Lung Cancer Hazard Research Articles

Estimating impacts of reducing acrylonitrile exposure on lung cancer mortality in an occupational cohort with the parametric g-formula

ObjectivesTo inform the potential human carcinogenicity of acrylonitrile, we estimate associations between acrylonitrile exposures and lung cancer mortality in US workers with the objectives of (1) assessing potential for healthy...

Association of plasma branched-chain amino acid with multiple cancers: A mendelian randomization analysis

Studies have suggested a possible relevance between branched-chain amino acid (BCAA) catabolic enzymes and cancers. However, few studies have explored the variation in circulating concentrations of BCAAs. Our study used bi-directional, two-sample Mendelian randomization (MR) analysis for predicting the causality between the BCAA levels and 9 types of cancers. The largest genome-wide association studies (GWAS) provided data for total BCAAs, valine, leucine, and isoleucine from the UK Biobank. Data on multiple cancer endpoints were collected from various sources, such as the International Lung Cancer Consortium (ILCCO), the Pancreatic Cancer Cohort Consortium 1 (PanScan1), the Breast Cancer Association Consortium (BCAC), the FinnGen Biobank, and the Ovarian Cancer National Alliance (OCAC). The mainly analysis method was the inverse-variance-weighted (IVW). For assessing horizontal pleiotropy, the researchers performed MR-Egger regression and MR-PRESSO global test. Finally, the Cochran's Q test served for evaluating the heterogeneity. Circulating total BCAAs levels (OR 1.708, 95%CI 1.168, 2.498; p=0.006), valine levels (OR 1.747, 95%CI 1.217, 2.402; p<0.001), leucine levels (OR 1.923, 95%CI 1.279, 2.890; p=0.002) as well as isoleucine levels (OR 1.898, 95%CI 1.164, 3.094; p=0.010) positively correlated with the squamous cell lung cancer risk. Nevertheless, no compelling evidence was found to support a causal link between BCAAs and any other examined cancers. Increased circulating total-BCAAs levels, leucine levels, isoleucine levels and valine levels had higher hazard of squamous cell lung cancer. No such associations were found for BCAAs with other cancers.

Estimation Hazard of Lung Cancer Due to Radiate Radon Gas in Diyala Governorate Schools

In this research, the concentration of radon gas has been calculated in the classrooms of schools in Diyala Governorate by using the nuclear track detector (CR-39), which was one of the organic solid-state nuclear detectors (SSNTDs). After calculating the radon gas concentration, the lung cancer cases were calculated. The results showed that the lowest value was found in (Alshumue) school (4.753) people. In contrast, the highest value was found in (Habhib) school (20.421). The average values of lung cancer cases in Diyala governorate were equal to (9.319) per person. The results showed that the number of lung cancer cases per year per million persons in Diyala Governorate schools was below the allowed limit from (ICRP) agency (170-230) people.

The parallels between particle induced lung overload and particle induced periprosthetic osteolysis (PPOL).

Background: When particles deposit for instance in the lung after inhalation or in the hip joint after local release from a hip implant material they can initiate a defense response. Even though these particles originate from inert materials such as polyethylene (PE) or titanium, they may cause harm when reaching high local doses and overwhelming local defense mechanisms. Main body: This paper describes the parallels between adverse outcome pathways (AOP) and particle properties in lung overload and periprosthetic osteolysis (PPOL). It is noted that in both outcomes in different organs , the macrophage and cytokine orchestrated persistent inflammation is the common driver of events, in the bone leading to loss of bone density and structure, and in the lung leading to fibrosis and cancer. Most evidence on lung overload and its AOP is derived from chronic inhalation studies in rats, and the relevance to man is questioned. In PPOL, the paradigms and metrics are based on human clinical data, with additional insights generated from in vitro and animal studies. In both organ pathologies the total volume of particle deposition has been used to set threshold values for the onset of pathological alterations. The estimated clinical threshold for PPOL of 130 mg/ml is much higher than the amount to cause lung overload in the rat (10 mg/ml),although the threshold in PPOL is not necessarily synonymous to particle overload. Conclusions: The paradigms developed in two very different areas of particle response in the human body have major similarities in their AOP. Connecting the clinical evidence in PPOL to lung overload challenges relevance of rat inhalation studies to the human lung cancer hazard. .

