Lung and extrathoracic cancer incidence among underground uranium miners exposed to radon progeny in the Příbram region of the Czech Republic: a case–cohort study

ObjectivesRadon is carcinogenic, but more studies are needed to understand relationships with lung cancer and extrathoracic cancers at low exposures. There are few studies evaluating associations with cancer incidence or assessing the modifying effects of smoking.MethodsWe conducted a case–cohort study with 16 434 underground uranium miners in the Czech Republic with cancer incidence follow-up 1977–1996. Associations between radon exposure and lung cancer, and extrathoracic cancer, were estimated with linear excess relative rate (ERR) models. We examined potential modifying effects of smoking, time since exposure and exposure rate.ResultsUnder a simple ERR model, assuming a 5-year exposure lag, the estimated ERR of lung cancer per 100 working level months (WLM) was 0.54 (95% CI 0.33 to 0.83) and the estimated ERR of extrathoracic cancer per 100 WLM was 0.07 (95% CI −0.17 to 0.72). Most lung cancer cases were observed among smokers (82%), and the estimated ERR of lung cancer per 100 WLM was larger among smokers (ERR/100 WLM=1.35; 95% CI 0.84 to 2.15) than among never smokers (ERR/100 WLM=0.12; 95% CI −0.05 to 0.49). Among smokers, the estimated ERR of lung cancer per 100 WLM decreased with time since exposure from 3.07 (95% CI −0.04 to 10.32) in the period 5–14 years after exposure to 1.05 (95% CI 0.49 to 1.87) in the period 25+ years after exposure.ConclusionsWe observed positive associations between cumulative radon exposure and lung cancer, consistent with prior studies. We observed a positive association between cumulative radon exposure and extrathoracic cancers, although the estimates were small. There was evidence that the association between radon and lung cancer was modified by smoking in a multiplicative or super-multiplicative fashion.

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Mortality and cancer incidence among underground uranium miners in the Czech Republic 1977–1992

Occupational and Environmental Medicine ◽

10.1136/oemed-2018-105562 ◽

2019 ◽

Vol 76 (8) ◽

pp. 511-518 ◽

Cited By ~ 3

Author(s):

Kaitlin Kelly-Reif ◽

Dale P Sandler ◽

David Shore ◽

Mary Schubauer-Berigan ◽

Melissa A Troester ◽

...

Keyword(s):

Lung Cancer ◽

Czech Republic ◽

Cancer Incidence ◽

Years Of Life Lost ◽

The Czech Republic ◽

Cancer Subtypes ◽

Uranium Miners ◽

Risk Of Mortality ◽

Mining Conditions ◽

Standardised Mortality Ratios

ObjectivesUranium miners in Příbram, Czech Republic were exposed to low and moderate levels of radon gas and other hazards. It is unknown whether these hazards increase the risk of mortality or cancer incidence when compared with the general Czech population.MethodsA cohort of 16 434 male underground miners employed underground for at least 1 year between 1946 and 1976, and alive and residing in the Czech Republic in 1977, were followed for mortality and cancer incidence through 1992. We compared observed deaths and cancer incidence to expectation based on Czech rates. Standardised mortality ratios (SMRs), standardised incidence ratios (SIRs) and causal mortality ratios were calculated.ResultsUnderground workers in the Příbram mines had higher rates of death than expected due to all causes (SMR=1.23, 95% CI 1.20 to 1.27), all cancers (SMR=1.52, 95% CI 1.44 to 1.60), lung cancer (SMR=2.12, 95% CI 1.96 to 2.28) and extrathoracic cancer (SMR=1.41, 95% CI 1.15 to 1.77). Similar excess was observed in cancer incidence analyses, with the addition of stomach cancer (SIR=1.37, 95% CI 1.11 to 1.63), liver cancer (SIR=1.70, 95% CI 1.16 to 2.25) and rectal cancer (SIR=1.41, 95% CI 1.16 to 1.66). The SIR was elevated for all leukaemias (SIR=1.51, 95% CI 1.08 to 2.07) and for lymphatic and haematopoietic cancers combined (SIR=1.31, 95% CI 1.05 to 1.61), but results for specific subtypes were imprecise. Deaths due to hazardous mining conditions resulted in 0.33 person-years of life lost per miner.ConclusionsOccupational exposure to the Příbram mines resulted in excess cancers at several sites, including sites previously linked to radon and uranium exposure. Incidence analyses showed relative excess of several additional cancer subtypes.

