Lung cancer and use of cigarettes: A french case-control study

Lung Cancer, 2(1986) 199-234

199

Elsevier

ABSTRACTS

i, PREVENTION

Lung Cancer and Use of Cigarettes: A French Case-Control Study. Benhamou, S., Benhamou, E., Tirmarche, M., Flamant, R. D e p a r t e m e n t de S t a t i s t i q u e M e d i c a l e Institut G u s t a v e Roussy, 94805 V i l l e j u i f Cedex, France. J. Natl. Cancer Inst. 74: 1169-1175, 1985. A c a s e - c o n t r o l study of 1,625 cases and 3,091 c o n t r o l s was c o n d u c t e d in France from 1976 to 1980 to compare the e f f e c t s of d i f f e r e n t smoking habits, e s p e c i a l l y the use o f filter cigarettes, t o b a c c o types (light or dark), and the use o f h a n d - r o l led or m a n u f a c t u r e d c i g a r e t t e s on the occ u r r e n c e o f lung cancer. All c a s e s h a d his t o l o g i c a l l y c o n f i r m e d lung cancer; the c o n t r o l s w e r e m a t c h e d b y sex, age, h o s p i tal of admission, and interviewer. The r e p o r t e d results c o n c e r n o n l y male nonsmokers and m a l e s who smoked (or h a d smoked) c i g a r e t t e s exclusively, i.e., a total of 1,217 K r e y b e r g I and K r e y b e r g II cancer cases and 1,915 controls. C i g a r e t te smoking w a s a s s o c i a t e d w i t h b o t h K r e y b e r g I and K r e y b e r g II cell c a t e g o r i e s a l t h o u g h w i t h d i f f e r e n t relative risks (RR) (17.2 and 3.6, resp.). W i t h i n the K r e y b e r g I category, R R w e r e s i g n i f i c a n t ly increased (P < .0001) w i t h c e r t a i n indices of d u r a t i o n and intensity of cigarette exposure, such as e a r l y age at first c i g a r e t t e smoked, d a i l y comsumption, d e p t h of inhalation, and d u r a t i o n of smoking. A s i g n i f i c a n t d i f f e r e n c e in risk was found w i t h i n the K r e y b e r g I c a t e g o r y for nonfilter versus filter c i g a r e t t e smokers (RR = 18.1 and 10.9, resp.) and dark versus light tobacco smokers (RR = 18.1 and 4.9, resp.) but not for h a n d - r o l l e d versus m a n u f a c t u r e d c i g a r e t t e smokers (RR = 19.8 16.0, resp.). W h e n all the c o v a r i a t e s were t a k e n into a c c o u n t in a m a t c h e d logistic regression, lung c a n c e r risks for nonfilter versus filter cigarette smokers was RR = 1.23, for h a n d - r o l l e d versus m a n u f a c t u r e d c i g a r e t t e users R R = 1.22, and for d a r k versus light t o b a c c o users RR = 1.94.

Protective Effect of Selenium on Lung Cancer in Smelter Workers. Gerhardsson, L., Brune, D., Nordberg, I.G. F., Wester, P.O. D e p a r t m e n t of Medicine, U n i v e r s i t y of Umea, S-901 87 Umea, Sweden. Br. J. Ind. Med. 42: 617-626, 1985. A p o s s i b l e p r o t e c t i v e effect of selen i u m against lung cancer has b e e n indicated in r e c e n t studies. W o r k e r s in copper

smelters are e x p o s e d to a c o m b i n a t i o n o f airborne s e l e n i u m and carcinogens. In this study lung tissue c o n c e n t r a t i o n s o f selenium, antimony, arsenic, cadmium, chromium, cobalt, lanthanum, and lead from 76 dead copper smelter workers were c o m p a r e d w i t h those o f 15 controls from a rural area and i0 controls from an u r b a n area. The m e a n exposure time for the d e a d workers was 31.2 years, and the m e a n r e t i r e m e n t time after the end o f exposure 7.2 years. L u n g cancer a p p e a r e d in the w o r k e r s w i t h the lowest s e l e n i u m lung tissue levels (selenium m e d i a n v a l u e 71 m u g / k g w e t weight), as comp a r e d w i t h b o t h the controls (rural group, m e d i a n value ii0; u r b a n group, m e d i a n value 136) and other causes of d e a t h among the w o r k e r s (median value 158). The q u o t i e n t between the metals and selenium was u s e d for comparison: a high q u o t i e n t i n d i c a t i n g a low p r o t e c t i v e effect of selenium and vice versa. The m e d i a n values of the quotients b e t w e e n antimony, arsenic, cadmium, lanthenum, lead, chromium, and cobalt versus selenium were all n u m e r i c a l l y higher a m o n g the cases of lung cancer, the first five s i g n i f i c a n t l y h i g h e r (p < 0.05) in 28 o f 35 c o m p a r i s o n s b e t w e e n the lung cancer group and all o t h e r groups of smelter workers and controls. The d i f f e r e n t lung m e t a l c o n c e n t r a t i o n s for each p e r s o n w e r e w e i g h t e d according to their carcinogenic p o t e n c y (Crx4 + Asx3 + Cdx2 + Sbxl + Coxl + Laxl + Pbxl) against their c o r r e s p o n d i n g s e l e n i u m concentrations. From these calculations the p r o t e c t i v e e f f e c t of selenium was even more pronounced. D i e t a r y C a r o t e n e and V i t a m i n A a n d R i s k o f Lung C a n c e r a m o n g W h i t e M e n in N e w Jersey. Ziegler, R.G., Mason, T.J., Stemhagen, A. et al. E n v i r o n m e n t a l E p i d e m i o l o g y Branch, N a t i o n a l Cancer Institute, NIH, U.S. D e p a r t m e n t of Health and Human Services, Bethesda, MD 20205, U . S . A . J . Natl. Cancer Inst. 73: 1429-1435, 1984. A p o p u l a t i o n - b a s e d incident c a s e - c o n t r o l study of lung cancer in w h i t e males was conducted during 1980-81 in six h i g h - r i s k areas of N e w Jersey. Interviews were c o m p l e t e d with 763 cases and 900 controls or w i t h their next of kin. In o r d e r to assess w h e t h e r d i e t a r y intake of carotene, p r e f o r m e d retinol, or total v i t a m i n A m o d i f i e d the risk o f lung cancer, subjects were asked about their usual freq u e n c y of consumption, several years earlier, of 44 food items, w h i c h provide 83% of the vitamin A in the A m e r i c a n diet, and about their use o f vitamin supplements. The men in the lowest q u a r t i l e of carotene intake had 1.3 the risk (P-value for trend = .05) of those in the h i g h e s t q u a r t i l e after adjustm e n ~ was m a d e for smoking d u r a t i o n and intensity and education. No a s s o c i a t i o n was seen for retinol (P-value for trend = .ii) or total vitamin A (P-value for t r e n d = .30). The inverse association b e t w e e n carotene intake and lung cancer was almost c o m p e l l i n g for squamous cell carcinoma, w i t h the

0169-5002/86/$03.30 © 1986 Elsevier Science Publishers B.V. (Biomedical Division)