Prospective cohort study on the relationship between smoking cessation and cancer risk in males / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of smoking cessation on the risk of cancer among male subjects.</p><p><b>METHODS</b>Participants of this study were derived from the workers in Kailuan Group who took the health check-up examination in its 11 affiliated hospitals. The check-up examinations were given biennially based on uniformed standard. From May 2006 to December 2011, health examinations were given for 3 rounds and a total of 104 809 male workers involved. The date of being enrolled in this study was defined as that of taking first check-up, and the date of end-of-observation was defined as that of cancer diagnosis, death or end of follow-up.</p><p><b>INCLUSION CRITERIA</b>age ≥18 while being enrolled in this study, and there was no information missing in the questionnaire for age (or date of birth), smoking status, the age of starting smoking, the age of quitting smoking, and smoking amount. The information of smoking status was collected by questionnaires, and the information of newly-diagnosed cancer cases was obtained by follow-up. After adjusted for age, education background, drinking habits, working environment and BMI, multi-variate Cox proportional hazard regression models were used to analyze the association between smoking cessation and cancer risk (all sites of cancers, smoking-related cancers, and lung cancer) by calculating the values of HR (hazard ratio) and 95% CI (confidence interval).</p><p><b>RESULTS</b>Totally, 104 809 subjects were followed up for 450 639.6 person-years, including 46 013 smokers (43.90%), 51 624 never-smokers (49.26%), and 7 172 smoking quitters (6.84%). Among all these subjects, 1 323 were diagnosed as cancer cases, including 1 082 smoking-related cancers, of which 378 were lung cancer cases. The results showed that, compared with never-smokers, smokers had increased risks for all sites of cancers (HR=1.38, 95% CI: 1.20- 1.59), smoking-related cancers (HR=1.45, 95% CI: 1.24- 1.69) and lung cancer (HR=1.70, 95% CI: 1.31- 2.21). While compared with the smokers, smoking quitters had decreased risk of lung cancer (HR=0.36, 95% CI: 0.20- 0.65). For the smokers with smoking history ≥20 pack-years, HR (95% CI) of lung cancer incidence was 0.09 (0.01- 0.65). For people age ≥60 smoke quitter, HR (95% CI) of lung cancer incidence was 0.33 (0.16- 0.68). For people who quit ≥10 years, HR (95% CI) of lung cancer incidence was 0.19(0.06- 0.58).</p><p><b>CONCLUSION</b>Smoking cessation might decrease the risk of lung cancer among male smokers. The risk of lung cancer was lower among the smoking quitters with longer history of smoking, older age, and longer years of quitting smoking.</p>

Effect of maximum blood pressure when discharged from the hospital on the prognosis among patients with acute ischemic stroke / 中华流行病学杂志

Objective To investigate the relationship between maximum blood pressure and the prognosis after discharged from the hospital,among patients with ischemic stroke.Methods A cohort study was conducted which including 471 cases of ischemic stroke patients that were collected from February 2014 to December 2014 at the Second Affiliated Hospital of Harbin Medical University.Values of everyday blood pressure were measured on each patient at the first six days after admitted to the hospital.Maximum blood pressure value of the 6 days was taken as an indicator of the blood pressure levels.The ability on daily living was measured by the modified Rankin score (mRs).Data were analyzed by Chi-square test,t test and multivariate logistic regression analysis.Results Confounding factors would include age,gender,culture,physical activity,income,smoking,alcohol,hypertension,diabetes,coronary heart disease,stroke history,hospitalization mrs,lipid parameters,homocysteine and blood sugar and were adjusted.Results from multivariate logistic regression analysis showed that the maximum SBP was associated with adverse outcomes.Compared with 140-159 mmHg for SBP,OR(95％CI) was 2.51 (1.30-4.85) for 160-179 mmHg,OR (95％ CI) was 2.68 (1.27-5.65) for those pressure levels higher than 180 mmHg,after multiple factors were adjusted.Compared with 90-99 mmHg for DBP,OR(95％CI) was 1.92 (1.00-3.67) for 100-109 mmHg,OR (95％ CI) was 2.78 (1.35-5.69) for the ones higher than 110 mmHg.Conclusion Maximum blood pressure during hospitalization might be associated with adverse outcome of ischemic stroke patients.