A Review on Air Quality Parameters for Ambient Pollution Management Framework

Pollution is the addition of perilous substances in to the environment that creates harmful atmosphere to human and other living creatures. Pollutants are components of solids, liquids or gases specifically emitted beyond the normal threshold level of concentrations that affects the atmosphere’s quality to a considerable extent. PM is one of the common air pollutants which is a combination of suspended solid and liquid particles in the air. PM2.5 pollution is becoming a severe problem due to automation of industries and more energy consumption. Because of this, the people will be affected by breathing issues leading to in heating, ventilation, and air conditioning (HVAC) due to the requirement of air cleansing. This paper assesses and evaluates the foundations of indoor and outdoor PM2.5 and the effect of PM2.5 pollution on surrounding prominence, occupational health and residents conduct.PM2.5 mainly creates heart disease, stroke, chronic obstructive pulmonary disease, lung cancer and other main health hazards. Inhaling SO2 induces irritation to the nose, eyes, throat and lungs. When someone inhales NO2, the gas rapidly dissolves into the blood stream and hits the brain within seconds. Low amounts of O3 can cause chest pain, coughing and shortness of breath and throat infection. Further studies will forward us to a broad movement for the impact of PM2.5 towards health issues.

Radioactive Thoron 220Rn Exhalation From Unfired Mud Building Material Into Room Air of Earthen Dwellings

Thoron (220Rn), an isotope of radon with a strong α-decay energy, and its short-lived metallic progeny can pose an elevated lung cancer hazard in room air when unfired-soil derived building materials are used in earthen dwellings. Changes in moisture content and density influencing the thoron exhalation rate from earthen materials into room air were studied in the laboratory with terra rossa from a village on the Ðồng Văn Karst Plateau Geopark, Việt Nam, where ethnic minorities construct traditional dwellings with unfired terra rossa walls and floors. Our results show that the thoron exhalation rate from mud surfaces depends on (i) the content of radioactive parental nuclides in mineral components; (ii) the moisture content of mud where ∼5–10 weight % water maximizes the 220Rn exhalation rate; and (iii) the density of dry mud as primarily controlled by internal macroscopic voids, fractures, and porosity. Additional time-series of 220Rn exhalation data from an interior mud wall of a terra rossa-built house under different seasonal and weather conditions show that the temperature is influencing thoron exhalation via the water vapor pressure deficit (VPD) in air and the associated amount of atmospheric moisture adsorbed onto indoor mud surfaces. Our data suggest that occupants of “mud house” earthen dwellings in northern Việt Nam are exposed to an increased thoron geohazard during cooler weather, low VPD, and high relative humidity in air. Detailed studies are needed to evaluate the thoron geohazard for inhabitants of mud-built dwellings in other climates and geological terrains.

Study of Lung Cancer Hazard Due to Radiate Radon Gas for Two Factories in Industrial Region (Shaikh Omar) of Baghdad Governorate

During the winter, in the industry region (Shaikh Omer) and by applying a passive radon detector (CR-39), lung cancer risk has been measured in twelve rooms of different workshops of two old factories in this site. The radon concentration is ranged from (123.345 Bq/m3) to (328.985 Bq/m3) with an average of (244.19±61.52 Bq/m3). Lung cancer risk ranged from 55.993 to 149.346 per million people and with an average of (110.855 per million people) which were lower than the recommended values (170-230 per million people), so there was no cancer risk on workers in these locations.

The Effect of Time-dependent Prognostic Factors on Survival of Non-Small Cell Lung Cancer using Bayesian Extended Cox Model

Background: Lung cancer is one of the most common cancers around the world. The aim of this study was to use Extended Cox Model (ECM) with Bayesian approach to survey the behavior of potential time-varying prognostic factors of Non-small cell lung cancer.&#x0D; Materials and Methods: Survival status of all 190 patients diagnosed with Non-Small Cell lung cancer referring to hospitals in Yazd were recorded from 2009 to 2013 by phone call. We fitted conventional Cox proportional hazards (Cox PH) as well as Bayesian ECM. Inference for estimated risk ratios was based on 90% credible intervals. Log pseudo marginal likelihood criteria (LMPL) was used for model comparison. Statistical computations were based on R language.&#x0D; Results: In this study, 190 patients with non-small cell lung cancer were followed, of whom 160 died because of the disease (84.2%). Median of survival time was 8 ± 0.076 month. After fitting the Cox PH Model, it was determined that the PH assumption was not satisfied for the type of treatment, the disease stage, and pathology status variables (p &lt;0.001). LPML for Cox PH and Bayesian ECM was -431.593 and -401.01, respectively. Estimated hazard ratio curves based on Bayesian ECM showed that the risk ratio for these variables exhibited significant time varying behavior on hazard of lung cancer through follow up time.&#x0D; Conclusion: Based on LMPL, Bayesian ECM was found to have a better fit than Cox PH Model which declares, results from Cox PH should be interpreted with care. Especially, from beginning of the study to about 20 month after, very high risk ratio was estimated for variables whose PH was not satisfying for them.

