Indoor Radon and Lung Cancer in France

Baysson, Hélène; Tirmarche, M.; Tymen, G.; Gouva, S.; Caillaud, D.; Artus, J. C.; Vergnenègre, A.; Ducloy, F.; Laurier, Dominique

doi:10.1097/01.ede.0000142150.60556.b8

Cited by 62 publications

(22 citation statements)

References 31 publications

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“…This result was entirely unexpected. There have been many other reports in case-control studies of ORs below one in the low dose region but in all cases without statistical significance (Blot et al 1990;Letourneau et al 1994;Alavanja et al 1994Alavanja et al , 1999Auvinen et al 1996;Kreuzer et al 2003;Baysson et al 2004;Wichmann et al 2005;Sandler et al 2006). What reasons can be offered for this difference?…”

Section: Discussionmentioning

confidence: 99%

Case-Control Study of Lung Cancer Risk From Residential Radon Exposure in Worcester County, Massachusetts

Thompson¹,

et al. 2008

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A study of lung cancer risk from residential radon exposure and its radioactive progeny was performed with 200 cases (58% male, 42% female) and 397 controls matched on age and sex, all from the same health maintenance organization. Emphasis was placed on accurate and extensive year-long dosimetry with etch-track detectors in conjunction with careful questioning about historic patterns of in-home mobility. Conditional logistic regression was used to model the outcome of cancer on radon exposure, while controlling for years of residency, smoking, education, income, and years of job exposure to known or potential carcinogens. Smoking was accounted for by nine categories: never smokers, four categories of current smokers, and four categories of former smokers. Radon exposure was divided into six categories (model 1) with break points at 25, 50, 75, 150, and 250 Bq m, the lowest being the reference. Surprisingly, the adjusted odds ratios (AORs) were, in order, 1.00, 0.53, 0.31, 0.47, 0.22, and 2.50 with the third category significantly below 1.0 (p < 0.05), and the second, fourth, and fifth categories approaching statistical significance (p < 0.1). An alternate analysis (model 2) using natural cubic splines allowed calculating AORs as a continuous function of radon exposure. That analysis produces AORs that are substantially less than 1.0 with borderline statistical significance (0.048 < or = p < or = 0.05) between approximately 85 and 123 Bq m. College-educated subjects in comparison to high-school dropouts have a significant reduction in cancer risk after controlling for smoking, years of residency, and job exposures with AOR = 0.30 (95% CI: 0.13, 0.69), p = 0.005 (model 1).

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Section: Discussionmentioning

confidence: 99%

Case-Control Study of Lung Cancer Risk From Residential Radon Exposure in Worcester County, Massachusetts

Thompson¹,

et al. 2008

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“…Among them, most were excluded after abstract because they were occupational studies on miners, no case control studies, no relevant exposure or endpoint, and reviews. After assessing the full-text of the 38 relevant articles, we identified 22 eligible studies for meta-analysis (Blot et al, 1990;Schoenberg et al, 1990;Pershagen et al,1992Pershagen et al, , 1994Alavanja et al, 1994Alavanja et al, , 1999Létourneau et al, 1994;Auvinen et al, 1996;Ruosteenoja et al, 1996;Darby et al, 1998;Field et al, 2000;Sobue et al, 2000;Lagarde et al, 2001;Pisa et al, 2001;Barros-Dios et al, 2002;Wang et al, 2002;Baysson et al, 2004;Bochicchio et al, 2005;Wichmann et al, 2005;Sandler et al, 2006;Thompson et al, 2008;Wilcox et al, 2008). Seven studies were excluded for previous mete-analysis (Lubin and Boice, 1997;Pavia et al, 2003) and combined analysis in Europe, North America or China Darby et al, 2005;Krewski et al, 2005;Wang et al, 2005;Darby et al, 2006).…”

