在低收入和中等收入国家展开的流行病学研究发现了木材家庭燃烧与肺癌之间的正向关联。然而，大多数研究是回顾性的，仅有少数在美国进行，而室内木材燃烧的使用模式在美国与其他地方有所不同。我们研究了在美国全国范围的女性队列中，暴露于壁炉和火炉室内木材烟雾与肺癌的关联。我们纳入了50,226名之前未患肺癌的参与美国基于前瞻性的姐妹研究的女性。在入组时（2003-2009年），女性报告了她们最长时间居住的成年住所中使用木材炉灶和/或壁炉的频率。我们使用Cox回归来估计室内壁炉/火炉使用和发生肺癌之间的调整死亡风险比（HRadj）和95％的置信区间（CI）。肺癌是根据自我报告和医疗记录确认的。在平均11.3年的随访中，累积了347例经医学记录确认的肺癌病例。总体上，研究人群中62.3％报告她们最长时间居住的成年住所中有室内壁炉/火炉存在，20.6％报告每年≥30天的使用频率。与没有壁炉/火炉的女性相比，使用壁炉/火炉年≥30天的女性肺癌发病率升高（HRadj = 1.68；95％ CI = 1.27, 2.20）。在从未吸烟者中，对于每年使用1-29天（HRadj = 1.64；95％ CI = 0.87, 3.10）和≥30天（HRadj = 1.99；95％ CI = 1.02, 3.89），仍然观察到正向关联。在各收入阶层、美国东北部、西部或中西部地区以及城市或农村/小镇地区生活的人群中，关联也升高。我们对美国女性队列的前瞻性分析发现，增加的室内壁炉/火炉使用频率与肺癌的发病率相关，即使在从未吸烟者中也是如此。版权所有©2023。由Elsevier Ltd.出版。

Epidemiological studies conducted mostly in low- and middle-income countries have found a positive association between household combustion of wood and lung cancer. However, most studies have been retrospective, and few have been conducted in the United States where indoor wood-burning usage patterns differ. We examined the association of exposure to indoor wood smoke from fireplaces and stoves with incident lung cancer in a U.S.-wide cohort of women.We included 50,226 women without prior lung cancer participating in the U.S.-based prospective Sister Study. At enrollment (2003-2009), women reported frequency of use of wood-burning stoves and/or fireplaces in their longest-lived adult residence. Cox regression was used to estimate adjusted hazard ratios (HRadj) and 95 % confidence intervals (CI) for the association between indoor wood-burning fireplace/stove use and incident lung cancer. Lung cancer was self-reported and confirmed with medical records.During an average 11.3 years of follow-up, 347 medically confirmed lung cancer cases accrued. Overall, 62.3 % of the study population reported the presence of an indoor wood-burning fireplace/stove at their longest-lived adult residence and 20.6 % reported annual usage of ≥30 days/year. Compared to those without a wood-burning fireplace/stove, women who used their wood-burning fireplace/stove ≥30 days/year had an elevated rate of lung cancer (HRadj = 1.68; 95 % CI = 1.27, 2.20). In never smokers, positive associations were seen for use 1-29 days/year (HRadj = 1.64; 95 % CI = 0.87, 3.10) and ≥30 days/year (HRadj = 1.99; 95 % CI = 1.02, 3.89). Associations were also elevated across all income groups, in Northeastern, Western or Midwestern U.S. regions, and among those who lived in urban or rural/small town settings.Our prospective analysis of a cohort of U.S. women found that increasing frequency of wood-burning indoor fireplace/stove usage was associated with incident lung cancer, even among never smokers.Copyright © 2023. Published by Elsevier Ltd.