Residential Radon Exposure, Histologic Types, and Lung Cancer Risk. A Case–Control Study in Galicia, Spain

Cancer Epidemiology Biomarkers and Prevention - Tập 21 Số 6 - Trang 951-958 - 2012
Juan Miguel Barros-Dios1, Alberto Ruano‐Raviña1, Mónica Pérez‐Ríos1, Margarita Castro-Bernárdez1, José Abal-Arca1, Marta Tojo-Castro1
1Authors' Affiliations: 1Department of Preventive Medicine and Public Health, University of Santiago de Compostela; 2Service of Preventive Medicine, University Hospital of Santiago de Compostela, Galician Health Service, Santiago de Compostela, Galicia; 3CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid; 4Service of Preventive Medicine, Hospital of Ourense, Ourense; 5Neumology Service, Hospital of Ourense, Ourense; and 6Spanish National Genotyping Center, Institute of Evolutionary Biology (CSIC-UPF), Universitat Pompeu Fabra, Barcelona, Spain

Tóm tắt

Abstract Background: Lung cancer is an important public health problem, and tobacco is the main risk factor followed by residential radon exposure. Recommended exposure levels have been progressively lowered. Galicia, the study area, has high residential radon concentrations. We aim (i) to assess the risk of lung cancer linked to airborne residential radon exposure, (ii) to ascertain whether tobacco modifies radon risk, and (iii) to know whether there is a lung cancer histologic type more susceptible to radon. Methods: A hospital-based case–control design was conducted in two Spanish hospitals. Consecutive cases with histologic diagnosis of lung cancer and controls undergoing trivial surgery not tobacco-related were included. Residential radon was measured using standard procedures. Results were obtained using logistic regression. Results: Three hundred and forty-nine cases and 513 controls were included. Radon exposure posed a risk even with a low exposure, with those exposed to 50 to 100 Bq/m3 having an OR of 1.87 [95% confidence interval (CI), 1.21–2.88] and of 2.21 (95% CI, 1.33–3.69) for those exposed to 148 Bq/m3 or more. Tobacco increased appreciably the risk posed by radon, with an OR of 73 (95% CI, 19.88–268.14) for heavy smokers exposed to more than 147 Bq/m3. Less frequent histologic types (including large cell carcinomas), followed by small cell lung cancer, had the highest risk associated with radon exposure. Conclusions: The presence of airborne radon even at low concentrations poses a risk of developing lung cancer, with tobacco habit increasing considerably this risk. Impact: Public health initiatives should address the higher risk of lung cancer for smokers exposed to radon. Cancer Epidemiol Biomarkers Prev; 21(6); 951–8. ©2012 AACR.

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