Epidemiology and Prevention of Lung Cancer in Nonsmokers

Brownson, Ross C.; Alavanja, Michael C.R.; Caporaso, Neil E.; Simões, Eduardo J.; Chang, Jincai

doi:10.1093/oxfordjournals.epirev.a017982

Cited by 74 publications

(61 citation statements)

References 142 publications

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“…In both these studies the number of nonsmokers was larger than that found herein. In an overview of the causes of lung cancer in nonsmokers significantly elevated odds-ratios in the range of 1.4-2.9 were found for a number of previous non-malignant lung diseases, including emphysema and pneumonia [31].…”

Section: Discussionmentioning

confidence: 97%

Risk factors for lung cancer in Iowa women: Implications for prevention

Neuberger

Mahnken

Mayo

et al. 2006

Cancer Detection and Prevention

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Background-Multiple risk factors possibly associated with lung cancer were examined as part of a large-scale residential radon case-control study conducted in Iowa between 1994 and 1997. We were particularly interested in stratifying risk factors by smoking status. Relatively little risk factor information is available for Midwestern rural women.Methods-Four hundred thirteen female lung cancer cases and 614 controls aged 40-84, who were residents of their current home for at least 20 years, were included. Risk factors examined included cigarette smoking, passive smoking, occupation, chemical exposure, previous lung disease, family history of cancer, and urban residence. Multiple logistic regression analysis was conducted after adjusting for age, education, and cumulative radon exposure.Results-As expected, active cigarette smoking was the major risk factor for lung cancer. While cessation of smoking was significantly associated with a reduced risk for lung cancer, the risk remained significantly elevated for 25 years. Among all cases, asbestos exposure was a significant risk. Among ex-smokers, pack-year history predominated as the major risk. Among never smokers, a family history of kidney or bladder cancer were significant risk factors (OR= 7.34, 95% CI = 1.91 -28.18; and 5.02, 95% CI = 1.64-15.39, respectively), as was a history of previous lung disease (OR=2.28, 95% CI=1.24-4.18) and asbestos exposure. No statistically significant increase in lung cancer risk was found for occupation or urban residence.Conclusions-Smoking prevention activities are urgently needed in rural areas of the United States. Relatives of individuals with smoking-related cancers are potentially at increased risk. Genetic risk factors should be more fully investigated in never smokers.

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Section: Discussionmentioning

confidence: 97%

Risk factors for lung cancer in Iowa women: Implications for prevention

Neuberger

Mahnken

Mayo

et al. 2006

Cancer Detection and Prevention

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“…1 Studies among nonsmokers point to an increased risk associated with pre-existing lung diseases such as tuberculosis and childhood pneumonia. 2,3 Environmental tobacco smoke (ETS) exposure has been estimated to confer an increased risk of 20 -30% in pooled analyses.…”

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confidence: 99%

Diet, reproductive factors and lung cancer risk among Chinese women in Singapore: Evidence for a protective effect of soy in nonsmokers

