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JNCI Journal of the National Cancer Institute 1999 91(9):803-804;
© 1999 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 91, No. 9, 803-804, May 5, 1999
© 1999 Oxford University Press

CORRESPONDENCE

RESPONSE: Re: Multicenter Case-Control Study of Exposure to Environmental Tobacco Smoke and Lung Cancer in Europe

Paolo Boffetta, Fredrik Nyberg, On Behalf of the IARC Study Group

Affiliations of authors: P. Boffetta, International Agency for Research on Cancer, Lyon, France; F. Nyberg, International Agency for Research on Cancer, Lyon, and Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.

Correspondence to: Paolo Boffetta, M.D., M.P.H., International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France (e-mail: boffetta{at}iarc.fr).

Dr. Denson questions our results and conclusions regarding lung cancer risk from environmental tobacco smoke because the estimated risks were not adjusted for intake of fat, in particular, saturated fat. Regarding possible confounding, he quotes the results of a study on women from Missouri by Alavanja et al. (1). However, the authors of that article later corrected their estimates of the risk of lung cancer from intake of saturated fat among nonsmokers (2). The corrected relative risks in the highest quintile of saturated fat intake were either 1.78 (95% confidence interval [CI] = 1.04-3.04, nutrient residual method) or 2.38 (95% CI = 1.35-4.17, nutrient density method), depending on the method of analysis used. Unfortunately, we did not collect information on saturated fat intake and could not control for the potential confounding effect exerted by this factor. The magnitude of the risk found in the study of Missouri women, however, makes it unlikely that uncontrolled confounding from saturated fat intake explains our results regarding exposure to environmental tobacco smoke.

REFERENCES

1 Alavanja MC, Brown CC, Swanson C, Brownson RC. Saturated fat intake and lung cancer risk among nonsmoking women in Missouri. J Natl Cancer Inst 1993;85:1906-16.[Abstract/Free Full Text]cancerlit;94047155

2 Swanson CA, Brown CC, Brownson RC, Alavanja MC. Re: Saturated fat intake and lung cancer risk among nonsmoking women in Missouri [letter]. J Natl Cancer Inst 1997;89:1724-5.[Free Full Text]cancerlit;98050910


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This Article
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