Epigenetic measures of ageing predict the prevalence and incidence of leading causes of death and disease burden

BackgroundIndividuals of the same chronological age display different rates of biological ageing. A number of measures of biological age have been proposed which harness age-related changes in DNA methylation profiles. These measures include five ‘epigenetic clocks’ which provide an index of how much an individual’s biological age differs from their chronological age at the time of measurement. The five clocks encompass methylation-based predictors of chronological age (HorvathAge, HannumAge), all-cause mortality (DNAm PhenoAge, DNAm GrimAge) and telomere length (DNAm Telomere Length). A sixth epigenetic measure of ageing differs from these clocks in that it acts as a speedometer providing a single time-point measurement of the pace of an individual’s biological ageing. This measure of ageing is termed DunedinPoAm. In this study, we test the association between these six epigenetic measures of ageing and the prevalence and incidence of the leading causes of disease burden and mortality in high-income countries (n ≤ 9537, Generation Scotland: Scottish Family Health Study).ResultsDNAm GrimAge predicted incidence of clinically diagnosed chronic obstructive pulmonary disease (COPD), type 2 diabetes and ischemic heart disease after 13 years of follow-up (hazard ratios = 2.22, 1.52 and 1.41, respectively). DunedinPoAm predicted the incidence of COPD and lung cancer (hazard ratios = 2.02 and 1.45, respectively). DNAm PhenoAge predicted incidence of type 2 diabetes (hazard ratio = 1.54). DNAm Telomere Length associated with the incidence of ischemic heart disease (hazard ratio = 0.80). DNAm GrimAge associated with all-cause mortality, the prevalence of COPD and spirometry measures at the study baseline. These associations were present after adjusting for possible confounding risk factors including alcohol consumption, body mass index, deprivation, education and tobacco smoking and surpassed stringent Bonferroni-corrected significance thresholds.ConclusionsOur data suggest that epigenetic measures of ageing may have utility in clinical settings to complement gold-standard methods for disease assessment and management.

Effectiveness of intensive clinical and radiological follow-up in patients with surgically resected NSCLC. Analysis of 2661 patients from the prospective MAGRIT trial

BackgroundLimited evidence is available on effectiveness of clinicoradiological follow-up of early-stage NSCLC patients. MAGRIT was a phase III adjuvant RCT conducted in surgically resected stage IB-IIIA NSCLC patients, in which all participants had a prospectively defined intensive clinicoradiological follow-up. MethodsAt patient-level data, we analyzed detection modality of disease recurrences and new primary lung cancer (i.e. detected by clinicoradiological scheduled exams versus by interim unscheduled exams), features associated with higher risk of locoregional and/or distant recurrence, and recurrence rates over time. ResultsIn the 2261 patients studied, there was a significant association between the type of recurrence and the modality of detection: 88.4% (95% CI, 84%–91%) of the locoregional recurrences and 93.2% (95% CI, 84%–99%) of the new primary lung cancers were detected by scheduled exams, whereas this was only 68.7% (95% CI, 65%–73%) for distant metastases (p < 0.001). Survival of patients with locoregional recurrence or new primary lung cancer detected by scheduled exams was significantly better as compared with those detected by unscheduled exams (HR 0.56, 95% CI 0.36–0.87; p = 0.01). Survival was similarly poor in patients with distant recurrences, both with scheduled and unscheduled detection (3-year survival after recurrence 22.0% and 21.8%, respectively). Recurrence rate was the highest in the first 18 months after surgery—with a peak between month 6 and 12—decreasing thereafter. The hazard of a second primary lung cancer was constant over time. ConclusionIntensive follow-up is effective in detecting locoregional recurrences and second primary lung cancers, with impact on patients’ survival but did not influence the detection of distant recurrences.

Predicting the Epidemiological Dynamics of Lung Cancer in Japan.

