Lung cancer and cigarette smoking in Europe: An update of risk estimates and an assessment of inter-country heterogeneity

Lorenzo Simonato, Antonio Agudo, Wolfgang Ahrens, Ellen Benhamou, Simone Benhamou, Paolo Boffetta, Paul Brennan, Sarah C. Darby, Francesco Forastiere, Cristina Fortes, Valérie Gaborieau, Michael Gerken, Carlos A. Gonzales, Karl Heinz Jöckel, Michaela Kreuzer, Franco Merletti, Fredrik Nyberg, Göran Pershagen, Hermann Pohlabeln, Franz RöschElise Whitley, Heinz Erich Wichmann, Paola Zambon

Research output: Contribution to journalArticlepeer-review


Ten case-control studies have been carried out in 6 European countries to investigate the major risk factors for lung cancer. Carcinogenic effect from cigarette smoke was the most relevant interest in our study, which has included 7,609 cases of lung cancer and 10,431 controls, mainly population based. The results indicate elevated odds ratios (ORs; 23.9 among men and 8.7 among women) with attributable risks exceeding 90% for men and close to 60% for women. A large, and statistically significant, variability of the results across countries was detected after adjusting for the most common confounding variables, and after controlling, at least in part, for the instability of the ORs due to the small number of non-smokers in some of the study subsets. This pattern of lung cancer risk associated with cigarettes smoke, across different European regions, reflects inherent characteristics of the studies as well as differences in smoking habits, particularly calender periods of starting, and it is likely to have been influenced by effect modifiers like indoor radon exposure, occupation, air pollution and dietary habits.

Original languageEnglish
Pages (from-to)876-887
Number of pages12
JournalInternational Journal of Cancer
Issue number6
Publication statusPublished - Mar 15 2001


  • Case-control study
  • Cigarette smoke
  • Lung cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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