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Tóth LJ, Mokánszki A, Méhes G. The rapidly changing field of predictive biomarkers of non-small cell lung cancer. Pathol Oncol Res 2024; 30:1611733. [PMID: 38953007 PMCID: PMC11215025 DOI: 10.3389/pore.2024.1611733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 06/04/2024] [Indexed: 07/03/2024]
Abstract
Lung cancer is a leading cause of cancer-related death worldwide in both men and women, however mortality in the US and EU are recently declining in parallel with the gradual cut of smoking prevalence. Consequently, the relative frequency of adenocarcinoma increased while that of squamous and small cell carcinomas declined. During the last two decades a plethora of targeted drug therapies have appeared for the treatment of metastasizing non-small cell lung carcinomas (NSCLC). Personalized oncology aims to precisely match patients to treatments with the highest potential of success. Extensive research is done to introduce biomarkers which can predict the effectiveness of a specific targeted therapeutic approach. The EGFR signaling pathway includes several sufficient targets for the treatment of human cancers including NSCLC. Lung adenocarcinoma may harbor both activating and resistance mutations of the EGFR gene, and further, mutations of KRAS and BRAF oncogenes. Less frequent but targetable genetic alterations include ALK, ROS1, RET gene rearrangements, and various alterations of MET proto-oncogene. In addition, the importance of anti-tumor immunity and of tumor microenvironment has become evident recently. Accumulation of mutations generally trigger tumor specific immune defense, but immune protection may be upregulated as an aggressive feature. The blockade of immune checkpoints results in potential reactivation of tumor cell killing and induces significant tumor regression in various tumor types, such as lung carcinoma. Therapeutic responses to anti PD1-PD-L1 treatment may correlate with the expression of PD-L1 by tumor cells. Due to the wide range of diagnostic and predictive features in lung cancer a plenty of tests are required from a single small biopsy or cytology specimen, which is challenged by major issues of sample quantity and quality. Thus, the efficacy of biomarker testing should be warranted by standardized policy and optimal material usage. In this review we aim to discuss major targeted therapy-related biomarkers in NSCLC and testing possibilities comprehensively.
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Affiliation(s)
- László József Tóth
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Järvholm B, Hedman L, Landström M, Liv P, Burdorf A, Torén K. Changing smoking habits and the occurrence of lung cancer in Sweden-a population analysis. Eur J Public Health 2024; 34:566-571. [PMID: 38519451 PMCID: PMC11161152 DOI: 10.1093/eurpub/ckae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND The objective is to estimate the importance of the decrease of smoking habits in Sweden for the occurrence of lung cancer. METHODS The change in smoking habits in the general population was retrieved from surveys and on taxation of sale of cigarettes. We used data from the Swedish Cancer Register on incidence of lung cancer between 1970 and 2021, stratified for sex, age and cell type, and compared the occurrence overtime in ages between 40 and 84 years. RESULTS The sale of cigarettes peaked in 1980 to 1800 cigarettes per person and decreased to 600 per person in 2021. The change in incidence rates of squamous cell cancer and other cell types varied over time, sex, and age in a pattern that partly seems to be explained by change in the prevalence of daily smokers. The incidence of adenocarcinoma was similar in men and women 1970-2021 and increased, e.g. for women and men 75-79 years of age from around 20 cases in early 1970s to around 120 cases per 100 000 person-years in the 2020s. CONCLUSIONS Our data indicate that the risk of lung cancer several years after smoking cessation is less favourable than previously studies have indicated. There is a similar increase in the incidence of adenocarcinoma in men and women which is hard to explain only with changing smoking habits. The change from non-filter to filter cigarettes in the 1960s-1970s may be a contributing factor.
