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We employed this approach to investigate the associations of smoking with several cancers. The NorTwinCan study combines data from the Danish, Finnish, Norwegian and Swedish twin and cancer registries. Follow\u2010up started when smoking status was determined and ended at cancer diagnosis confirmed by information in the cancer registry, death or end of follow\u2010up. We classified the participants as never (n\u00a0=\u00a059\u2009093), former (n\u00a0=\u00a021\u2009168) or current (n\u00a0=\u00a047\u2009314) smokers. We pooled data from twin pairs where one co\u2010twin was diagnosed with any of the following tobacco\u2010related cancers: esophagus, kidney, larynx, liver, oral cavity, pancreas, pharynx or urinary bladder, while their co\u2010twin had none of those. Lung cancer was included in further analysis. We used Cox regression allowing for pair\u2010specific baseline functions to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). For tobacco\u2010related cancer sites, we recorded 7379 cases during median 27\u2009years of follow\u2010up. The analyses based on individual twins showed that former (HR 1.31, 95% CI: 1.17\u20101.48) and current (HR 2.14 [1.95\u20102.34]) smokers are at increased risk to develop one of cancers listed above, compared to never smokers. Among 109 monozygotic twin pairs discordant for cancer and smoking, the HR was 1.85 (95% CI: 1.15\u20102.98) among current smokers and 1.69 (1.00\u20102.87) among former smokers when compared to their never smoking co\u2010twin. Thus, associations of smoking with several cancers were replicated for discordant identical twin pairs. Analyses based on genetically informative data provide evidence consistent with smoking causing multiple cancers.<\/jats:p>","DOI":"10.1002\/ijc.33963","type":"journal-article","created":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T13:33:00Z","timestamp":1644499980000},"page":"33-43","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Cancer in twin pairs discordant for smoking: The Nordic Twin Study of Cancer"],"prefix":"10.1002","volume":"151","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2838-3085","authenticated-orcid":false,"given":"Tellervo","family":"Korhonen","sequence":"first","affiliation":[{"name":"Institute for Molecular Medicine Finland University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Hjelmborg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Biostatistics and Biodemography, University of Southern Denmark  Odense Denmark"},{"name":"The Danish Twin Registry University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"Harris","sequence":"additional","affiliation":[{"name":"Center for Fertility and Health The Norwegian Institute of Public Health  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Signe","family":"Clemmensen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Biostatistics and Biodemography, University of Southern Denmark  Odense Denmark"},{"name":"The Danish Twin Registry University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans\u2010Olov","family":"Adami","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Clinical Effectiveness Group Institute of Health, University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaakko","family":"Kaprio","sequence":"additional","affiliation":[{"name":"Institute for Molecular Medicine Finland University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Nordic Twin Study of Cancer (NorTwinCan) collaboration","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32203-7"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32225-6"},{"key":"e_1_2_12_4_1","volume-title":"The Cancer Atlas","author":"Jemal A","year":"2014"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2012.00268"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-011-9647-5"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-13-0568"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/thg.2019.71"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.17703"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-207921"},{"key":"e_1_2_12_11_1","volume-title":"The Health Consequences of Smoking: A Report of the Surgeon General","author":"Office of the Surgeon General (US); 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