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Table 2 Comparison of individual and overall (random-effects) estimates for the two reviews – oropharyngeal cancer

From: The relation between smokeless tobacco and cancer in Northern Europe and North America. A commentary on differences between the conclusions reached by two recent reviews

 

ST usea

     

Ref

Type

Exposure

Inclusion of smokersb

Reviewc

Sex

Relative risk (95% CI)

Comments

[3]

ST

Current

NS

L&H

M

2.02 (0.53–7.74)

 

(CPS-I)

ST

Current

NS

B

M

2.0 (0.5–7.7)

Estimates agreed

[3]

ST

Current

NS

L&H

M

0.90 (0.12–6.71)

 

(CPS-II)

ST

Current

NS

B

M

0.9 (0.1–6.7)

Estimates agreed

[4]

Snuff

Ever

SNS

L&H

M

1.10 (0.50–2.41)

 
 

Snuff

Ever

SNS

B

M

1.1 (0.5–2.4)

Estimates agreed

[5]

Snuff

Ever

SNS

L&H

M

0.7 (0.5–0.9)

 
 

Snuff

Ever

NS

B

M

0.8 (0.4–1.7)

NS not SNS

[6]

Snuff

Ever

SNS

L&H

M

3.1 (1.5–6.6)

Too recent to be included by B

[7]

Chew

Ever

SNS

L&H

M+F

2.05 (1.48–2.83)e

Not included by B

[8]

Chew

Ever

SNS

L&H

M

2.00 (1.16–3.47)e

Not included by B

[9]

ST

Ever

SNS

L&H

M

3.63 (1.02–12.95)e

Not included by B

[10]

Snuff

Ever

SNS

L&H

F

2.67 (1.83–3.90)e

 
 

Snuff

Ever

NSf

B

F

4.2 (2.6–6.7)

Whites

 

Snuff

Ever

NSf

B

F

1.5 (0.5–4.8)

Blacks

[11]

ST

Ever

SNS

B

M

2.3 (0.2–12.9)

Tongue cancer

 

ST

Ever

SNS

B

M

11.2 (4.1–30.7)

Mouth cancer

       

Not included by L&H as no valid smoking adjustmentg

[12]

ST

Ever

NS

L&H

F

6.2 (1.9–19.8)

 
 

ST

Ever

NS

B

F

6.2 (1.9–19.8)

Estimates agree

[13]

Snuff

Ever

NS

L&H

M+F

0.67 (0.08–5.75)e

Not included by B

[14]

ST

Ever

SNS

L&H

M+F

1.04 (0.41–2.68)e

Not included by B

[15]

ST

Ever

SNS

L&H

M

0.96 (0.70–1.33)e

 
 

Chew

Ever

SNS

B

M

1.0 (0.7–1.4)

Chew not ST

[16]

Chew

Ever

SNS

L&H

M

1.11 (0.81–1.53)e

 
 

Chew

Ever

NS

B

M

2.3 (0.7–7.3)

NS not SNS

[17]h

ST

Ever

SNS

L&H

M+F

1.43 (0.64–3.21)e

Not included by B

[18]

Snuff

Ever

SNS

L&H

M

0.98 (0.63–1.50)e

 
 

Snuff

Ever

SNS

B

M

1.4 (0.8–2.4)

Oral cancer excluding pharynx

[19]

Snuff

Ever

SNS

L&H

M+F

0.8 (0.5–1.3)

Estimate for NS also available

 

Snuff

Ever

SNS

B

M+F

0.8 (0.5–1.3)

Estimates agree

[20]

ST

Ever

SNS

L&H

M

1.0 (0.4–2.3)

Not included by B

[21]

Snuff

Ever

SNS

L&H

M+F

0.7 (0.3–1.3)

Not included by B

Total

   

L&H

 

1.36 (1.04–1.77)

19 estimates

    

B

 

1.8 (1.1–2.9)

13 estimates

  1. a ST = smokeless tobacco; Chew = chewing tobacco; ever exposure includes undefined use.
  2. b NS = never smokers; SNS = smokers and nonsmokers combined (with adjustment for smoking).
  3. c L&H = Lee and Hamling review [2]; B = Boffetta et al. review [1].
  4. d To within rounding error, as B only expressed estimates to one decimal place.
  5. e Estimated from data provided.
  6. f B stated that the results were for never smokers, but L&H consider the result relates to non-current smoking. L&H's estimate is for current and non-current smokers combined.
  7. g Valid smoking adjustment was impossible in this study as "for users of multiple tobacco products, only the primary product was recorded".
  8. h The results were cited by Gross et al. [17] based on an unpublished report by Perry et al., "Attributable oral cancer risk due to smokeless tobacco use based on a case-control study at Sinai Hospital in Detroit".