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Affiliation(s)
- Bengt Järvholm
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Maréne Landström
- Pathology Section, Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Per Liv
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Alex Burdorf
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - Kjell Torén
- Section of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
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3
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Zhu M, Lv J, Huang Y, Ma H, Li N, Wei X, Ji M, Ma Z, Song C, Wang C, Dai J, Tan F, Guo Y, Walters R, Millwood IY, Hung RJ, Christiani DC, Yu C, Jin G, Chen Z, Wei Q, Amos CI, Hu Z, Li L, Shen H. Ethnic differences of genetic risk and smoking in lung cancer: two prospective cohort studies. Int J Epidemiol 2023; 52:1815-1825. [PMID: 37676847 DOI: 10.1093/ije/dyad118] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND The role of genetic background underlying the disparity of relative risk of smoking and lung cancer between European populations and East Asians remains unclear. METHODS To assess the role of ethnic differences in genetic factors associated with smoking-related risk of lung cancer, we first constructed ethnic-specific polygenic risk scores (PRSs) to quantify individual genetic risk of lung cancer in Chinese and European populations. Then, we compared genetic risk and smoking as well as their interactions on lung cancer between two cohorts, including the China Kadoorie Biobank (CKB) and the UK Biobank (UKB). We also evaluated the absolute risk reduction over a 5-year period. RESULTS Differences in compositions and association effects were observed between the Chinese-specific PRSs and European-specific PRSs, especially for smoking-related loci. The PRSs were consistently associated with lung cancer risk, but stronger associations were observed in smokers of the UKB [hazard ratio (HR) 1.26 vs 1.15, P = 0.028]. A significant interaction between genetic risk and smoking on lung cancer was observed in the UKB (RERI, 11.39 (95% CI, 7.01-17.94)], but not in the CKB. Obvious higher absolute risk was observed in nonsmokers of the CKB, and a greater absolute risk reduction was found in the UKB (10.95 vs 7.12 per 1000 person-years, P <0.001) by comparing heavy smokers with nonsmokers, especially for those at high genetic risk. CONCLUSIONS Ethnic differences in genetic factors and the high incidence of lung cancer in nonsmokers of East Asian ethnicity were involved in the disparity of smoking-related risk of lung cancer.
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Affiliation(s)
- Meng Zhu
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Yanqian Huang
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Hongxia Ma
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
- Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing, China
| | - Ni Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoxia Wei
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Mengmeng Ji
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Zhimin Ma
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Ci Song
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Cheng Wang
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Juncheng Dai
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Fengwei Tan
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Guo
- Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Robin Walters
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iona Y Millwood
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
| | - David C Christiani
- Department of Environmental Health, Harvard School of Public Health, Department of Medicine, Harvard Medical School/Massachusetts General Hospital, Boston, USA
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Guangfu Jin
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Qingyi Wei
- Duke Cancer Institute, Duke University Medical Center, Durham, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, USA
| | - Christopher I Amos
- Baylor College of Medicine, Institute for Clinical and Translational Research, Houston, USA
| | - Zhibin Hu
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Hongbing Shen
- Department of Epidemiology, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
- Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing, China
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Everaert S, Schoeters G, Lardon F, Janssens A, Van Larebeke N, Raquez JM, Bervoets L, Spanoghe P. Protecting public health and the environment: towards a general ban on cellulose acetate cigarette filters in the European Union. Front Public Health 2023; 11:1282655. [PMID: 38026410 PMCID: PMC10644169 DOI: 10.3389/fpubh.2023.1282655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
After the establishment of a causal relationship between tobacco use and cancer in the 1950s, cellulose acetate filters were introduced with the claim to reduce the adverse health impact of unfiltered cigarettes. Often perceived to be more pleasant and healthy, filters encouraged smoking. However, filtered cigarettes are more deeply inhaled to obtain the same nicotine demand while altered combustion releases more tobacco-specific nitrosamines. The increasing use of cigarette filter ventilation is associated with a sharp rise in lung adenocarcinomas in recent decades. While not preventing adverse health effects, a global environmental problem has been created due to the non-biodegradable filter litter, causing ecotoxicological effects and the spread of microplastics. Recently, the Belgian Superior Health Council advised policymakers to ban cigarette filters as single-use plastics at both national and European levels. This article outlines the arguments used to justify this plea (human health and environment), the expected effects of a filter ban, as well as the public reception and reactions of the tobacco industry. The specific context of the European Union is discussed including the revision of the Single-Use Plastics Directive, affording a new opportunity to ban plastic filters. This perspective article aims to fuel the momentum and cooperation among member states for this purpose.
