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Table 1
Cohort studies of smokeless tobacco and cancer
Study	Country	Follow-up period	Baseline population	Exposure^a	Reference^b	Cancers studied (cases)^c

Lutheran Brotherhood cohort^d	USA	1966 to 1986	17,633 white men aged 35+ years	ST	Hsing et al. 1990 [11]	Prostate (149)
					Kneller et al. 1991 [12]	Stomach (75)
					Zheng et al. 1993 [13]	Pancreas (57)
US Veterans cohort^e	USA	1954/57 to 1980	248,046 US veterans aged 31–84 years, over 99.5% men	ST	Hsing et al. 1991 [15]	Prostate (4,607)
					Heineman et al. 1992 [16]	Multiple myeloma (582)^f
					Zahm et al. 1992 [17]	Soft tissue sarcoma (119), pharynx (55), buccal cavity (74)
					Heineman et al. 1995 [18]	Colon (3,812), rectum (1,100)
Iowa cohort	USA	1986/89 to 1995	1,572 men aged 40+ years, controls in a case-control study	ST	Putnam et al. 2000 [20]	Prostate (101)^f
NHANES I follow-up cohort^g	USA	1971/75 to 2002	14,407 adults aged 25–74 years^h	ST	Accort et al. 2002 [21]	All, lungⁱ
					Accort et al. 2005 [22]	All, lung, breast, digestive, oral, prostate^{f, i}
CPS-I^j	USA	1959 to 1972	77,407 never smoking men aged 30+ years from 25 states	ST	Henley et al. 2005 [23]	All (2,332), oral (13), digestive (913), lung (134), genitourinary (559)
CPS-II^k	USA	1982 to 2000	114,809 never smoking men aged 30+ years nationwide	ST^l	Henley et al. 2005 [23]	All (6,140), oral (46), digestive (1,999), lung (400), genitourinary (1,709), haematopoietic (923)
		1982 to 1996	467,788 men aged 30+ years nationwide	ST	Chao et al. 2002 [24]	Stomach (996)
Norway cohorts^m	Norway	1966 to 2001	10,136 men from two cohorts, a sample of the 1960 census and relatives of Norwegian migrants to the USA	Snuff	Boffetta et al. 2005 [26]	Oral (34), oesophagus (27), stomach (217), pancreas (105), lung (343), kidney (88), bladder (239)ⁿ
Swedish construction workers	Sweden	1974 to 1985	135,036 men	Snuff	Bolinder et al. 1994 [28]	All (1,269), lung (204)
		1971 to 2000	337,311 men		Odenbro et al. 2005 [29]	Cutaneous squamous cell carcinoma (756)^f
		1971 to 2000	335,612 adults, over 99.3% men		Fernberg et al. 2006 [30]	Malignant lymphoma (1,514)^f
		1971 to 2004	336,381 men		Fernberg et al. 2007 [31]	Leukaemia (372), multiple myeloma (520)^f
		1978 to 2004	279,897 men		Luo et al. 2007 [32]	Oral (248), lung (2,198), pancreas (448)^f
		1971 to 2004	339,802 men		Odenbro et al. 2007 [33]	Melanoma (1,639)°
		1971 to 2004	336,381 men		Zendehdel et al. 2008 [34]	Stomach (1,385), oesophagus (366)^f
Uppsala County cohort	Sweden	1973/74 to 2002	9,976 men	Snuff	Roosaar et al. 2008 [35]	All (1,572), smoking-related (493), oral (34)^p

^aOnly exposures for which results are available are shown. ^bMain references. Other references supplying limited data are indicated in footnotes. ^cNumbers of cases are totals for the sexes specified. Numbers of cases exposed to ST are shown in the tables presenting results by site. Cases are deaths, unless indicated. Oral is used as an abbreviation for oropharnyx. ^dSome limited additional results for the Lutheran Brotherhood cohort, based on follow-up to 1981, were reported earlier for cancers of the prostate, pancreas and oesophagus in IARC Monograph 37 in 1985 [14]. ^eSome limited additional results for the US Veterans cohort, based on follow-up from 1954 to 1969 were presented earlier for a range of cancers in an abstract by Winn et al. in 1982 [19]. ^fCancers listed are incident cases. ^gNHANES I = First National Health and Nutrition Examination Survey. ^hData on ST use were only collected in 3,847 subjects at baseline in 1971–1975, but were collected for all subjects in follow-up surveys in 1982–1984. 6,805 subjects were considered in the mortality analyses [21] and 7,779 in the incidence analyses [22]. ⁱNumbers of cases not given. ^jCPS-I = Cancer Prevention Study I. ^kCPS-II = Cancer Prevention Study II. Some additional results for lung cancer, based on mortality to 2002, comparing 111,952 men who quit cigarette smoking with 4,443 who switched to ST, were presented by Henley et al. in 2007 [25]. ^lResults for chewing and snuff are also given for all cancers and lung cancers. ^mSome limited additional results, based on follow-up to 1978, were reported by Heuch et al. in 1983 [27] for pancreatic cancer incidence and in IARC Monograph 37 in 1985 [14] for cancers of the buccal cavity/pharynx, oesophagus, pancreas and prostate. ⁿCancers listed include incident cases. ° Includes cutaneous malignant melanoma, melanoma in situ and intraocular malignant melanoma. ^pNumbers are incident cases. An analysis of overall cancer based on 1,574 deaths was also conducted. ST = smokeless tobacco.
Lee and Hamling BMC Medicine 2009 7:36 doi:10.1186/1741-7015-7-36

Table 1