Section: Literature Searchmentioning

confidence: 99%

“…The number of control ranged from 35 to 4232, with a sum of 21102. Of the included studies, the majority was populationbase control, whereas three were hospital-based control (Baysson et al, 2004;Bochicchio et al, 2005;Thompson et al, 2008) and one combined population and hospital subjects as control (Darby et al, 1998). Half studies ascertained lung cancers from national/local cancer registries and the other half from hospitals.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…However, significant unexplained heterogeneity across studies and lack of subgroup and sensitivity analyses in both studies suggested the necessity for proper improvement of the meta-analysis. Furthermore, some new case-control studies, most of which found no significant effect, emerged since then (Baysson et al, 2004;Bochicchio et al, 2005;Wichmann et al, 2005;Sandler et al Thompson et al, 2008;Wilcox et al, 2008). Therefore, we systematically evaluated the association of residential radon with lung cancer risk by conducting an updated meta-analysis.…”

Section: Introductionmentioning

confidence: 99%

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Residential Radon and Lung Cancer Risk: An Updated Meta-analysis of Case-control Studies

Zhang¹,

Sun²,

Dong³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Background: Numbers of epidemiological studies assessing residential radon exposure and risk of lung cancer have yielded inconsistent results. Methods: We therefore performed a meta-analysis of relevant published casecontrol studies searched in the PubMed database through July 2011 to examine the association. The combined odds ratio (OR) were calculated using fixed-or random-effects models. Subgroup and dose-response analyses were also performed. Results: We identified 22 case-control studies of residential radon and lung cancer risk involving 13,380 cases and 21,102 controls. The combined OR of lung cancer for the highest with the lowest exposure was 1.29 (95% CI 1.10-1.51). Dose-response analysis showed that every 100 Bq/m 3 increment in residential radon exposure was associated with a significant 7% increase in lung cancer risk. Subgroup analysis displayed a more pronounced association in the studies conducted in Europe. Studies restricted to female or non-smokers demonstrated weakened associations between exposure and lung cancer. Conclusions: This metaanalysis provides new evidence supporting the conclusion that residential exposure to radon can significantly increase the risk of lung cancer in a dose-response manner.

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“…However, some studies showed a negative ERR (Blot et al 1990;Letourneau et al 1994;Kreienbrock et al 2001). In a report on indoor radon and lung cancer in France, Baysson et al (2004) claimed a small ERR. The data was compatible with a decreasing risk rather than an increasing risk (Lachet 2005).…”

Section: Radon Exposure and Relative Riskmentioning

confidence: 99%

Smoking and Hormesis as Confounding Factors in Radiation Pulmonary Carcinogenesis

Sanders

Scott

2006

Dose-Response

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ᮀ Confounding factors in radiation pulmonary carcinogenesis are passive and active cigarette smoke exposures and radiation hormesis. Significantly increased lung cancer risk from ionizing radiation at lung doses < 1 Gy is not observed in never smokers exposed to ionizing radiations. Residential radon is not a cause of lung cancer in never smokers and may protect against lung cancer in smokers. The risk of lung cancer found in many epidemiological studies was less than the expected risk (hormetic effect) for nuclear weapons and power plant workers, shipyard workers, fluoroscopy patients, and inhabitants of highdose background radiation. The protective effect was noted for low-and mixed high-and low-linear energy transfer (LET) radiations in both genders. Many studies showed a protection factor (PROFAC) > 0.40 (40% avoided) against the occurrence of lung cancer. The ubiquitous nature of the radiation hormesis response in cellular, animal, and epidemiological studies negates the healthy worker effect as an explanation for radiation hormesis. Low-dose radiation may stimulate DNA repair/apoptosis and immunity to suppress and eliminate cigarette-smoke-induced transformed cells in the lung, reducing lung cancer occurrence in smokers.

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Indoor Radon and Lung Cancer in France

Abstract: Our results support the presence of a small excess lung cancer risk associated with indoor radon exposure after precise adjustment on smoking. They are in agreement with results from some other indoor radon case-control studies and with extrapolations from studies of underground miners.

Cited by 62 publications

References 31 publications

Case-Control Study of Lung Cancer Risk From Residential Radon Exposure in Worcester County, Massachusetts

Case-Control Study of Lung Cancer Risk From Residential Radon Exposure in Worcester County, Massachusetts

Residential Radon and Lung Cancer Risk: An Updated Meta-analysis of Case-control Studies

Smoking and Hormesis as Confounding Factors in Radiation Pulmonary Carcinogenesis

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