Nonfilter and filter cigarette consumption and the incidence of lung cancer by histological type in Japan and the United States: Analysis of 30-year data from population-based cancer registries

Shifts in the histologic type of lung cancer accompanying changes in lung cancer incidence have been observed in Japan and the United States. We examined the association between the shift in tobacco design from nonfilter to filter cigarettes with changes in the incidence of adenocarcinoma (AD) and squamous cell carcinoma (SQ) of the lung. We compiled population-based incidence data from the Surveillance, Epidemiology and End Results in the United States (1973-2005) and from selected Japanese cancer registries (1975-2003). Trends in age-standardized rates of lung cancer incidence by histologic type were characterized using joinpoint analyses. A multiple regression framework was used to examine the relationship between tobacco use and incidence by histologic type. We observed that AD has replaced SQ as the most frequent histologic type in males and females in both Japan and the United States. Filter cigarette consumption was positively associated with the incidence of AD, with time lags of 25 and 15 years in Japan and the United States, respectively (β^AD₂: 1.946 × 10^-3, p < 0.001 and 3.142 × 10^-3, p < 0.001). In contrast, nonfilter cigarette consumption was positively associated with the incidence of SQ, with time lags of 30 and 20 years in Japan and the United States, respectively (β^SQ₂: 0.464 × 10^-3, p = 0.006 and 0.364 × 10^-3, p = 0.008). In conclusion, the shift from nonfilter to filter cigarettes appears to have merely altered the most frequent type of lung cancer, from SQ to AD.