A Prospective Study of the Effect of Smoking and Body Mass Index on the Risk of Lung Cancer in Male Workers of Beijing Steel Industry / 中国慢性病预防与控制

ABSTRACT

Objective To assess the effect of smoking and body mass index(BMI) on lung cancer incidence density in male workers.Methods Risk factors of cardiovascular diseases in baseline were surveyed in 1974,1979 and 1980 for 5 137 men aged more than 18 years old from Beijing Capital Steel and Iron Company.Follow-up was carried out to 2001;all diseases were identified by uniform standard.Cox proportional hazards model was used to analyze the relationship between smoking,BMI and lung cancer.Results During mean follow-ups of 20.8 years,106 cases of lung cancer occurred.The crude incident rates of lung cancer were 102.2 cases per 100 000 person-years.After adjustment for age,BMI and other established risk factors,cigarettes consumption of greater than 20 cigarettes/day versus no smoking was associated with a relative risk of lung cancer of 3.45(95% confidence interval(CI) 1.58～7.53).In categories of BMI of less than 18.5(underweight),18.5～24.9(normal weight) and more than 25 kg/m2(overweight and obesity),adjusting for age and other covariables,all workers and smoking workers both showed decreasing tendencies in relative risks of lung cancer in higher BMI groups.The pattern was similar after excluding the early 5-year lung cancer patients.Grouping in smoking and BMI levels,compared with underweight smokers,the relative risks for lung cancer of normal-weight nonsmokers and nonsmokers with overweight and obesity,as well as smokers with overweight and obesity were 0.25(95% CI 0.08～0.84),0.16(95% CI 0.04～0.74) and 0.23(95% CI 0.07～0.77),respectively.Smokers with underweight had higher risk for lung cancer.Conclusion Smoking and underweight increased the risk of lung cancer.Keeping normal weight and giving up tobacco were important for the prevention of lung cancer.