While the prevalence of smoking has steadily declined over time, the absolute numbers of lung cancer cases and deaths have continued to increase in Japan. We employed a simple mathematical model that describes the relationship between demographic dynamics and smoking prevalence to predict future epidemiological trends of lung cancer by age and sex. Never-smokers, smokers, and ex-smokers were assumed to experience different hazard of lung cancer, and the model was parameterized using data from 2014 and before, as learning data, and a future forecast was obtained from 2015 onwards. The maximum numbers of lung cancer cases and deaths in men will be 76,978 (95% confidence interval (CI): 76,630–77,253) and 63,284 (95% CI: 62,991–63507) in 2024, while those in women will be 42,838 (95% CI: 42,601–43,095) and 32,267 (95% CI: 32,063–32,460) in 2035 and 2036, respectively. Afterwards, the absolute numbers of cases and deaths are predicted to decrease monotonically. Our compartmental modeling approach is well suited to predicting lung cancer in Japan with dynamic ageing and drastic decline in smoking prevalence. The predicted burden is useful for anticipating demands for diagnosis, treatment, and care in the healthcare sector.

Clinical and Prognostic Significance of Lupus Anticoagulant Measurement in Patients With Lung Cancer.

Lupus anticoagulants is related to both recurrent thrombosis and cancer. Thrombotic complications occur more frequently in patients with lung cancer. The aim of this study is to investigate the association of lupus anticoagulants with hypercoagulability and thrombotic complications, as well as prognostic significance of lupus anticoagulants for patients with lung cancer. The study comprised 205 patients with non–small cell lung cancer. Plasma normalized LAC ratio, D-dimer, fibrinogen, activities of antithrombin, and FVIII before treatment were analyzed by coagulation analyzer, and routine hematologic and biochemical parameters were also evaluated. In patients, normalized LAC ratio, D-dimer, fibrinogen, and procoagulant activity of coagulating factor VIII levels significantly increased, whereas antithrombin activity significantly decreased compared with healthy controls (P < .001). Normalized LAC ratio was positively correlated with D-dimer, fibrinogen, and procoagulant activity of coagulating factor VIII, and negatively correlated with antithrombin activity, respectively (P < .01). D-dimer, procoagulant activity of coagulating factor VIII, and antithrombin levels revealed statistical difference in non–deep venous thrombosis patients with elevated or normal normalized LA ratio (P < .05). The incidence of deep venous thrombosis and tumor metastasis was higher, and 1-year survival rate was lower in elevated normalized LAC ratio patients than in normal ones, respectively (P < .01). There was higher normalized LAC ratio level in patients with deep venous thrombosis and/or metastasis (P < .05). In 1-year deceased patients, normalized LAC ratio level and the incidence of deep venous thrombosis and metastasis were higher than those in survivors, respectively (P < .05). Hazard regression analysis demonstrated normalized LAC ratio was independently associated with short survival time in patients with non–small cell lung cancer (hazard regression: 2.871, 95%confidence interval: 1.704-4.835; χ2: 19.130; P < .01). Our study suggests that lupus anticoagulants is a useful marker to predict thrombotic complications and prognosis in patient with lung cancer.

Comparison of outcomes for cancer patients discussed and not discussed at a multidisciplinary meeting

ObjectivesComparison of outcomes for cancer patients discussed and not discussed at a multidisciplinary meeting (MDM). Study designRetrospective analysis of the association of MDM discussion with survival. MethodsAll newly diagnosed cancer patients from 2009 to 2012, presenting to a large regional cancer service in South West Victoria, Australia (620 colorectal, 657 breast, 593 lung and 511 haematological) were recorded and followed up to 5 years after diagnosis. Treatment patterns and survival of patients whose treatment was discussed at an MDM compared to those who were not, were explored. ResultsThe proportion of patients presented to an MDM within 60 days after diagnosis was 56% (n = 366) for breast cancer, 59% (n = 363) for colorectal cancer, 27% (n = 137) for haematological malignancies and 60% (n = 355) for lung cancer. Seventy-three percent (n = 886) of patients discussed at an MDM had their tumour stage recorded in their medical records while only 52% (n = 604) of patients not discussed had their tumour stage recorded (P < 0.01). We found for haematological and lung cancer patients that those presented to an MDM prior to treatment had a significant reduction in mortality (lung cancer hazard ratio [HR] 0.62, 95% confidence interval [CI] 0.50–0.76, P < 0.01) (haematological cancer HR 0.58, 95% CI 0.35–0.96, P = 0.03) compared to patients whose cases were not discussed at an MDM after adjusting for the potential cofounders of age, stage, comorbidities and treatment. This was not the case for colorectal and breast cancer patients where there was no significant difference. ConclusionMDM discussion has been recommended as best practice in the management of cancer patients, however, from a public health perspective this creates potential issues around access and resources. It is likely that MDM presentation patterns and outcomes across tumour streams are linked in complex ways. We believe that our data would demonstrate that these patterns differ across tumour streams and that more detailed work is required to better allocate relatively scarce and potentially costly MDM resources to tumour streams and patient groups that may get the most benefit.

