Residential Radon Exposure and Cigarette Smoking in Association with Lung Cancer: A Matched Case-Control Study in Korea.

Eung Joo Park,Sang Baek Koh,Hokyou Lee,Hyeon Chang Kim,Cheol-Min Lee,Seung Soo Sheen,Dae Ryong Kang,Ki Soo Park,Nam Han Cho

doi:10.3390/ijerph17082946

Abstract

Residential radon exposure and cigarette smoking are the two most important risk factors for lung cancer. The combined effects thereof were evaluated in a multi-center matched case-control study in South Korea. A total of 1038 participants were included, comprising 519 non-small cell lung cancer cases and 519 age- and sex- matched community-based controls. Residential radon levels were measured for all participants. Multivariate logistic regression was used to calculate odds ratios (OR) for lung cancer according to radon exposure (high ≥ 100 Bq/m3 vs. low < 100 Bq/m3), smoking status, and combinations of the two after adjusting for age, sex, indoor hours, and other housing information. The median age of the participants was 64 years, and 51.3% were women. The adjusted ORs (95% confidence intervals [CIs]) for high radon and cigarette smoking were 1.56 (1.03–2.37) and 2.53 (1.60–3.99), respectively. When stratified according to combinations of radon exposure and smoking status, the adjusted ORs (95% CIs) for lung cancer in high-radon non-smokers, low-radon smokers, and high-radon smokers were 1.40 (0.81–2.43), 2.42 (1.49–3.92), and 4.27 (2.14–8.52), respectively, with reference to low-radon non-smokers. Both residential radon and cigarette smoking were associated with increased odds for lung cancer, and the difference in ORs according to radon exposure was much greater in smokers than in non-smokers.

Highlights

IntroductionThe two most important environmental contributors to lung cancer development are cigarette smoking and radon exposure
An aggressive cancer, lung cancer is the most common cause of cancer death worldwide [1].While prognoses of lung cancer at advanced stages remain disappointing [2], survival rates for early localized disease are often promising [3], early detection of lung cancer is uncommon.current preventive strategies focus on controlling environmental hazards or routine radiologic screening of individuals at high risk for lung cancer [4].The two most important environmental contributors to lung cancer development are cigarette smoking and radon exposure
confidence intervals (CI), confidence interval; odds ratios (OR), odds ratio. † Conventional logistic regression was further adjusted for age and sex. In this matched case-control study, we discovered significant associations for lung cancer with residential radon exposure, with cigarette smoking, and with combinations of the two

Summary

Introduction

The two most important environmental contributors to lung cancer development are cigarette smoking and radon exposure. The association between radon exposure and lung cancer has been widely reported [6,7,8] and the combined effect of radon and tobacco smoke is thought to be higher than additive [9,10]. Studies on the combined effect of radon and smoking on lung cancer have primarily focused on exposure to radon at high concentration sites, such as uranium mines [11,12,13].

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