Seow

Poh

Teh

et al. 2001

Intl Journal of Cancer

104

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The factors associated with risk of lung cancer among nonsmokers have not been fully elucidated, but dietary factors have consistently been shown to play a role. Chinese women are unique in having a high incidence of lung cancer despite a low smoking prevalence. This population is also known to have a high intake of soy, a dietary source of phytoestrogens. We conducted a hospital-based case-control study among Singapore Chinese women, comprising 303 cases and 765 age-matched controls, of whom 176 cases and 663 controls were lifetime nonsmokers. Data on demographic background, reproductive factors and dietary intake of fruit, vegetables and soy foods were obtained by in-person interview. We observed an inverse association between intake of total, cruciferous and non-cruciferous vegetables and risk of lung cancer among smokers. Although smokers in the highest tertile of fruit intake also had a lower risk, this was not statistically significant. Higher intake of soy foods significantly reduced risk of lung cancer among lifetime nonsmokers, but not among smokers. When soy isoflavonoid intake in mg/week was computed based on frequency and portion size of intake of eight common local soy foods, the adjusted OR among nonsmokers for the highest tertile compared to the lowest was 0.56, 95% CI 0.37-0.85 (p for trend <0.01). Fruit intake was also significantly associated with reduced lung cancer risk among nonsmokers, but the effect was not significant after adjustment for soy intake. On the other hand, soy intake remained an independent predictor of risk after controlling for fruit intake. Reproductive effects were also primarily confined to lifetime nonsmokers, among whom having 3 or more livebirths (adjusted OR 0.65, 0.44 -0.96) and a menstrual cycle length of more than 30 days (OR 0.46, 0.25-0.84) accorded a significantly reduced risk of lung cancer. Place of birth was significantly associated with risk among nonsmokers (OR 2.6, 1.7-3.9 for China-born vs. local born) but not among smokers. When analysis was restricted to nonsmokers with adenocarcinomas, the dietary effects were consistent or enhanced. On stepwise regression, soy intake and cycle length emerged as the independent dietary and reproductive predictors of lung cancer risk in nonsmokers. These findings are consistent with other evidence suggesting an involvement of estrogen-related pathways in lung cancer among non-smoking women.

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“…A high consumption of green-yellow vegetables or fruits has been believed to reduce the risk of lung cancer although some β-carotene intervention studies resulted in failure. [1][2][3][4][5][6][7] It is considered that experimental mutagenesis and carcinogenesis in animals could be inhibited by a large number of compounds from edible plants, including carotenoids, polyphenols, thiols, trace metals, terpenes, tocophenols, and degradation products of glucosinolates. 1) Recently, the protective activity of vegetables and fruits has been focused on antioxidative micronutrients such as carotenoids, vitamin C, folate and others, and recent studies have been focusing on the interactions among them.…”

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confidence: 99%

“…1) Recently, the protective activity of vegetables and fruits has been focused on antioxidative micronutrients such as carotenoids, vitamin C, folate and others, and recent studies have been focusing on the interactions among them. [1][2][3][4][5][6][7][8] Some studies reported that the protective effect of vegetables and fruits was stronger among current smokers than among nonsmokers. [9][10][11] It is thought that antioxidants strongly reduce the oxidative stress due to smoking.…”

mentioning

confidence: 99%

Dietary Habits and Risk of Lung Cancer Death in a Large‐scale Cohort Study (JACC Study) in Japan by Sex and Smoking Habit

Ozasa¹,

Watanabe²,

Ito³

et al. 2001

Japanese Journal of Cancer Research

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Lung cancer has increased and is the leading cause of cancer death among Japanese males. The associations of dietary habits with the risk of lung cancer death were evaluated by sex and smoking habits in this study. In the Japan Collaborative Cohort (JACC) Study, a cohort established in 1988-90 and consisting of 42 940 males and 55 308 females was observed for lung cancer deaths up to the end of 1997. During the observation period, 446 males and 126 females died of lung cancer. A self-administered food frequency questionnaire was used as the baseline survey. Hazard ratios for dietary factors were calculated by Cox's proportional hazards model. Among males, a high intake of ham and sausages, cheese, green-leafy vegetables, oranges, and other fruits significantly and dose-dependently decreased the risk of lung cancer death. Among females, a high intake of miso-soup, ham and sausages, and liver significantly and almost dose-dependently increased the risk. Vegetables and fruits rich in antioxidative and carcinogenic agents reduced the risk of lung cancer deaths among male smokers more than among female nonsmokers. The results among female nonsmokers were partially consistent with the hypothesis that high fat consumption increases the risk of lung cancer, especially that of adenocarcinoma.

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Epidemiology and Prevention of Lung Cancer in Nonsmokers

Cited by 74 publications

References 142 publications

Risk factors for lung cancer in Iowa women: Implications for prevention

Risk factors for lung cancer in Iowa women: Implications for prevention

Diet, reproductive factors and lung cancer risk among Chinese women in Singapore: Evidence for a protective effect of soy in nonsmokers

Dietary Habits and Risk of Lung Cancer Death in a Large‐scale Cohort Study (JACC Study) in Japan by Sex and Smoking Habit

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