Division of Family Medicine;
Department of Medical Epidemiology and Biostatistics;
Karolinska Institutet;
Department of Health Sciences;
Mid Sweden University;
Department of Public Health and Clinical Medicine;
Ume? University;
Social Medicine and Global Health;
Institute of Environmental Medicine;
Clinical Epidemiology Unit;
Lund University;
Department of Public Health Sciences;
Department of Clinical Sciences;
关键词：
smokeless tobacco;
Oral cancer;
snus;
incidence;
期刊名称：
Scandinavian journal of public health
i s s n：
1403-4948
年卷期：
2021 年
49 卷
8 期
页 码：
833-840
页 码：
摘 要：
Aims: Worldwide, smokeless-tobacco use is a major risk factor for oral cancer. Evidence regarding the particular association between Swedish snus use and oral cancer is, however, less clear. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between snus use and oral cancer. Methods: A total of 418,369 male participants from nine cohort studies were followed up for oral cancer incidence through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. Results: During 9,201,647 person-years of observation, 628 men developed oral cancer. Compared to never-snus use, ever-snus use was not associated with oral cancer (adjusted HR 0.90, 95% CI: 0.74, 1.09). There were no clear trends in risk with duration or intensity of snus use, although lower intensity use (? 4 cans/week) was associated with a reduced risk (HR 0.65, 95% CI: 0.45, 0.94). Snus use was not associated with oral cancer among never smokers (HR 0.87, 95% CI: 0.57, 1.32). Conclusions: Swedish snus use does not appear to be implicated in the development of oral cancer in men.
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