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Chronic obstructive pulmonary disease and lung cancer incidence in never smokers: a cohort study

Thorax ◽

10.1136/thoraxjnl-2019-213732 ◽

2020 ◽

Vol 75 (6) ◽

pp. 506-509 ◽

Cited By ~ 3

Author(s):

Hye Yun Park ◽

Danbee Kang ◽

Sun Hye Shin ◽

Kwang-Ha Yoo ◽

Chin Kook Rhee ◽

...

Keyword(s):

Lung Cancer ◽

Chronic Obstructive Pulmonary Disease ◽

Cohort Study ◽

Pulmonary Disease ◽

Cancer Incidence ◽

Chronic Obstructive ◽

Lung Cancer Incidence ◽

Obstructive Pulmonary Disease ◽

Never Smokers

There has been limited evidence for the association between chronic obstructive pulmonary disease (COPD) and the incidence of lung cancer among never smokers. We aimed to estimate the risk of lung cancer incidence in never smokers with COPD, and to compare it with the risk associated with smoking. This cohort study involved 338 548 subjects, 40 to 84 years of age with no history of lung cancer at baseline, enrolled in the National Health Insurance Service National Sample Cohort. During 2 355 005 person-years of follow-up (median follow-up 7.0 years), 1834 participants developed lung cancer. Compared with never smokers without COPD, the fully-adjusted hazard ratios (95% CI) for lung cancer in never smokers with COPD, ever smokers without COPD, and ever smokers with COPD were 2.67 (2.09 to 3.40), 1.97 (1.75 to 2.21), and 6.19 (5.04 to 7.61), respectively. In this large national cohort study, COPD was also a strong independent risk factor for lung cancer incidence in never smokers, implying that COPD patients are at high risk of lung cancer, irrespective of smoking status.

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Cancer incidence and mortality among uranium miners in the Příbram region of the Czech Republic

BIO Web of Conferences ◽

10.1051/bioconf/20191404008 ◽

2019 ◽

Vol 14 ◽

pp. 04008 ◽

Cited By ~ 1

Author(s):

Kaitlin Kelly-Reif ◽

Dale Sandler ◽

David Shore ◽

Mary Schubauer-Berigan ◽

Melissa Troester ◽

...

Keyword(s):

Czech Republic ◽

Cancer Incidence ◽

The Czech Republic ◽

Uranium Miners ◽

Incidence And Mortality

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Lung cancer incidence in the Czech Republic in 1970–1990

Lung Cancer ◽

10.1016/0169-5002(94)94008-8 ◽

1994 ◽

Vol 11 ◽

pp. 62

Keyword(s):

Lung Cancer ◽

Czech Republic ◽

Cancer Incidence ◽

Lung Cancer Incidence ◽

The Czech Republic

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Lung Cancer Incidence in the Czech Republic: A Time-Trend Study

Oncology Research and Treatment ◽

10.1159/000079091 ◽

2004 ◽

Vol 27 (4) ◽

pp. 376-379 ◽

Cited By ~ 1

Author(s):

V. Janout ◽

P. Siroky ◽

J. Novak ◽

L. Cizek ◽

H. Koukalova ◽

...

Keyword(s):

Lung Cancer ◽

Czech Republic ◽

Cancer Incidence ◽

Time Trend ◽

Lung Cancer Incidence ◽

The Czech Republic ◽

Trend Study

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Multiple air pollutant exposure and lung cancer in Tehran, Iran

Scientific Reports ◽

10.1038/s41598-021-88643-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Zahra Khorrami ◽

Mohsen Pourkhosravani ◽

Maysam Rezapour ◽

Koorosh Etemad ◽

Seyed Mahmood Taghavi-Shahri ◽

...

