© 2004 by Oxford University Press
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2004 Oxford University Press
CORRESPONDENCE |
RESPONSE: Re: Are Women More Susceptible to Lung Cancer?
Correspondence to: Chris Bain, MBBS, MPH, School of Population Health, University of Queensland, Herston Rd., Herston, Queensland 4006, Australia (e-mail: c.bain{at}sph.uq.edu.au)
Risch and Miller raise a number of points regarding our study design and the central message of our paper (1)—that similar doses of cigarette smoke led to similar rates of lung cancer in men and women. Our view was based on evidence from a consistent set of findings from all published prospective data (from seven cohort studies) bearing on this issue and supported by our new primary data analysis comparing lung cancer incidence rates of female smokers from the Nurses' Health Study with those of male smokers from the Health Professionals Follow-up Study. Nothing in Risch and Miller's letter gives any cause for doubting these data. The central tenet of our reasoning, not addressed in their letter, is that the only direct way to address the true underlying force of morbidity from smoking is by measuring dose-specific incidence rates (which they do not mention were displayed in some detail). Comparing these incidence rates among men and women allows us to look at exactly what we want to know. It also prevents the comparison from being distorted by the unstable, and thus variable, lung cancer rates among nonsmokers in different populations, an unavoidable problem when contrasting two relative measures (although Risch and Miller still seem to favor this approach). This potential distortion is precisely why nonsmokers were excluded from all analyses we reported, contrary to what Risch and Miller seem to imply in their second paragraph. We hope readers clearly understand that the implication of the findings from all cohort studies and from general population trends (2) is that the public health issues for men and women are the same.
REFERENCES
1 Bain C, Feskanich D, Speizer FE, Thun M, Hertzmark E, Rosner BA, et al. Lung cancer rates in men and women with comparable histories of smoking. J Natl Cancer Inst 2004;96:826–34.
2 Jemal A, Travis WD, Tarone RE, Travis L, Devesa SS. Lung cancer rates convergence in young men and women in the United States: analysis by birth cohort and histologic type. Int J Cancer 2003;105:101–7.[CrossRef][ISI][Medline]
Related Correspondence
CiteULike 
Connotea 
Del.icio.us What's this?
J Natl Cancer Inst 2004 96: 1560.
J Natl Cancer Inst 2004 96: 1560-1561.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||