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Affiliation(s)
- Stijn Everaert
- Chemical Environmental Factors Group, Superior Health Council, Brussels, Belgium
| | - Greet Schoeters
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Filip Lardon
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium
| | - Annelies Janssens
- Department of Thoracic Oncology, University Hospital Antwerp, Antwerp, Belgium
| | - Nicolas Van Larebeke
- Department of Radiotherapy and Experimental Cancerology, Ghent University, Ghent, Belgium
- Department of Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jean-Marie Raquez
- Polymer and Composite Materials Department, University of Mons, Mons, Belgium
| | - Lieven Bervoets
- Department of Biology, University of Antwerp, Antwerp, Belgium
| | - Pieter Spanoghe
- Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
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5
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The Tumorigenic Effect of the High Expression of Ladinin-1 in Lung Adenocarcinoma and Its Potential as a Therapeutic Target. Molecules 2023; 28:molecules28031103. [PMID: 36770773 PMCID: PMC9919345 DOI: 10.3390/molecules28031103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 01/24/2023] Open
Abstract
The oncogenic role of Ladinin-1 (LAD1), an anchoring filament protein, is largely unknown. In this study, we conducted a series of studies on the oncogenic role of LAD1 in lung adenocarcinoma (LUAD). Firstly, we analyzed the aberrant expression of LAD1 in LUAD and its correlation with patient survival, tumor immune infiltration, and the activation of cancer signaling pathways. Furthermore, the relationship between LAD1 expression and K-Ras and EGF signaling activation, tumor cell proliferation, migration, and colony formation was studied by gene knockout/knockout methods. We found that LAD1 was frequently overexpressed in LUAD, and high LAD1 expression predicts a poor prognosis. LAD1 exhibits promoter hypomethylation in LUAD, which may contribute to its mRNA upregulation. Single-sample gene set enrichment analysis (ssGSEA) showed that acquired immunity was negatively correlated with LAD1 expression, which was verified by the downregulated GO terms of "Immunoglobulin receptor binding" and "Immunoglobulin complex circulating" in the LAD1 high-expression group through Gene Set Variation Analysis (GSVA). Notably, the Ras-dependent signature was the most activated signaling in the LAD1 high-expression group, and the phosphorylation of downstream effectors, such as ERK and c-jun, was strongly inhibited by LAD1 deficiency. Moreover, we demonstrated that LAD1 depletion significantly inhibited the proliferation, migration, and cell-cycle progression of LUAD cells and promoted sensitivity to Gefitinib, K-Ras inhibitor, and paclitaxel treatments. We also confirmed that LAD1 deficiency remarkably retarded tumor growth in the xenograft model. Conclusively, LAD1 is a critical prognostic biomarker for LUAD and has potential as an intervention target.
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Wang Q, Gümüş ZH, Colarossi C, Memeo L, Wang X, Kong CY, Boffetta P. SCLC: Epidemiology, Risk Factors, Genetic Susceptibility, Molecular Pathology, Screening, and Early Detection. J Thorac Oncol 2023; 18:31-46. [PMID: 36243387 PMCID: PMC10797993 DOI: 10.1016/j.jtho.2022.10.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/13/2022]
Abstract
We review research regarding the epidemiology, risk factors, genetic susceptibility, molecular pathology, and early detection of SCLC, a deadly tumor that accounts for 14% of lung cancers. We first summarize the changing incidences of SCLC globally and in the United States among males and females. We then review the established risk factor (i.e., tobacco smoking) and suspected nonsmoking-related risk factors for SCLC, and emphasize the importance of continued effort in tobacco control worldwide. Review of genetic susceptibility and molecular pathology suggests different molecular pathways in SCLC development compared with other types of lung cancer. Last, we comment on the limited utility of low-dose computed tomography screening in SCLC and on several promising blood-based molecular biomarkers as potential tools in SCLC early detection.
