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Cigarette smoking and the risk of nasopharyngeal carcinoma: a meta-analysis of epidemiological studies
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  • Published on:
    RE:One misinterpretation
    • Zhenming Fu, Vice Director, Consultant Oncologist Cancer Center, Renmin Hospital of Wuhan University

    We thank Mr/Ms Lin for the comments regarding our recent report (Long et al., 2017). We updated a meta-analysis on the association of smoking with NPC risk.
    We agree with Mr/Ms Lin that Lin rightly stated that his/her paper used 'mortality' as the outcome, but the authors reported 'incidence' in the meta-analysis. We have to point out that we did include some valuable articles including Lin’s regarding the mortality or morbidity of NPC to make the review more comprehensive. However, we excluded these in the summary statistics of NPC incidence. For example, we did not Include Lin’s data in Figure 2.

    We agree with Lin in that a meta-analysis of individual participant data (IPD) is needed to clarify the association between smoking and NPC. However, we do not think it is so called “a gold standard”. Instead, we recommend a novel Mendelian randomization analysis (MRA) approach. Using a gene-environment interaction and pathway analysis, we designed MRA to clarify the causal role of environmental exposures such as cigarette smoking in carcinogenesis (Fu et al 2012), because it is always difficult to address or clarify causal-effects by observational studies. We have used this strategy and clarified the causal role of red meat (Fu et al 2012) and cigarette smoking (Fu et al 2013) in pathogenesis of colorectal polyps, the precursors of colorectal cancer. This strategy was highlighted and orally presented in AACR annual meeting 2012 (...

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    Conflict of Interest:
    None declared.
  • Published on:
    One misinterpretation
    • JIAHUANG LIN, PhD student School of Public Health, The University of Hong Kong

    We appreciate this updated meta-analysis on smoking and NPC. However, one misinterpretation of our paper (Lin et al., 2015) was found.
    The paper used 'mortality' as the outcome, but the authors reported 'incidence' in this paper.
    The authors stated, the lack of individual participant data for adjustment of potential confounders. We agree that as a gold standard, a meta-analysis of individual participant data is needed to clarify the association between smoking and NPC.

    Conflict of Interest:
    None declared.