+1'\ I„ L i, 2. There ia joint effect of smoking wi~th occupational ezpos,ire,his- tory of lung diseases and cooking with coal. 60% of femalie~lung cancer in Tianjin may be attributed to smoking. most important risk factors of' female lung cancer in Tian j',in. About 1'. Both active smoking and passi've smoki'nr• from hor husband are t'he ~=;~~ Publishbng House,3e33ing, vol I, Pp 153-15b!,188-191 3'. Genr GY (11980) In: Genp GY (eds), Fpidembology•People"s t4edical R?7?R"FNCI~S 1. HirayAma T(:1981')' Brit Med J 282:183 2. Xu RH1,Geng GY (1983) Chinese J1:'pideninl 4:193-197. ~ ~ ~