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Table 23 Haematopoietic and lymphoid cancer; individual effect (relative risk/odds ratio) estimates

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

 

ST use

  

RR/OR

Sourcea

Typeb

Exposurec

Smoking

Sex

Id.

Casesd

Estimate (95%CI)

Adjustment factorse

Cohort studies

        

US veterans: Heinemann et al. 1992 [16]

        

- multiple myeloma

ST

Use

Never

Mf

1

6

1.00 (0.40–2.30)

age, time, yriv

CPS-II: Henley et al. 2005 [23]

        

- any haematopoietic cancer

ST

Current

Never

M

2

19

0.95 (0.60–1.51)

age, alc, asp, bmi, diet, edu, exer, occ, race

  

Former

  

3

9

1.16 (0.60–2.25)

 
  

Ever

  

4

28

1.01 (0.69–1.48)g

 

Swedish construction workers: Fernberg et al. 2006 [30]

        

- non-Hodgkin's lymphoma

Snuff

Ever

Never

M

5

66

0.77 (0.59–1.01)

age, bmi

- Hodgkin's disease

Snuff

Ever

Never

M

6

15

0.88 (0.49–1.58)

 

Swedish construction workers: Fernberg et al. 2007 [31]

        

- leukaemia

Snuff

Ever

Never

M

7

NA

no increased risk

age, bmi

- multiple myeloma

Snuff

Ever

Never

M

8

NA

no increased risk

age, bmi

Case-control studies

        

Williams and Horm 1977 [55]

        

- any haemopoietic cancer

ST

Ever

Any

M

9

13

0.63 (0.35–1.14)g

none

    

F

10

3

1.01 (0.31–3.29)g

 

Lindquist et al. 1987 [72]

        

- leukaemia

Snuff

Ever

Any

M+F

11

18

0.94 (0.47–1.89)h

age, res, sex

Morris Brown et al. 1992 [87]

        

- leukaemia

ST

Use

Never

M

12

24

1.80 (0.90–3.30)i

age, alc, res

Morris Brown et al. 1992 [88]

        

- non-Hodgkin's lymphoma

ST

Use

Never

M

13

19

1.30 (0.70–2.50)j

age, res

- multiple myeloma

ST

Use

Never

M

14

5

1.90 (0.50–6.60)

age, res

Hardell et al. 1994 [95]

        

- non-Hodgkin's lymphoma

Snuff

Use

Any

M

15

35

1.50 (0.90–2.50)

none

Schroeder et al. 2002 [110]

        

- non-Hodgkin's lymphoma

Chew

Ever

Any

M

16

19

1.23 (0.80–1.88)k

age, res

 

Snuff

   

17

19

0.93 (0.61–1.41)k

 
 

ST

   

18

38

1.06 (0.77–1.45)l

 

Bracci and Holly 2005 [112]

        

- non-Hodgkin's lymphoma

ST

Ever

Never

M

19

7

4.00 (1.30–12.00)

age, alc, edu

  1. a Fuller details of the studies are given in Tables 1 and 2.
  2. b ST implies smokeless tobacco unspecified, or combined snuff use or chewing.
  3. c Ever, former and current ST use were compared with never ST. Use indicates timing not given and comparison is with non use.
  4. d 'Id.' is the RR/OR identification number used in Table 24, and 'Cases' is the number of cases in ST users as defined. NA = not available.
  5. e Abbreviations used: alc = alcohol, asp = aspirin, bmi = body mass index, edu = education, exer = exercise, occ = occupation, smok = smoking, tadm = time of admission, yriv = year of interview.
  6. f The population included < 0.5% females.
  7. g Estimated from data on limited number of exposed cases for eight sub-types of haemopoietic cancer.
  8. h RR/OR and/or 95% CI estimated from data provided in the source.
  9. i Data for six subtypes of leukaemia were also provided, but none were statistically significant.
  10. j Data for five subtypes of non-Hodgkin's lymphoma were also provided, but none were statistically significant.
  11. k Estimated from data for t (14,18)-positive and t (14,18)-negative cases.
  12. l Estimated from the results for chew and snuff, assuming that no one both chewed and used snuff.
  13. CI = confidence interval; ST = smokeless tobacco; OR = odds ratio; RR = relative risk.
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