Cancer risk in East Asian patients associated with acquired haemolytic anaemia: a nationwide population-based cohort study.

BackgroundThis study investigated whether patients with acquired haemolytic anaemia (AHA) would have elevated cancer risk including that for non-haematological solid tumours. We further examined whether the cancer risk would be different between patients with autoimmune type AHA (AIHA) and patients of non-AIHA.MethodsUsing nationwide population-based insurance claims data of Taiwan we identified a cohort of patients with AHA with no pre-existing cancer, (n = 3902) and a comparison cohort (n = 39020) without AHA, frequency-matched by gender, age, urbanization of residency and diagnosis date. Incidence and Cox method estimated adjusted hazard ratios (aHR) of cancers controlling covariates by the end of 2010 were calculated. Risks between patients with AIHA and non-AIHA were compared. Sensitivity analysis was carried out to measure the risk of cancer between patients with and without AHA by follow-up years.ResultsPatients with AHA had a 90 % greater incidence of cancer than controls, with an aHR of 1.78 (95 % confidence interval (CI), 1.50–2.12)]. The overall aHRs of cancer for patients with AIHA and non-AIHA were 2.01 (95 % CI, 1.56–2.59) and 1.87 (95 % CI, 1.53–2.29), respectively, compared with the comparison cohort. The aHRs for lymphatic-haematopoietic malignancy were 19.5 and 9.59 in the AIHA and non-AIHA cohorts, respectively. No hazard of colorectal, lung, liver or breast cancer was significant.ConclusionsThere is a near 2-fold elevated risk for subsequent cancer in patients with AHA, particularly for lymphatic-haematopoietic malignancy, which is much greater for patients with AIHA than non-AIHA. These findings can help clinicians decide patient-centred personalized long-term management.

Oxidative burden of fine particulate air pollution and risk of cause-specific mortality in the Canadian Census Health and Environment Cohort (CanCHEC)

BackroundFine particulate air pollution (PM2.5) is known to contribute to cardiorespiratory mortality but it is not clear how PM2.5 oxidative burden (i.e. the ability of PM2.5 to cause oxidative stress) may influence long-term mortality risk. MethodsWe examined the relationship between PM2.5 oxidative burden and cause-specific mortality in Ontario, Canada. Integrated PM2.5 samples were collected from 30 provincial monitoring sites between 2012 and 2013. The oxidative potential (% depletion/µg) of regional PM2.5 was measured as the ability of filter extracts to deplete antioxidants (glutathione and ascorbate) in a synthetic respiratory tract lining fluid. PM2.5oxidative burden was calculated as the product of PM2.5 mass concentrations and regional estimates of oxidative potential. In total, this study included 193,300 people who completed the Canadian long-form census in 1991 and who lived within 5km of a site where oxidative potential was measured. Deaths occurring between 1991 and 2009 were identified through record linkages and Cox proportional hazard models were used to estimate hazard ratios (and 95% confidence intervals) for interquartile changes in exposure adjusting for individual-level covariates and indirect-adjustment for smoking and obesity. ResultsGlutathione-related oxidative burden was associated with cause-specific mortality. For lung cancer specifically, this metric was associated with a 12% (95% CI: 5.0–19) increased risk of mortality whereas a 5.0% (95% CI: 0.1, 10) increase was observed for PM2.5. Indirect adjustment for smoking and obesity decreased the lung cancer hazard ratio for glutathione-related oxidative burden but it remained significantly elevated (HR=1.07, 95% CI: 1.005, 1.146). Ascorbate-related oxidative burden was not associated with mortality. ConclusionsOur findings suggest that glutathione-related oxidative burden may be more strongly associated with lung cancer mortality than PM2.5 mass concentrations.

