SynthesisInternational journal of epidemiology2021
Smoking and nasopharyngeal cancer: individual data meta-analysis of six prospective studies on 334 935 men.
Synthesis in International journal of epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 24 citations in OpenAlex.
- Epidemiologic and clinicopathologic characteristics of nasopharyngeal carcinoma at a tertiary care center in Saudi Arabia.Annals of medicine and surgery (2012) · 2026Article
- Nasopharyngeal carcinoma: epidemiology, risk factors, signaling pathways, clinical features, diagnosis, and management.Molecular biomedicine · 2026Review
- Hierarchical dynamic model for risk-stratified screening of nasopharyngeal carcinoma.Nature communications · 2026Article
- Smoking, Alcohol, and Their Interaction in the Risk of Head and Neck Cancer: A Nationwide Cohort Study.Cancer medicine · 2026Article
- Research progress on the regulation of ferroptosis in NPC (Review).Oncology reports · 2026Review
- Achieving control of nasopharyngeal carcinoma: the role of Epstein-Barr virus-based screening and vaccines.Nature reviews. Clinical oncology · 2026Review
- Screening of Theaflavins That Inhibit Proliferation of Nasopharyngeal Carcinoma Cells Through Metabolomics Approaches.Food science & nutrition · 2025Article
- Patient Characteristics and Treatment Outcomes of Nasopharyngeal Carcinoma in Nonendemic Regions.JAMA network open · 2025Article
- Development of a Predictive Model for the Risk of Myelosuppression in Patients With Nasopharyngeal Carcinoma Undergoing Chemoradiotherapy.Clinical Medicine Insights. Oncology · 2025Article
- Global, regional, and national temporal trends in mortality and disease burden of nasopharyngeal carcinoma attributable to smoking from 1990 to 2021 and predictions to 2040.Tobacco induced diseases · 2025Article
- Trends in incidence and mortality of nasopharyngeal cancer in China (2004-2018): an age-period-cohort analysis.Frontiers in oncology · 2025Article
- Long-term trends of nasopharyngeal carcinoma mortality in China from 2006 to 2020 by region and sex: an age-period-cohort analysis.BMC public health · 2023Article
- Prediction of outcomes in patients with local recurrent nasopharyngeal carcinoma: development and validation of a four-factor prognostic model integrating baseline characteristics and [European radiology · 2023Article
- Risk-Reducing Measures for Cancer Prevention.Korean journal of family medicine · 2023Article
- Article
- Germline Variants Associated with Nasopharyngeal Carcinoma Predisposition Identified through Whole-Exome Sequencing.Cancers · 2022Article
- Head and Neck Cancer Types and Risks of Cervical-Cranial Vascular Complications within 5 Years after Radiation Therapy.Journal of personalized medicine · 2022Article
- Trends in the Incidence of Nasopharyngeal Cancer in Saudi Arabia Across One Decade (2007 to 2016).Cureus · 2022Article
- Causes of Death in Long-Term Nasopharyngeal Carcinoma Survivors.Frontiers in public health · 2022Article
- Management of Nasopharyngeal Carcinoma in Elderly Patients.Frontiers in oncology · 2022Review
Corrections and comments
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Authors and funding
22 authors at 13 institutions in 5 countries.
Funding
Abstract
backgroundThe role of smoking in nasopharyngeal carcinoma (NPC) remains uncertain, especially in endemic regions. We conducted an individual participant data (IPD) meta-analysis of prospective cohort studies to investigate the associations between smoking exposure and risk of NPC.
methodsWe obtained individual participant data of 334 935 male participants from six eligible population-based cohorts in NPC-endemic regions, including two each in Guangzhou and Taiwan, and one each in Hong Kong and Singapore. We used one- and two-stage approaches IPD meta-analysis and Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of NPC for smoking exposure adjusting for age and drinking status.
resultsDuring 2 961 315 person-years of follow-up, 399 NPC evens were ascertained. Risks of NPC were higher in ever versus never smokers (HRone-stage = 1.32, 95% CI = 1.07-1.63, P = 0.0088; HRtwo-stage = 1.27, 1.01-1.60, 0.04). These positive associations appeared to be stronger in ever smokers who consumed 16+ cigarettes/day (HRone-stage = 1.67, 95% CI = 1.29-2.16, P = 0.0001), and in those who started smoking at age younger than 16 (2.16, 1.33-3.50, 0.0103), with dose-response relationships (P-values for trend = 0.0028 and 0.0103, respectively). Quitting (versus daily smoking) showed a small reduced risk (stopped for 5+ years: HRone-stage = 0.91, 95% CI = 0.60-1.39, P = 0.66; for former smokers: HRtwo-stage = 0.84, 0.61-1.14, 0.26).
conclusionsThis first IPD meta-analysis from six prospective cohorts in endemic regions has provided robust observational evidence that smoking increased NPC risk in men. NPC should be added to the 12-16 cancer sites known to be tobacco-related cancers. Strong tobacco control policies, preventing young individuals from smoking, would reduce NPC risk in endemic regions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.