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Affiliation(s)
- Qian Wang
- University Hospitals Seidman Cancer Center, Cleveland, Ohio.
| | - Zeynep H Gümüş
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, New York; Center for Thoracic Oncology, Tisch Cancer Center, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Cristina Colarossi
- Pathology Unit, Department of Experimental Oncology, Mediterranean Institute of Oncology, Catania, Italy
| | - Lorenzo Memeo
- Pathology Unit, Department of Experimental Oncology, Mediterranean Institute of Oncology, Catania, Italy
| | - Xintong Wang
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Chung Yin Kong
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Paolo Boffetta
- Department of Family, Population & Preventive Medicine, Stony Brook University, Stony Brook, New York; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Documento de posicionamiento de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) ante las estrategias de reducción del daño del tabaco. OPEN RESPIRATORY ARCHIVES 2022. [PMID: 37497325 PMCID: PMC10369613 DOI: 10.1016/j.opresp.2022.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the last decade, the appearance of electronic cigarettes and new tobacco products (heated tobacco or smokeless tobacco) has generated a growing interest in harm reduction methods that are defined as mechanisms that seek to reduce the harmful consequences of tobacco without give up the pleasant effects of it by replacing it with these new electronic devices. However, these products are addictive and not safe as they contain nicotine. Harm reduction is a false solution as it represents a commercial strategy of the tobacco industry to increase its sales, making it difficult to control smoking, since it keeps smokers from consuming tobacco and prevents them from making serious attempts to quit. In addition, these products are a gateway to adolescents in tobacco.
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8
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Nguyen PT, Katanoda K, Saito E, Hori M, Nakayama T, Matsuda T. Trends in lung cancer incidence by gender, histological type and stage at diagnosis in Japan, 1993-2015: A multiple imputation approach. Int J Cancer 2022; 151:20-32. [PMID: 35138642 PMCID: PMC9303961 DOI: 10.1002/ijc.33962] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/21/2022] [Accepted: 01/28/2022] [Indexed: 11/08/2022]
Abstract
Continued decrease in smoking prevalence and increasing use of sensitive diagnostic procedures necessitate updated monitoring of trends in lung cancer incidence in Japan. We analyzed histology- and stage-specific trends in 1993-2015 using data from 62,870 diagnosed cases from the Monitoring of Cancer Incidence in Japan project. After applying a multiple imputation approach to impute missing/unknown values of stage and histology, we estimated age-standardized incidence rates and applied joinpoint regression analyses. We observed long-term growth trends in adenocarcinoma (ADC) and localized cancer among both genders, long-term declining trends among men and leveling-off trends among women in small-cell carcinoma (SMC) and squamous cell carcinoma (SQC). Stratifying by gender, we observed an increase in localized ADC with average annual percentage changes (AAPC) of 4.5 (95% confidence interval: 3.9 to 5.0) and 5.7 (5.0 to 6.4), a decrease in regional ADC with AAPC of -1.5 (-2.5 to -0.6) and -2.3 (-4.6 to 0.0), but an increase in distant ADC with AAPC of 1.5 (1.1 to 1.9) and 1.6 (0.9 to 2.3) among males and females, respectively. Additionally, increasing trends in female-to-male incidence rate ratios were observed in localized ADC with significantly above one in the most recent diagnosis period. Our results revealed evidence for a partial shift from advanced to early cancer stage, which may suggest the modest effectiveness of nationwide organized screening programs. The observed increasing localized and distant ADC may be linked to improved diagnostic procedures, especially for metastasis detection. Further investigation is needed for more accurate quantification of these factors.
