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15.07.2016 | Original Article | Ausgabe 1/2017 Open Access

International Journal of Public Health 1/2017

Cancer risk in waterpipe smokers: a meta-analysis

Zeitschrift:
International Journal of Public Health > Ausgabe 1/2017
Autoren:
Ravinder Mamtani, Sohaila Cheema, Javaid Sheikh, Ahmad Al Mulla, Albert Lowenfels, Patrick Maisonneuve

Abstract

Objectives

To quantify by meta-analysis the relationship between waterpipe smoking and cancer, including cancer of the head and neck, esophagus, stomach, lung and bladder.

Methods

We performed a systematic literature search to identify relevant studies, scored their quality, used fixed and random-effect models to estimate summary relative risks (SRR), evaluated heterogeneity and publication bias.

Results

We retrieved information from 28 published reports. Considering only highquality studies, waterpipe smoking was associated with increased risk of head and neck cancer (SRR 2.97; 95 % CI 2.26–3.90), esophageal cancer (1.84; 1.42–2.38) and lung cancer (2.22; 1.24–3.97), with no evidence of heterogeneity or publication bias. Increased risk was also observed for stomach and bladder cancer but based mainly on poor-quality studies. For colorectum, liver and for all sites combined risk estimates were elevated, but there were insufficient reports to perform a meta-analysis.

Conclusions

Contrary to the perception of the relative safety of waterpipe smoking, this meta-analysis provides quantitative estimates of its association with cancers of the head and neck, esophagus and lung. The scarcity and limited quality of available reports point out the need for larger carefully designed studies in well-defined populations.

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