***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Abstract Objective To compare the hazards of cigarette smoking in men who formed their habits at different periods , and the extent of the reduction in risk when cigarette smoking is stopped at different ages . Design Prospect i ve study that has continued from 1951 to 2001 . Setting United Kingdom . Participants 34 439 male British doctors . Information about their smoking habits was obtained in 1951 , and periodically thereafter ; cause specific mortality was monitored for 50 years . Main outcome measures Overall mortality by smoking habit , considering separately men born in different periods . Results The excess mortality associated with smoking chiefly involved vascular , neoplastic , and respiratory diseases that can be caused by smoking . Men born in 1900 - 1930 who smoked only cigarettes and continued smoking died on average about 10 years younger than lifelong non-smokers . Cessation at age 60 , 50 , 40 , or 30 years gained , respectively , about 3 , 6 , 9 , or 10 years of life expectancy . The excess mortality associated with cigarette smoking was less for men born in the 19th century and was greatest for men born in the 1920s . The cigarette smoker versus non-smoker probabilities of dying in middle age ( 35 - 69 ) were 42 % ν24 % ( a twofold death rate ratio ) for those born in 1900 - 1909 , but were 43 % ν 15 % ( a threefold death rate ratio ) for those born in the 1920s . At older ages , the cigarette smoker versus non-smoker probabilities of surviving from age 70 to 90 were 10 % ν 12 % at the death rates of the 1950s ( that is , among men born around the 1870s ) but were 7 % ν 33 % ( again a threefold death rate ratio ) at the death rates of the 1990s ( that is , among men born around the 1910s ) . Conclusion A substantial progressive decrease in the mortality rates among non-smokers over the past half century ( due to prevention and improved treatment of disease ) has been wholly outweighed , among cigarette smokers , by a progressive increase in the smoker ν non-smoker death rate ratio due to earlier and more intensive use of cigarettes . Among the men born around 1920 , prolonged cigarette smoking from early adult life tripled age specific mortality rates , but cessation at age 50 halved the hazard , and cessation at age 30 avoided almost all of it CONTEXT The surgeon general estimates that more than 400,000 deaths are attributable to smoking annually in the United States . The tobacco industry has criticized the surgeon general 's estimates because they do not control for the lower educational and socioeconomic status of modern-day smokers . OBJECTIVE To determine whether controlling for education , occupation , race , alcohol consumption , and various dietary factors , in addition to age and sex , substantially alters the relative and attributable risk estimates associated with tobacco smoking . DESIGN , SETTING , AND PARTICIPANTS Nationwide American Cancer Society prospect i ve cohort study of 974 , 150 US adults aged 30 years or older , enrolled in 1982 and followed up through 1988 . ( The same study is used for the surgeon general and Centers for Disease Control and Prevention [ CDC ] estimates of smoking-attributable deaths in the United States . ) MAIN OUTCOME MEASURES Death from each of the chronic diseases considered in the CDC 's estimate of smoking-attributable mortality ( cancers of the lung , oropharynx , larynx , esophagus , pancreas , kidney , bladder , and cervix ; ischemic heart disease , arterial disease , and other heart conditions ; stroke ; chronic obstructive pulmonary disease ; and other respiratory conditions ) . Estimates adjusted for multiple covariates were compared with those adjusted for age only among current and former vs never smokers . RESULTS Adjusting for multiple covariates slightly decreased the relative and attributable risk estimates for current smoking in both men and women , but slightly increased the estimates for former smoking in women . Multivariate adjustment decreased the overall estimate of deaths attributable to smoking in the United States by approximately 1 % , from 401,109 to 396,741 per year . CONCLUSIONS Our study suggests that federal estimates of deaths caused by smoking are not substantially altered by adjustment for behavioral and demographic factors associated with smoking beyond the current adjustment for age and sex . JAMA . 2000;284:706 - Prolonged cigarette smoking causes even more deaths from other diseases than from lung cancer . In developed countries , the absolute age-sex-specific lung cancer rates can be used to indicate the approximate proportions due to tobacco of deaths not only from lung cancer itself but also , indirectly , from vascular disease and from various other categories of disease . Even in the absence of direct information on smoking histories , therefore , national mortality from tobacco can be estimated approximately just from the disease mortality statistics that are available from all major developed countries for about 1985 ( and for 1975 and so , by extrapolation , for 1995 ) . The relation between the absolute excess of lung cancer and the proportional excess of other diseases can only be approximate , and so as not to overestimate the effects of tobacco it has been taken to be only half that suggested by a recent large prospect i ve study of smoking and death among one million Americans . Application of such methods indicates that , in developed countries alone , annual deaths from smoking number about 0.9 million in 1965 , 1.3 million in 1975 , 1.7 million in 1985 , and 2.1 million in 1995 ( and hence about 21 million in the decade 1990 - 99 : 5 - 6 million European Community , 5 - 6 million USA , 5 million former USSR , 3 million Eastern and other Europe , and 2 million elsewhere , [ ie , Australia , Canada , Japan , and New Zeal and ] ) . More than half these deaths will be at 35 - 69 years of age : during the 1990s tobacco will in developed countries cause about 30 % of all deaths at 35 - 69 ( making it the largest single cause of premature death ) plus about 14 % of all at older ages . Those killed at older ages are on average already almost 80 years old , however , and might have died soon anyway , but those killed by tobacco at 35 - 69 lose an average of about 23 years of life . At present just under 20 % of all deaths in developed countries are attributed to tobacco , but this percentage is