Abstract 5581: A model incorporating spirometry to predict absolute risk of lung cancer: The UK Biobank prospective cohort study

Abstract Background Screening with computed tomography has been shown to reduce the rate of death from lung cancer, but at substantial cost in terms of morbidity associated with overdiagnosis. The performance of screening programs can be improved by restricting screening to those people who are at sufficiently high risk of lung cancer. We sought to develop a lung cancer risk prediction model incorporating a measure of lung function (forced expiratory volume in one second: FEV1) as well as other information that is routinely available to general practitioners. Methods We built the model using participants and data from the UK Biobank prospective cohort study, which recruited 500000 people aged 37 to 73 years between 2006-2010. Follow-up for cancer incidence and death was conducted via linkage to registries. Each participant was followed up for an average of 3 years and a maximum of 6 years. We investigated factors that are routinely available or can be easily ascertained by general practitioners: sex, variables related to smoking history and addiction to nicotine, personal medical history, and family history of lung cancer. We additionally investigated lung function, which was assessed via sprirometry as the forced expiratory volume in 1 second (FEV1, litres). Conditional on these predictors, we separately modeled the hazard of lung cancer and the hazard of death using flexible parametric survival models with age as the timescale, and combined the estimated hazards to predict the 2-year absolute risk of lung cancer. Internal validation of model discrimination was assessed by calculating the bootstrap optimism-corrected c-statistic. Results There were 738 incident lung cancer diagnoses and 3956 deaths from all causes among the UK Biobank population in the follow-up period. FEV1 at baseline was strongly and inversely associated with subsequent lung cancer risk: hazard ratios [95% confidence intervals] of 0.57 [0.43,0.77] per additional liter of FEV for never, 0.50 [0.40,0.63] for former, and 0.62 [0.48,0.80] for current smoking participants. Model discrimination was high (c-statistic 0.85) and the model is likely to discriminate well when applied to new data (bootstrap optimism-corrected c-statistic 0.83). Applying the current National Lung Screening Trial(NLST) inclusion criteria to the UK Biobank data yielded a specificity of 0.95 and sensitivity of 0.37. By applying a risk prediction model-based inclusion criteria where additional factors such as FEV1 were taken into account, we could improve the sensitivity to 0.47 for the same specificity. Conclusions Comprehensive risk prediction models based on standard risk factor information, along with FEV1, can clearly outperform currently used screening criteria in terms of specificity and sennsitivity in predicting future lung cancer diagnoses, and applying a model-based screening strategy has the potential to improve the performance of lung cancer screening programs. Citation Format: David C. Muller, Mattias Johansson, Paul Brennan. A model incorporating spirometry to predict absolute risk of lung cancer: The UK Biobank prospective cohort study. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5581. doi:10.1158/1538-7445.AM2015-5581

Study on theoretical models of regional humanity lung cancer hazards assessment.

To establish the concept of lung cancer hazard assessment theoretical models, evaluating the degree of lung cancer risk of Beijing for regional population lung cancer hazard assessment to provide a basis for technical support. ISO standards were used to classify stratified analysis for the entire population, life cycle, processes and socioeconomic management. Associated risk factors were evaluated as lung cancer hazard risk assessment first class indicators. Using the above materials, indicators were given the weight coefficients, building lung cancer risk assessment theoretical models. Regional data for Beijing were entered into the theoretical model to calculate the parameters of each indicator and evaluate the degree of local lung cancer risk. Adopting the concept of lung cancer hazard assessment and theoretical models for regional populations, we established a lung cancer hazard risk assessment system, including 2 first indicators, 8 secondary indicators and 18 third indicators. All indicators were given weight coefficients and used as information sources. Score of hazard for lung cancer was 84.4 in Beijing. Comprehensively and systematically building a lung cancer risk assessment theoretical model for regional populations in conceivable, evaluating the degree of lung cancer risk of Beijing, providing technical support and scientific basis for interventions for prevention.