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Affiliation(s)
- Phuong The Nguyen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.,National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kota Katanoda
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan
| | - Megumi Hori
- School of Nursing, University of Shizuoka, Shizuoka, Japan
| | - Tomio Nakayama
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Tomohiro Matsuda
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
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9
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Sung MR, Tomasini P, Le LW, Kamel-Reid S, Tsao MS, Liu G, Bradbury PA, Shepherd FA, Li JJ, Feld R, Leighl NB. Effects of Ethnicity on Outcomes of Patients With EGFR Mutation–Positive NSCLC Treated With EGFR Tyrosine Kinase Inhibitors and Surgical Resection. JTO Clin Res Rep 2022; 3:100259. [PMID: 35112092 PMCID: PMC8790496 DOI: 10.1016/j.jtocrr.2021.100259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/15/2021] [Accepted: 11/18/2021] [Indexed: 12/09/2022] Open
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10
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Kawakita D, Oze I, Iwasaki S, Matsuda T, Matsuo K, Ito H. Trends in the incidence of head and neck cancer by subsite between 1993 and 2015 in Japan. Cancer Med 2022; 11:1553-1560. [PMID: 35029329 PMCID: PMC8921930 DOI: 10.1002/cam4.4539] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/05/2021] [Accepted: 11/26/2021] [Indexed: 12/24/2022] Open
Affiliation(s)
- Daisuke Kawakita
- Division of Cancer Epidemiology and Prevention Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
- Department of Otorhinolaryngology, Head and Neck Surgery Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
| | - Shinichi Iwasaki
- Department of Otorhinolaryngology, Head and Neck Surgery Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Tomohiro Matsuda
- Division of International Collaborative Research Center for Public Health Sciences National Cancer Center Tokyo Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
- Department of Epidemiology Nagoya University Graduate School of Medicine Nagoya Japan
| | - Hidemi Ito
- Division of Cancer Information and Control Department of Preventive Medicine Aichi Cancer Center Research Institute Nagoya Japan
- Division of Descriptive Cancer Epidemiology Nagoya University Graduate School of Medicine Nagoya Japan
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11
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Okawa S, Tabuchi T, Nakata K, Morishima T, Koyama S, Odani S, Miyashiro I. Surgical volume threshold to improve 3-year survival in designated cancer care hospitals in 2004-2012 in Japan. Cancer Sci 2022; 113:1047-1056. [PMID: 34985172 PMCID: PMC8898718 DOI: 10.1111/cas.15264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/17/2021] [Accepted: 12/27/2021] [Indexed: 12/12/2022] Open
Abstract
In Japan, cancer care hospitals designated by the national government have a surgical volume requirement of 400 annually, which is not necessarily defined based on patient outcomes. This study aimed to estimate surgical volume thresholds that ensure optimal 3‐year survival for three periods. In total, 186 965 patients who had undergone surgery for solid cancers in 66 designated cancer care hospitals in Osaka between 2004 and 2012 were examined using data from a population‐based cancer registry. These hospitals were categorized by the annual surgical volume of each 50 surgeries (eg, 0‐49, 50‐99, and so on). Using multivariable Cox proportional hazard regression, we estimated the adjusted 3‐year survival probability per surgical volume category for 2004‐2006, 2007‐2009, and 2010‐2012. Using the joinpoint regression model that computes inflection points in a linear relationship, we estimated the points at which the trend of the association between surgical volume and survival probability changes, defining them as surgical volume thresholds. The adjusted 3‐year survival ranges were 71.7%‐90.0%, 68.2%‐90.0%, and 79.2%‐90.3% in 2004‐2006, 2007‐2009, and 2010‐2012, respectively. The surgical volume thresholds were identified at 100‐149 in 2004‐2006 and 2007‐2009 and 200‐249 in 2010‐2012. The extents of change in the adjusted 3‐year survival probability per increase of 50 surgical volumes were +4.00%, +6.88%, and +1.79% points until the threshold and +0.41%, +0.30%, and +0.11% points after the threshold in 2004‐2006, 2007‐2009, and 2010‐2012, respectively. The existing surgical volume requirements met our estimated thresholds. Surgical volume thresholds based on the association with patient survival may be used as a reference to validate the surgical volume requirement.
