Lung cancer incidence among Japanese A-bomb survivors, 1950-80.

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The incidence of lung cancer during 1950-80 in a cohort of Japanese A-bomb survivors and controls was investigated. A total of 1, 057 cases were identified; 608 of these diagnoses were based on histopathological examination, and 442 were confirmed by the present investigators. The distributions of histologic types varied significantly between the sexes (p < .001), with adenocarcinoma more frequent among women and epidermoid and small cell carcinoma more frequent among men. The distributions of primary sites did not differ significantly between the sexes. The relative risk (RR) of lung cancer increased significantly with A-bomb radiation dose (p < .0001): based on tentative 1965 dose estimates as revised in 1978 (T65DR) and a linear RR model, the estimated RR at 100 rad (±s.e.) is 1.41 ± 0.09. Among Hiroshima survivors the women experienced radiation-related excess RR nearly twice as great as men (p = .06). RR increased with decreasing age at the time of bombing (ATB; p = .07), and after allowing for this effect, there was no significant evidence that RR varied systematically with attained age. Small cell carcinoma displayed somewhat greater sensitivity to radiation than did adenocarcinoma or epidermoid carcinoma; however the variation between the histology-specific RR functions was not statistically significant (p = .44).