Abstract
BACKGROUND: Young age at onset of smoking is a known risk factor for cancer; however, few studies have investigated the risk of cancer associated with onset of smoking during adolescence in Japan. METHODS: We analyzed a portion of the data from a population-based cohort of 40 897 subjects aged 40 to 69 years with a history of smoking and no history of cancer at baseline. RESULTS: During a 14-year follow-up period, 4386 total cancers and 681 lung cancers were newly diagnosed. As compared with smokers who started smoking after the age of 20 years, those who started before the age of 17 years smoked a significantly larger number of cigarettes per day for a significantly longer duration; they also had a significantly higher risk of lung cancer. The hazard ratios in men and women were 1.48 (95% confidence interval, 1.11-1.96) and 8.07 (2.34-27.85), respectively. After further adjustment for smoking amount, the associations remained significant. There was a statistically significant inverse correlation between lung cancer risk and age at onset of smoking in male current smokers whose baseline age was 50 to 59 years; no such association was detected among other age strata. CONCLUSIONS: There was no clear evidence of increased risk of cancer due to adolescent smoking. However, adolescent smoking appeared to indirectly increase lung cancer risk because it was associated with a longer duration and larger amount of smoking.