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Affiliation(s)
- Sumiyo Okawa
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan.,Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | | | - Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Satomi Odani
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Green DS, Tongue ADW, Boots B. The ecological impacts of discarded cigarette butts. Trends Ecol Evol 2021; 37:183-192. [PMID: 34690005 DOI: 10.1016/j.tree.2021.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/23/2021] [Accepted: 10/01/2021] [Indexed: 12/21/2022]
Abstract
Cigarette butts, one of the most littered items globally, present a unique challenge to ecosystems due to their ubiquity, persistence, and potential for harm. Over 35 studies have examined the toxicity of cigarette butts in biota from aquatic and terrestrial habitats from microbes to mice, but many organisms and habitats have not been tested. Two-thirds of studies are on aquatic organisms, and lethal effects were common. Research on the impacts on terrestrial life is lagging behind. Cigarette butts can affect the growth, behaviour, and reproductive output of individual organisms in all three habitats, but research on wider effects on biodiversity and ecosystem functioning is lacking. Here, we summarise the ecotoxicological concerns and identify important knowledge gaps for future research.
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Affiliation(s)
- Dannielle S Green
- Applied Ecology Research Group, School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1PT, UK.
| | - Andrew D W Tongue
- Applied Ecology Research Group, School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Bas Boots
- Applied Ecology Research Group, School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1PT, UK
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Wang B, Hamal P, Meng X, Sun K, Yang Y, Sun Y, Sun X. Evaluation of the Radiomics Method for the Prediction of Atypical Adenomatous Hyperplasia in Patients With Subcentimeter Pulmonary Ground-Glass Nodules. Front Oncol 2021; 11:698053. [PMID: 34422651 PMCID: PMC8374940 DOI: 10.3389/fonc.2021.698053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/16/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives We aimed to develop a prediction model to distinguish atypical adenomatous hyperplasia (AAH) from early lung adenocarcinomas in patients with subcentimeter pulmonary ground-glass nodules (GGNs), which may help avoid aggressive surgical resection for patients with AAH. Methods Surgically confirmed cases of AAH and lung adenocarcinomas manifesting as GGNs of less than 1 cm were retrospectively collected. A prediction model based on radiomics and clinical features identified from a training set of cases was built to differentiate AAH from lung adenocarcinomas and tested on a validation set. Results Four hundred and eighty-five eligible cases were included and randomly assigned to the training (n = 339) or the validation sets (n = 146). The developed radiomics prediction model showed good discrimination performance to distinguish AAH from adenocarcinomas in both the training and the validation sets, with, respectively, 84.1% and 82.2% of accuracy, and AUCs of 0.899 (95% CI: 0.867–0.931) and 0.881 (95% CI: 0.827–0.936). Conclusion The prediction model based on radiomics and clinical features can help differentiate AAH from adenocarcinomas manifesting as subcentimeter GGNs and may prevent aggressive resection for AAH patients, while reserving this treatment for adenocarcinomas.
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Affiliation(s)
- Bin Wang
- Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Preeti Hamal
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xue Meng
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ke Sun
- Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yang Yang
- Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yangyang Sun
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiwen Sun
- Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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Santos-Echeandía J, Zéler A, Gago J, Lacroix C. The role of cigarette butts as vectors of metals in the marine environment: Could it cause bioaccumulation in oysters? JOURNAL OF HAZARDOUS MATERIALS 2021; 416:125816. [PMID: 34492782 DOI: 10.1016/j.jhazmat.2021.125816] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 06/13/2023]
Abstract
Tobacco is a well-documented threat to human health. However, its environmental impact has only recently been considered. Metals can interact with cigarette butts (CBs) being transported in the marine environment and reaching organisms. To understand this mechanism, a series of metal(loid)s were analyzed in cigarette filters (virgin, artificially smoked, leached in seawater and aged in beach and harbour) as well as in artificially contaminated oyster tissues. Smoked filters showed higher levels of metals compared to the virgin ones showing enrichment factors up to 90, probably associated with tobacco metal content. Once the CBs are delivered to the environment, metals can be leached to seawater until reaching equilibrium, which may be dependent on initial metal levels in the water. Copper was the element with the highest percentage of desorption (91 ± 3%) while strontium showed the lowest percentage (40 ± 0%). CBs revealed a great capacity to accumulate metals from the environment when weathered in contaminated areas. A chemical impact derived from CBs contamination might exist as they serve as a carrier for metals in the marine environment. The release of metals from CBs or the ingestion of metal loaded CBs may pose a toxicological risk for marine organisms via accumulation in their tissues.
