Abstract
Epidemiological studies on residential radon exposure and the risk of histological types of lung cancer have yielded inconsistent results. We conducted a meta-analysis on this topic and updated previous related meta-analyses. We searched the databases of Cochrane Library, Embase, PubMed, Web of Science and Chinese National Knowledge Infrastructure for papers published up to 13 November 2018. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using fixed and random effects models. Subgroup and dose‒response analyses were also conducted. This study was registered with PROSPERO (No. CRD42019127761). A total of 28 studies, which included 13,748 lung cancer cases and 23,112 controls, were used for this meta-analysis. The pooled OR indicated that the highest residential radon exposure was significantly associated with an increased risk of lung cancer (OR = 1.48, 95% CI = 1.26–1.73). All histological types of lung cancer were associated with residential radon. Strongest association with small-cell lung carcinoma (OR = 2.03, 95% CI = 1.52–2.71) was found, followed by adenocarcinoma (OR = 1.58, 95% CI = 1.31–1.91), other histological types (OR = 1.54, 95% CI = 1.11–2.15) and squamous cell carcinoma (OR = 1.43, 95% CI = 1.18–1.74). With increasing residential radon levels per 100 Bq/m3, the risk of lung cancer, small-cell lung carcinoma and adenocarcinoma increased by 11%, 19% and 13%, respectively. This meta-analysis provides new evidence for a potential relationship between residential radon and all histological types of lung cancer.
Highlights
Lung cancer is the most commonly diagnosed cancer in the world and the leading cause of death from cancer [1]
NSCLC can be divided into three predominant histological subtypes, namely, adenocarcinoma, squamous cell carcinoma and large-cell carcinoma [3,4,5]
After assessing the full text of the relevant articles, 30 studies were selected for detailed review for inclusion in the meta-analysis
Summary
Lung cancer is the most commonly diagnosed cancer in the world and the leading cause of death from cancer [1]. According to GLOBOCAN (2018), lung cancer accounted for 11.6% (2.1 million) of total cancer cases and 18.4% (1.8 million) of cancer deaths in 2018 [2]. This malignancy has a diverse histological structure. Lung cancer is generally divided into two main histological groups, namely, small-cell lung carcinoma (SCLC, approximately 15% of all lung cancers) and non-small-cell lung cancer (NSCLC, approximately 85% of all lung cancers). Contrary to NSCLC, SCLC is characterised by rapid doubling time, high growth fraction, early metastatic spread and initial responsiveness to chemotherapy and radiation [6].
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