Résumé :
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[BDSP. Notice produite par INIST-CNRS VyIbYR0x. Diffusion soumise à autorisation]. Alcohol drinking increases the risk of several types of cancer, but studies of the relation between alcohol and lung cancer risk are complicated by smoking. The authors carried out meta-analyses for four study designs and conducted sensitivity analyses to assess the results. Pooled smoking-unadjusted relative risks (RRs) for brewery workers and alcoholics were 1.17 (95% confidence interval (Cl) : 0.99,1.39) and 1.99 (95% Cl : 1.66,2.39), respectively, relative to population rates. For cohort and case-control studies, the authors conducted dose-specific meta-analyses for ethanol consumption of 1-499,500-999,1,000-1,999, and>=2,000 g/month, relative to nondrinking. Smoking-adjusted RRs for ascending dose groups in cohort studies were 0.98 (95% CI : 0.79,1.21), 0.92 (95% CI : 0.81,1.04), 1.04 (95% CI : 0.88,1.22), and 1.53 (95% CI : 1.04,2.25), respectively. Smoking-adjusted odds ratios for ascending groups in case-control studies were 0.63 (95% Cl : 0.51,0.78), 1.30 (95% Cl : 0.98,1.70), 1.13 (95% Cl : 0.46,2.75), and 1.86 (95% Cl : 1.39,2.49), respectively. Elevated odds ratios were seen for hospital-based case-control studies but not for population-based case-control studies. Sensitivity analyses indicated that smoking explained the elevated RRs in studies of alcoholics and that strong misclassification of smoking status could produce an elevated smoking-adjusted RR in cohort and case-control studies. Overall, evidence for a smoking-adjusted association between alcohol and lung cancer risk is limited to very high consumption groups in cohort and hospital-based case-control studies. At lower levels, any associations observed appear to be explained by confounding.
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