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Affiliation(s)
- Juan Santos-Echeandía
- Instituto Español de Oceanografía (IEO), Centro Oceanográfico de Vigo, Subida a Radio Faro, 50-52, Vigo 36390, Spain.
| | - Aurore Zéler
- Centre of Documentation, Research and Experimentation on Accidental Water Pollution (Cedre), 715 rue Alain Colas, CS 41836, Brest Cedex 2 29218, France
| | - Jesús Gago
- Instituto Español de Oceanografía (IEO), Centro Oceanográfico de Vigo, Subida a Radio Faro, 50-52, Vigo 36390, Spain
| | - Camille Lacroix
- Centre of Documentation, Research and Experimentation on Accidental Water Pollution (Cedre), 715 rue Alain Colas, CS 41836, Brest Cedex 2 29218, France
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Cancer incidence and mortality trends in France over 1990-2018 for solid tumors: the sex gap is narrowing. BMC Cancer 2021; 21:726. [PMID: 34167516 PMCID: PMC8223369 DOI: 10.1186/s12885-021-08261-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/22/2021] [Indexed: 01/05/2023] Open
Abstract
Objective To analyze trends in cancer incidence and mortality (France, 1990–2018), with a focus on men-women disparities. Methods Incidence data stemmed from cancer registries (FRANCIM) and mortality data from national statistics (CépiDc). Incidence and mortality rates were modelled using bidimensional penalized splines of age and year (at diagnosis and at death, respectively). Trends in age-standardized rates were summarized by the average annual percent changes (AAPC) for all-cancers combined, 19 solid tumors, and 8 subsites. Sex gaps were indicated using male-to-female rate ratios (relative difference) and male-to-female rate differences (absolute difference) in 1990 and 2018, for incidence and mortality, respectively. Results For all-cancers, the sex gap narrowed over 1990–2018 in incidence (1.6 to 1.2) and mortality (2.3 to 1.7). The largest decreases of the male-to-female incidence rate ratio were for cancers of the lung (9.5 to 2.2), lip - oral cavity - pharynx (10.9 to 3.1), esophagus (12.6 to 4.5) and larynx (17.1 to 7.1). Mixed trends emerged in lung and oesophageal cancers, probably explained by differing risk factors for the two main histological subtypes. Sex incidence gaps narrowed due to increasing trends in men and women for skin melanoma (0.7 to 1, due to initially higher rates in women), cancers of the liver (7.4 to 4.4) and pancreas (2.0 to 1.4). Sex incidence gaps narrowed for colon-rectum (1.7 to 1.4), urinary bladder (6.9 to 6.1) and stomach (2.7 to 2.4) driven by decreasing trends among men. Other cancers showed similar increasing incidence trends in both sexes leading to stable sex gaps: thyroid gland (0.3 to 0.3), kidney (2.2 to 2.4) and central nervous system (1.4 to 1.5). Conclusion In France in 2018, while men still had higher risks of developing or dying from most cancers, the sex gap was narrowing. Efforts should focus on avoiding risk factors (e.g., smoking) and developing etiological studies to understand currently unexplained increasing trends. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08261-1.
