Journal
CHINESE JOURNAL OF CANCER
Volume 33, Issue 6, Pages 306-316Publisher
SUN YAT SEN UNIV MED SCI WHO
DOI: 10.5732/cjc.013.10248
Keywords
Systematic review; meta-analysis; active smoking; passive smoking; breast cancer; Chinese females
Categories
Funding
- National Natural Science Foundation of China [81172762]
- program for Changjiang Scholars and Innovation Research Team in University in China [IRT1076]
- National Scientific and Technological Project [2011ZX09307-001-04]
- Tianjin Science Committee Foundation [09ZCZDSF04800, 09ZCZDSF04700]
- Tianjin Science and Technology Committee Foundation [12ZCDZSY16000, 11ZCGYSY02200]
- Major State Basic Research Program for China (973 Program) [2009CB918903]
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Previous studies suggested that smoking and passive smoking could increase the risk of breast cancer, but the results were inconsistent, especially for Chinese females. Thus, we systematically searched cohort and case-control studies investigating the associations of active and passive smoking with breast cancer risk among Chinese females in four English databases (PubMed, Embase, ScienceDirect, and Wiley) and three Chinese databases (CNKI, WanFang, and VIP). Fifty-one articles (3 cohort studies and 48 case-control studies) covering 17 provinces of China were finally included in this systematic review. Among Chinese females, there was significant association between passive smoking and this risk of breast cancer [odds ratio (OR): 1.62; 95% confidence interval (CI): 1.39-1.85; I2 = 75.8%, P < 0.001; n = 26] but no significant association between active smoking and the risk of breast cancer (OR: 1.04; 95% CI: 0.89-1.20; I2 = 13.9%, P = 0.248; n = 31). The OR of exposure to husband's smoking and to smoke in the workplace was 1.27 (95% CI: 1.07-1.50) and 1.66 (95% CI: 1.07-2.59), respectively. The OR of light and heavy passive smoking was 1.11 and 1.41, respectively, for women exposed to their husband's smoke (< 20 and = 20 cigarettes per day), and 1.07 and 1.87, respectively, for those exposed to smoke in the workplace (< 300 and = 300 min of exposure per day). These results imply that passive smoking is associated with an increased risk of breast cancer, and the risk seems to increase as the level of passive exposure to smoke increases among Chinese females. Women with passive exposure to smoke in the workplace have a higher risk of breast cancer than those exposed to their husband's smoking.
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