Systematic review of the relation between smokeless tobacco and cancer in Europe and North America

Table 17 Prostate cancer; individual effect (relative risk/odds ratio) estimates

	ST use			RR/OR
Source^a	Type^b	Exposure^c	Smoking	Id.	Cases^d	Estimate (95%CI)	Adjustment factors^e
Cohort studies
Lutheran Brotherhood: Hsing et al. 1990 [11]	ST	Ever	Any	1	38	1.51 (1.03–2.19)^f	age, smok
			Never	2	10	4.50 (2.10–9.70)	age
US Veterans: Hsing et al. 1991 [15]	ST	Ever	Never	3	48	1.17 (0.88–1.56)	age
Iowa cohort: Putnam et al. 2000 [20]	ST	Ever	Any	4	NA	no association	age
NHANES I: Accortt et al. 2005 [22]	ST	Ever	Never	5	19	1.20 (0.50–3.40)	age, pov, race
Norway cohorts: IARC Monograph 37 1985 [14]	ST	Use	Any	6	NA	no association	age, res, smok
Case-control studies
Williams and Horm 1977 [55]	ST	Ever	Any	7	65	1.32 (0.94–1.84)^f	age, race, smok
Hayes et al. 1994 [96]	Chew	Current	Any	8	14	0.56 (0.30–1.06)^f	none
		Former		9	56	1.08 (0.75–1.55)^f
		Ever		10	70	0.91 (0.67–1.25)^f
	Snuff	Current	Any	11	10	6.74 (1.47–30.84)^f
		Former		12	10	0.79 (0.36–1.74)^f
		Ever		13	20	1.42 (0.75–2.67)^f
	ST	Current	Any	14	24	0.92 (0.54–1.58)^g
		Former		15	66	1.03 (0.74–1.43)^g
		Ever		16	90	1.00 (0.75–1.33)^g

^a Fuller details of the studies are given in Tables 1 and 2.
^b ST implies smokeless tobacco unspecified, or combined snuff use or chewing.
^c Ever, former and current ST use were compared with never ST. Use indicates timing not given and comparison is with non use.
^d 'Id.' is the RR/OR identification number used in Table 18, and 'Cases' is the number of cases in ST users as defined. NA = not available.
^e Abbreviations used: pov = poverty, res = area of residence, smok = smoking.
^f RR/OR and/or 95% CI estimated from data provided in the source.
^g RR/OR and/or 95% CI estimated from data provided in the source assuming that no one both chewed and used snuff.
CI = confidence interval; ST = smokeless tobacco; OR = odds ratio; RR = relative risk.

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