Chapter 6: Lung Cancer in Never Smokers: Epidemiology and Risk Prediction Models

Division of Cancer Prevention & Control Research, University of California-Los Angeles, 650 Charles Young Drive, Los Angeles, CA 90095-6900, USA.
Risk Analysis (Impact Factor: 2.5). 07/2012; 32 Suppl 1(supplement 1):S69-84. DOI: 10.1111/j.1539-6924.2012.01768.x
Source: PubMed


In this chapter we review the epidemiology of lung cancer incidence and mortality among never smokers/nonsmokers and describe the never smoker lung cancer risk models used by the Cancer Intervention and Surveillance Network (CISNET) modelers. Our review focuses on those influences likely to have measurable population impact on never smoker risk, such as secondhand smoke, even though the individual-level impact may be small. Occupational exposures may also contribute importantly to the population attributable risk of lung cancer. We examine the following risk factors in this chapter: age, environmental tobacco smoke, cooking fumes, ionizing radiation including radon gas, inherited genetic susceptibility, selected occupational exposures, preexisting lung disease, and oncogenic viruses. We also compare the prevalence of never smokers between the three CISNET smoking scenarios and present the corresponding lung cancer mortality estimates among never smokers as predicted by a typical CISNET model.

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Available from: Rafael Meza, Apr 04, 2015
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    • "Lung cancer in never smokers is the seventh leading cause of cancer mortality , and therefore is a significant cause of death worldwide. The main risk factors include age, environmental tobacco exposure , cooking fumes, inherited genetic susceptibility, occupational and environmental exposure to carcinogens, hormonal factors, pre-existing lung disease and oncogenic viruses[40]. Nonsmall cell lung cancer (NSCLC) in never smokers is clinically characterised by an increased incidence in females and a higher occurrence of adenocarcinoma in comparison to NSCLC in ever smokers in both surgical patients and nonresectable advanced stage patients[41]. "
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    ABSTRACT: Lung cancer is the most frequently fatal cancer, with poor survival once the disease is advanced. Annual low-dose computed tomography has shown a survival benefit in screening individuals at high risk for lung cancer. Based on the available evidence, the European Society of Radiology and the European Respiratory Society recommend lung cancer screening in comprehensive, quality-assured, longitudinal programmes within a clinical trial or in routine clinical practice at certified multidisciplinary medical centres. Minimum requirements include: standardised operating procedures for low-dose image acquisition, computer-assisted nodule evaluation, and positive screening results and their management; inclusion/exclusion criteria; expectation management; and smoking cessation programmes. Further refinements are recommended to increase quality, outcome and cost-effectiveness of lung cancer screening: inclusion of risk models, reduction of effective radiation dose, computer-assisted volumetric measurements and assessment of comorbidities (chronic obstructive pulmonary disease and vascular calcification). All these requirements should be adjusted to the regional infrastructure and healthcare system, in order to exactly define eligibility using a risk model, nodule management and a quality assurance plan. The establishment of a central registry, including a biobank and an image bank, and preferably on a European level, is strongly encouraged.
    Full-text · Article · May 2015 · European Radiology
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    • "There is a controversy about whether there is an association between smoking and the effects of radon. Nonetheless, radon inhalation is considered the second risk factor for the development of LC [4] [5] [6] [7] [8] [9] [10]. Radon is a radioactive element, colorless, odorless, of natural origin, occurring in rocks and soil. "
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    ABSTRACT: This study correlated lung cancer (LC) mortality with statistical data obtained from government public databases. In order to asses a relationship between LC deaths and radon accumulation in dwellings, indoor radon concentrations were measured with passive detectors randomly distributed in Chihuahua City. Kriging (K) and Inverse-Distance Weighting (IDW) spatial interpolations were carried out. Deaths were georeferenced and Moran's I correlation coefficients were calculated. The mean values (over n = 171) of the interpolation of radon concentrations of deceased's dwellings were 247.8 and 217.1 Bq/m(3), for K and IDW, respectively. Through theMoran's I values obtained, correspondingly equal to 0.56 and 0.61, it was evident that LC mortality was directly associated with locations with high levels of radon, considering a stable population formore than 25 years, suggesting spatial clustering of LC deaths due to indoor radon concentrations.
    Full-text · Dataset · Sep 2014
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    • "asbestos, cooking fumes, ionizing radiation, radon gas, occupational exposure to carcinogens), current or previous medical conditions (e.g. COPD, other previous cancer, pneumonia, family history of lung cancer, and genetic susceptibility such as Single Nucleotide Polymorphisms (SNPs) at 5p15, 6p21, 15q25) (McCarthy et al. 2012; Brennan, Hainaut, and Boffetta 2011). Approximately 10– 20% of lung cancer patients have no history of tobacco smoking (Brennan, Hainaut, and Boffetta 2011). "
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    ABSTRACT: Lung cancer is among the most common and fatal malignancies worldwide, and is often diagnosed at an advanced stage. Self-assessment tools for individualised lung cancer risk could potentially refine our understanding of risk factors, and contribute to disease prevention and earlier detection, thus reducing the disease burden. The originally published algorithm of the validated Liverpool Lung Project risk prediction model for lung cancer was transformed into a web-based questionnaire called MyLungRisk (MLR, This provides a user-friendly interface for individuals aged 50–79 years to estimate their risk of developing lung cancer in the next five years. It incorporates epidemiological risk factors such as age, gender, smoking duration, family history of lung cancer, previous history of pneumonia, previous diagnosis of cancer (other than lung cancer) and exposure to asbestos. Upon the completion of the web-based questionnaire, the individual is given an estimated lung cancer risk score for the next five years with an explanation of their risk, as per 100 average people in the population. In addition, advice is provided if the individual completing the questionnaire has any current symptoms (as per UK National Institute for Health and Care guidelines). MLR is a user-friendly interface for lung cancer risk assessment, based on validated scientific modelling. It is the first of its kind to be put on a widely accessible platform to the public.
    Full-text · Article · Feb 2014 · International Journal of Health Promotion and Education
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