Keyword(s):

Lung Cancer ◽

Air Pollution ◽

Cancer Incidence ◽

Latent Profile Analysis ◽

Negative Binomial ◽

Profile Analysis ◽

Positive Association ◽

Air Pollutant ◽

World Health ◽

Lung Cancer Incidence

AbstractLung cancer is the most rapidly increasing malignancy worldwide with an estimated 2.1 million cancer cases in the latest, 2018 World Health Organization (WHO) report. The objective of this study was to investigate the association of air pollution and lung cancer, in Tehran, Iran. Residential area information of the latest registered lung cancer cases that were diagnosed between 2014 and 2016 (N = 1,850) were inquired from the population-based cancer registry of Tehran. Long-term average exposure to PM10, SO2, NO, NO2, NOX, benzene, toluene, ethylbenzene, m-xylene, p-xylene, o-xylene (BTEX), and BTEX in 22 districts of Tehran were estimated using land use regression models. Latent profile analysis (LPA) was used to generate multi-pollutant exposure profiles. Negative binomial regression analysis was used to examine the association between air pollutants and lung cancer incidence. The districts with higher concentrations for all pollutants were mostly in downtown and around the railway station. Districts with a higher concentration for NOx (IRR = 1.05, for each 10 unit increase in air pollutant), benzene (IRR = 3.86), toluene (IRR = 1.50), ethylbenzene (IRR = 5.16), p-xylene (IRR = 9.41), o-xylene (IRR = 7.93), m-xylene (IRR = 2.63) and TBTEX (IRR = 1.21) were significantly associated with higher lung cancer incidence. Districts with a higher multiple air-pollution profile were also associated with more lung cancer incidence (IRR = 1.01). Our study shows a positive association between air pollution and lung cancer incidence. This association was stronger for, respectively, p-xylene, o-xylene, ethylbenzene, benzene, m-xylene and toluene.

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Socio-Economic Position, Cancer Incidence and Stage at Diagnosis: A Nationwide Cohort Study in Belgium

Cancers ◽

10.3390/cancers13050933 ◽

2021 ◽

Vol 13 (5) ◽

pp. 933

Author(s):

Michael Rosskamp ◽

Julie Verbeeck ◽

Sylvie Gadeyne ◽

Freija Verdoodt ◽

Harlinde De Schutter

Keyword(s):

Breast Cancer ◽

Lung Cancer ◽

Cohort Study ◽

Cancer Incidence ◽

Regression Models ◽

Female Breast Cancer ◽

Stage At Diagnosis ◽

Female Breast ◽

Economic Parameters ◽

Economic Position

Background: Socio-economic position is associated with cancer incidence, but the direction and magnitude of this relationship differs across cancer types, geographical regions, and socio-economic parameters. In this nationwide cohort study, we evaluated the association between different individual-level socio-economic and -demographic factors, cancer incidence, and stage at diagnosis in Belgium. Methods: The 2001 census was linked to the nationwide Belgian Cancer Registry for cancer diagnoses between 2004 and 2013. Socio-economic parameters included education level, household composition, and housing conditions. Incidence rate ratios were assessed through Poisson regression models. Stage-specific analyses were conducted through logistic regression models. Results: Deprived groups showed higher risks for lung cancer and head and neck cancers, whereas an inverse relation was observed for malignant melanoma and female breast cancer. Typically, associations were more pronounced in men than in women. A lower socio-economic position was associated with reduced chances of being diagnosed with known or early stage at diagnosis; the strongest disparities were found for male lung cancer and female breast cancer. Conclusions: This study identified population groups at increased risk of cancer and unknown or advanced stage at diagnosis in Belgium. Further investigation is needed to build a comprehensive picture of socio-economic inequality in cancer incidence.

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