Lung Cancer Risk Among Cooks When Accounting for Tobacco Smoking: A Pooled Analysis of Case–Control Studies From Europe, Canada, New Zealand, and China

OBJECTIVES:To investigate the risk of lung cancer among cooks, while controlling for smoking habits. METHODS:We used data from the SYNERGY project including pooled information on lifetime work histories and smoking habits from 16 case–control studies conducted in Europe, Canada, New Zealand, and China. RESULTS:Before adjustment for smoking, we observed an increased risk of lung cancer in male cooks, but not in female cooks. After adjusting, there was no increased risk and no significant exposure–response relationship. Nevertheless, subgroup analyses highlighted some possible excess risks of squamous cell carcinoma and small cell carcinoma in female cooks. CONCLUSIONS:There is evidence that lung cancer risks among cooks may be confounded by smoking. After adjustment, cooks did not experience an increased risk of lung cancer overall. The subgroup analyses showing some excess risks among female cooks require cautious interpretation.