Lung, Laryngeal and Other Respiratory Cancer Incidence among Japanese Atomic Bomb Survivors: An Updated Analysis from 1958 through 2009

Abstract

The Life Span Study (LSS) of Japanese atomic bomb survivors is comprised of a large, population-based cohort offering one of the best opportunities to study the relationship between exposure to radiation and incidence of respiratory cancers. Risks of lung, laryngeal and other cancers of the respiratory system were evaluated among 105,444 LSS subjects followed from 1958 to 2009. During this period, we identified 2,446 lung, 180 laryngeal and 115 other respiratory (trachea, mediastinum and other ill-defined sites) first primary incident cancer cases. Ten additional years of follow-up, improved radiation dose estimates, revised smoking data, and updated migration information were used to investigate the joint effects of radiation and smoking using Poisson regression methods. For nonsmokers, the sex-averaged excess relative risk per Gy (ERR/Gy) for lung cancer (at age 70 after radiation exposure at age 30) was estimated as 0.81 (95% CI: 0.51, 1.18) with a female-to-male ratio of 2.83. There was no evidence of curvature in the radiation dose-response relationship overall or by sex. Lung cancer risks increased with pack-years of smoking and decreased with time since quitting smoking at any level of radiation exposure. Similar to the previously reported study, which followed cohort members through 1999, the ERR/Gy for lung cancer was significantly higher for low-to-moderate smokers than for heavy smokers, with little evidence of any radiation-associated excess risk in heavy smokers. Of 2,446 lung cancer cases, 113 (5%) could be attributed to radiation exposure. Of the 1,165 lung cancer cases occurring among smokers, 886 (76%) could be attributed to smoking. While there was little evidence of a radiation effect for laryngeal cancer, a nonsignificantly elevated risk of other respiratory cancers was observed. However, significant smoking effects were observed for both laryngeal (ERR per 50 pack-years = 23.57; 95% CI: 8.44, 71.05) and other respiratory cancers (ERR per 50 pack-years = 1.21; 95% CI: 0.10, 3.25).

Radiation-Related Risk of Cancers of the Upper Digestive Tract among Japanese Atomic Bomb Survivors

“…For comparison with earlier LSS reports (4) we also show results without adjustment for smoking history and alcohol consumption. Detailed description of the smoking history data in the LSS and the form of the smoking ERR can be found elsewhere in recently published work (19,22). In brief, ERR smk was described as a function of smoking intensity (packs per day), time-dependent smoking duration, and for past smokers, years since smoking cessation with sex-and time-dependent indicators of unknown smoking status (see additional details in the Supplementary Information, http://dx.doi.…”

Risk of lung adenocarcinoma from smoking and radiation arises in distinct molecular pathways

“…In conclusion, our study answers a longstanding question on the biological origins of age-risk patterns for LADC from concomitant exposure to smoking and radiation. To describe such patterns, standard epidemiological models must inevitably rely on a vague implementation of synergistic effects, which are commonly couched in mathematical terms as either "additive" or "multiplicative" sometimes with further generalizations (8,26,27). We have shown here that MS-25 MS-26…”

Analyses of cancer incidence and other morbidities in gamma irradiated B6CF1 mice

“…Beyond standard conditions over time, conditions are likely variable across universities and countries, as well. In humans, females have been shown to be at a greater risk of lung cancer than males (54, 55). Determining the cause for changes in lung tumor sensitivity in response to ionizing radiation between male and female mice could lead to a better understanding of the radiation induction of lung tumors.…”