Prognosis in Patients With Symptomatic Metastatic Spinal Cord Compression

A retrospective cohort study of 2321 patients consecutively admitted to one center and diagnosed with acute symptoms of metastatic spinal cord compression (MSCC). To assess the possible change in 1-year survival for patients with MSCC from year 2005 through 2010 with respect to the primary cancer diagnosis. An increasing number of patients are offered surgical treatment for MSCC. Among the reasons for this development are high evidence clinical studies, improved surgical techniques, and an increasing number of patients being treated for an oncological condition. Preoperative scoring systems are routinely used in the evaluation of these patients, and the primary oncological diagnosis is an important variable in all these systems. To our knowledge, no studies in a large group of patients have assessed the change in survival in these patients. This is of relevance because such changes in survival could have implications on the scoring systems used in the preoperative evaluation. All patients referred to the university hospital, Rigshospitalet, suspected of acute symptoms caused by spinal metastases and diagnosed with MSCC from January 1, 2005, to December 31, 2010, were included in a retrospective cohort, n = 2321. For all patients primary tumor, treatment, and 1-year survival was registered. The overall 1-year survival did not change significantly from 2005 to 2010, but there was a significant increase in 1-year survival for the subgroups of patients with lung cancer hazard ratio = 0.93 (P = 0.008, 95% CI: 0.83-0.98) and renal cancer hazard ratio = 0.77 (P = 0.004, 95% CI: 0.56-0.92). Patients with MSCC from pulmonary and renal cancers experienced improved survival in the study period. No improvement was seen for patients with other oncological diagnoses. This corresponds to reports from oncological studies and could affect preoperative scoring systems.

Pulmonary Infections and Risk of Lung Cancer Among Persons With AIDS

Lung cancer risk is significantly increased among persons with AIDS (PWA), and increased smoking may not explain all of the elevated risk, suggesting a role for additional cofactors. We investigated whether AIDS-defining pulmonary infections (recurrent pneumonia, Pneumocystis jirovecii pneumonia, and pulmonary tuberculosis) affected the risk of subsequent lung cancer over 10 years after AIDS onset among 322,675 PWA, whose records were linked with cancer registries in 11 US regions. We assessed lung cancer hazard ratios (HRs) using Cox regression and indirectly adjusted HRs for confounding by smoking. Individuals with recurrent pneumonia (n = 5317) were at significantly higher lung cancer risk than those without [HR = 1.63, 95% confidence interval (CI) = 1.08 to 2.46, adjusted for age, race, sex, HIV acquisition mode, CD4 count, and AIDS diagnosis year]. This association was especially strong among young PWA (<50 years HR = 1.99 vs. ≥50 years HR = 1.10) and was significantly elevated during 5-10 years after recurrent pneumonia diagnosis (HR = 2.41; 95% CI = 1.07 to 5.47). Although attenuated, HRs for recurrent pneumonia remained nonsignificantly elevated after indirect adjustment for smoking. Lung cancer risk was unrelated to tuberculosis [(n = 13,878) HR = 1.12, 95% CI = 0.82 to 1.53] or Pneumocystis jirovecii pneumonia [(n = 69,771) HR = 0.97, 95% CI = 0.80 to 1.18]. The increased lung cancer risk associated with recurrent pneumonia supports the hypothesis that chronic pulmonary inflammation arising from infections contributes to lung carcinogenesis.

Lung Fibrosis and Lung Cancer Incidence in Beagle Dogs that Inhaled 238PuO2 or 239PuO2

Determination of radiation protection guidelines for persons working with plutonium has been complicated by limited human data on the biological behavior and subsequent health effects from internally deposited plutonium. One solution has been the use of animal models to predict likely health effects in humans. To compare the relationships between plutonium inhalation and lung fibrosis and lung cancer, data from life-span studies of beagle dogs given a single exposure to either plutonium-238 dioxide (238PuO2) or plutonium-239 dioxide(239PuO2) were analyzed. Estimates of the cumulative hazard of lung fibrosis and lung cancer after exposure to either were generated. The hazard of lung fibrosis was not consistent with a linear no-threshold model, although the magnitude of the threshold differed by radionuclide. In dogs given 239PuO2,the best model of lung fibrosis incorporated a linear dose response function; a linear-quadratic dose-response function fit the data better in dogs given 238PuO2. At any given cumulative dose, the lung fibrosis hazard was greater for dogs given 238PuO2. In dogs given 238PuO2, with or without covariates, aquadratic dose-response function for lung cancer hazard fit better than a linear no-threshold model. In dogs given 239PuO2, models of lung cancer with the dose-response function as the sole predictor variable were consistent with a linear no-threshold model; however, a quadratic dose-response function with a cell-killing term fit better. These findings have implications for radiation protection because, while lung cancer hazard was dependent on cumulative dose, regardless of isotope, the lung fibrosis hazard depended on both cumulative dose and isotope.