Passive smoking increases children's risk of nasal cancer
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《英国医生杂志》
Passive smoking in childhood may increase the risk of nasal cancer, says a study of children whose parents had lung cancer. The incidence of bladder and kidney cancer was also greater in the offspring, possibly as a result of exposure to tobacco carcinogens either in the womb or through breast feeding, say researchers writing online in the International Journal of Cancer on 10 August (http://www3.interscience.wiley.com, doi: 10.1002/ijc.21387).
Although the carcinogenic effects of active smoking have been seen at many sites, the effects of passive smoking and exposure in pregnancy and breastfeeding are less well documented, say the researchers.
The authors used the nationwide Swedish family cancer database from 1958 to 2002 to see whether the children of parents with lung cancer are at a risk of cancer that could not be explained by their smoking or familial risk. Most patients with lung cancer are smokers, and in populations with long term cigarette use, the population attributable risk of smoking is thought to be up to 90%.
The database used included 17 693 mothers and 41 838 fathers with lung cancer, and a total of 173 715 cancers were recorded in their offspring aged up to 70.
The results, based on age standardised incidence ratios (SIRs), show that offspring of affected mothers are at increased risk for upper aerodigestive (SIR 1.45), nasal (2.93), lung (1.71), and bladder (1.52) cancers.
For kidney cancer the SIR was 6.41 in 20 to 29 year olds. The risk of bladder cancer was greater in younger age groups than that of lung cancer. Bladder cancer showed a significant increase (SIR 2.82) in the 30 to 39 age group.
Cancers at many of these sites, but not the kidney or the bladder, were also greater in children of fathers with lung cancer. Nasal cancer was more likely if either parent was diagnosed as having lung cancer. The highest risk was for nasal adenoid cystic carcinoma (SIR 7.73).
"Passive smoking during childhood contributes to nasal cancer risks because an excess was observed through lung cancer in either parent, though stronger through the mother," say the authors from the German Cancer Research Center, Heidelberg, and the Karolinska Institute, Stockholm.
"There is also strong evidence that passive smoking is causing middle ear infections and a number of respiratory effects, such as asthma, wheezing, coughing, bronchitis and impaired pulmonary function in children, in line with its activity on the respiratory epithelium.
"The effects on the urinary bladder and the kidney are probably less related to passive smoking because the paternal contribution was nil. Rather, we assume that exposures in utero and through mother抯 milk are contributing to the effects observed on these target organs. Milk of smoking mothers contains high levels of nicotine, and urinary cotinine levels in infants may equal those of adult smokers."
They added, "The present data suggest that passive smoking during childhood is associated with an increase risk of nasal cancer, particularly of adenoid cystic carcinoma histology. For the excesses of bladder and kidney cancers, we propose a contribution of tobacco carcinogens that are transmitted through breastfeeding and in utero exposure."(Abergavenny Roger Dobson)
Although the carcinogenic effects of active smoking have been seen at many sites, the effects of passive smoking and exposure in pregnancy and breastfeeding are less well documented, say the researchers.
The authors used the nationwide Swedish family cancer database from 1958 to 2002 to see whether the children of parents with lung cancer are at a risk of cancer that could not be explained by their smoking or familial risk. Most patients with lung cancer are smokers, and in populations with long term cigarette use, the population attributable risk of smoking is thought to be up to 90%.
The database used included 17 693 mothers and 41 838 fathers with lung cancer, and a total of 173 715 cancers were recorded in their offspring aged up to 70.
The results, based on age standardised incidence ratios (SIRs), show that offspring of affected mothers are at increased risk for upper aerodigestive (SIR 1.45), nasal (2.93), lung (1.71), and bladder (1.52) cancers.
For kidney cancer the SIR was 6.41 in 20 to 29 year olds. The risk of bladder cancer was greater in younger age groups than that of lung cancer. Bladder cancer showed a significant increase (SIR 2.82) in the 30 to 39 age group.
Cancers at many of these sites, but not the kidney or the bladder, were also greater in children of fathers with lung cancer. Nasal cancer was more likely if either parent was diagnosed as having lung cancer. The highest risk was for nasal adenoid cystic carcinoma (SIR 7.73).
"Passive smoking during childhood contributes to nasal cancer risks because an excess was observed through lung cancer in either parent, though stronger through the mother," say the authors from the German Cancer Research Center, Heidelberg, and the Karolinska Institute, Stockholm.
"There is also strong evidence that passive smoking is causing middle ear infections and a number of respiratory effects, such as asthma, wheezing, coughing, bronchitis and impaired pulmonary function in children, in line with its activity on the respiratory epithelium.
"The effects on the urinary bladder and the kidney are probably less related to passive smoking because the paternal contribution was nil. Rather, we assume that exposures in utero and through mother抯 milk are contributing to the effects observed on these target organs. Milk of smoking mothers contains high levels of nicotine, and urinary cotinine levels in infants may equal those of adult smokers."
They added, "The present data suggest that passive smoking during childhood is associated with an increase risk of nasal cancer, particularly of adenoid cystic carcinoma histology. For the excesses of bladder and kidney cancers, we propose a contribution of tobacco carcinogens that are transmitted through breastfeeding and in utero exposure."(Abergavenny Roger Dobson)