still rising , suggesting that on current smoking patterns just over 20 % of those now living in developed countries will eventually be killed by tobacco ( ie , about a quarter of a billion , out of a current total population of just under one and a quarter billion ) To examine the interrelationships of cigarette smoking , relative weight , and the occurrence of natural menopause , the authors prospect ively evaluated the experience of 66,663 female US registered nurses who were premenopausal in 1976 . Over a two-year period , 5004 women became post-menopausal . Current smokers were more likely than past or never smokers to develop menopause , although the effects of smoking diminished with age . The rate ratios of menopause for current smokers vs. never smokers ( with 95 % confidence limits ) for women aged 30 - 39 , 40 - 44 , 45 - 49 , and 50 - 55 years were 1.90 ( 1.10 - 3.28 ) , 2.16 ( 1.73 - 2.69 ) , 1.53 ( 1.41 - 1.67 ) , and 1.20 ( 1.12 - 1.28 ) . These rate ratios were not appreciably affected by adjustment for relative weight . Median ages at menopause were 52.4 for never smokers and 51.9 , 51.0 , 50.7 , and 50.4 years for women who currently smoked 1 - 14 , 15 - 24 , 25 - 34 , and 35 or more cigarettes per day . A crude linear relationship between relative weight and occurrence of menopause was observed . Comparing the leanest and heaviest quintiles , rate ratios for menopause among women aged 30 - 39 , 40 - 44 , 45 - 49 , and 50 - 55 years were 1.42 ( 0.74 - 2.75 ) , 1.26 ( 0.95 - 1.69 ) , 1.25 ( 1.13 - 1.41 ) and 1.08 ( 0.99 - 1.19 ) . The effect of relative weight was in part explained by the tendency of current smokers to weigh less than nonsmokers . After adjustment for current cigarette consumption a weak linear relationship between relative weight and menopause remained among women who smoked , although no such association was seen among nonsmokers Objective To examine the relation between body mass index ( kg/m2 ) and  cancer incidence and mortality . Design Prospect i ve cohort study . Participants 1.2 million UK women recruited into the Million Women Study , aged 50 - 64 during 1996 - 2001 , and followed up , on average , for 5.4 years for cancer incidence and 7.0 years for cancer mortality . Main outcome measures Relative risks of incidence and mortality for all cancers , and for 17 specific types of cancer , according to body mass index , adjusted for age , geographical region , socioeconomic status , age at first birth , parity , smoking status , alcohol intake , physical activity , years since menopause , and use of hormone replacement therapy . Results 45 037 incident cancers and 17 203 deaths from cancer occurred over the follow-up period . Increasing body mass index was associated with an increased incidence of endometrial cancer ( trend in relative risk per 10 units=2.89 , 95 % confidence interval 2.62 to 3.18 ) , adenocarcinoma of the oesophagus ( 2.38 , 1.59 to 3.56 ) , kidney cancer ( 1.53 , 1.27 to 1.84 ) , leukaemia ( 1.50 , 1.23 to 1.83 ) , multiple myeloma ( 1.31 , 1.04 to 1.65 ) , pancreatic cancer ( 1.24 , 1.03 to 1.48 ) , non-Hodgkin 's lymphoma ( 1.17 , 1.03 to 1.34 ) , ovarian cancer ( 1.14 , 1.03 to 1.27 ) , all cancers combined ( 1.12 , 1.09 to 1.14 ) , breast cancer in postmenopausal women ( 1.40 , 1.31 to 1.49 ) and colorectal cancer in premenopausal women ( 1.61 , 1.05 to 2.48 ) . In general , the relation between body mass index and mortality was similar to that for incidence . For colorectal cancer , malignant melanoma , breast cancer , and endometrial cancer , the effect of body mass index on risk differed significantly according to menopausal status . Conclusions Increasing body mass index is associated with a significant increase in the risk of cancer for 10 out of 17 specific types examined . Among postmenopausal women in the UK , 5 % of all cancers ( about 6000 annually ) are attributable to being overweight or obese . For endometrial cancer and adenocarcinoma of the oesophagus , body mass index represents a major modifiable risk factor ; about half of all cases in postmenopausal women are attributable to overweight or obesity In prospect i ve studies , disease rates during follow-up are typically analyzed with respect to the values of factors measured during an initial baseline survey . However , because of " regression dilution , " this generally tends to underestimate the real associations of disease rates with the " usual " levels of such risk factors during some particular exposure period . The " regression dilution ratio " describes the ratio of the steepness of the uncorrected association to that of the real association . To assess the relevance of the usual value of a risk factor during particular exposure periods ( e.g. , first , second , and third decades ) to disease risks , regression dilution ratios can be derived by relating baseline measurements of the risk factor to replicate measurements from a reasonably representative sample of study participants after an interval equivalent to about the midpoint of each exposure period ( e.g. , at 5 , 15 , and 25 years , respectively ) . This report illustrates the impact of this time interval on the magnitude of the regression dilution ratios for blood pressure and blood cholesterol . The analyses were based on biennial re measurements over 30 years for participants in the Framingham Study ( Framingham , Massachusetts ) and a 26-year resurvey for a sample of men in the Whitehall Study ( London , Engl and ) . They show that uncorrected associations of disease risk with baseline measurements underestimate the strength of the real associations with usual levels of these risk factors during the first decade of exposure by about one-third , the second decade by about one-half , and the third decade by about two-thirds . Hence , to correct appropriately for regression dilution , replicate measurements of such risk factors may be required at varying intervals after baseline for at least a sample of participants BACKGROUND Recent studies suggest that long-term cigarette smoking is associated with an increased risk of colorectal cancer .  Whether 
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CONCLUSIONS Smoking and high blood pressure , which both have effective interventions , are responsible for the largest number of deaths in the US .
Other dietary , lifestyle , and metabolic risk factors for chronic diseases also cause a substantial number of deaths in the US