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Katanoda K, Hori M, Saito E, Shibata A, Ito Y, Minami T, Ikeda S, Suzuki T, Matsuda T. Updated Trends in Cancer in Japan: Incidence in 1985-2015 and Mortality in 1958-2018-A Sign of Decrease in Cancer Incidence. J Epidemiol 2021; 31:426-450. [PMID: 33551387 PMCID: PMC8187612 DOI: 10.2188/jea.je20200416] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Unlike many North American and European countries, Japan has observed a continuous increase in cancer incidence over the last few decades. We examined the most recent trends in population-based cancer incidence and mortality in Japan. Methods National cancer mortality data between 1958 and 2018 were obtained from published vital statistics. Cancer incidence data between 1985 and 2015 were obtained from high-quality population-based cancer registries maintained by three prefectures (Yamagata, Fukui, and Nagasaki). Trends in age-standardized rates (ASR) were examined using Joinpoint regression analysis. Results For males, all-cancer incidence increased between 1985 and 1996 (annual percent change [APC] +1.1%; 95% confidence interval [CI], 0.7–1.5%), increased again in 2000–2010 (+1.3%; 95% CI, 0.9–1.8%), and then decreased until 2015 (−1.4%; 95% CI, −2.5 to −0.3%). For females, all-cancer incidence increased until 2010 (+0.8%; 95% CI, 0.6–0.9% in 1985–2004 and +2.4%; 95% CI, 1.3–3.4% in 2004–2010), and stabilized thereafter until 2015. The post-2000 increase was mainly attributable to prostate in males and breast in females, which slowed or levelled during the first decade of the 2000s. After a sustained increase, all-cancer mortality for males decreased in 1996–2013 (−1.6%; 95% CI, −1.6 to −1.5%) and accelerated thereafter until 2018 (−2.5%; 95% CI, −2.9 to −2.0%). All-cancer mortality for females decreased intermittently throughout the observation period, with the most recent APC of −1.0% (95% CI, −1.1 to −0.9%) in 2003–2018. The recent decreases in mortality in both sexes, and in incidence in males, were mainly attributable to stomach, liver, and male lung cancers. Conclusion The ASR of all-cancer incidence began decreasing significantly in males and levelled off in females in 2010.
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Affiliation(s)
- Kota Katanoda
- Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center
| | - Megumi Hori
- Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center
| | - Eiko Saito
- Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center
| | - Akiko Shibata
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University
| | - Tetsuji Minami
- Department of Cancer Epidemiology, Division of Social Medicine, Graduate School of Medicine, The University of Tokyo.,Division of Prevention, Center for Public Health Sciences, National Cancer Center
| | - Sayaka Ikeda
- Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center.,Department of Society and Environmental Medicine, Osaka University
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital
| | - Tomohiro Matsuda
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center
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Lei L, Huang A, Cai W, Liang L, Wang Y, Liu F, Peng J. Spatial and Temporal Analysis of Lung Cancer in Shenzhen, 2008-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010026. [PMID: 33375213 PMCID: PMC7793115 DOI: 10.3390/ijerph18010026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/19/2020] [Accepted: 12/20/2020] [Indexed: 02/05/2023]
Abstract
Lung cancer is the most commonly diagnosed cancer in China. The incidence trend and geographical distribution of lung cancer in southern China have not been reported. The present study explored the temporal trend and spatial distribution of lung cancer incidence in Shenzhen from 2008 to 2018. The lung cancer incidence data were obtained from the registered population in the Shenzhen Cancer Registry System between 2008 and 2018. The standardized incidence rates of lung cancer were analyzed by using the joinpoint regression model. The Moran's I method was used for spatial autocorrelation analysis and to further draw a spatial cluster map in Shenzhen. From 2008 to 2018, the average crude incidence rate of lung cancer was 27.1 (1/100,000), with an annual percentage change of 2.7% (p < 0.05). The largest average proportion of histological type of lung cancer was determined as adenocarcinoma (69.1%), and an increasing trend was observed in females, with an average annual percentage change of 14.7%. The spatial autocorrelation analysis indicated some sites in Shenzhen as a high incidence rate spatial clustering area. Understanding the incidence patterns of lung cancer is useful for monitoring and prevention.
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Affiliation(s)
- Lin Lei
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
| | - Anyan Huang
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou 515065, China
| | - Weicong Cai
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
| | - Ling Liang
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
| | - Yirong Wang
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
| | - Fangjiang Liu
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
| | - Ji Peng
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
- Correspondence: ; Tel.: +86-13602658282
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18
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Kudwongsa W, Promthet S, Suwanrungruang K, Phunmanee A, Vatanasapt P. Coffee Consumption and Lung Cancer Risk: A Prospective Cohort Study in Khon Kaen Thailand. Asian Pac J Cancer Prev 2020; 21:2367-2371. [PMID: 32856867 PMCID: PMC7771955 DOI: 10.31557/apjcp.2020.21.8.2367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Lung cancer is a major cause of cancer death worldwide. The incidence of lung cancer in Thailand increasing, but risk factors are rarely reported. Objective: To investigate the effect of coffee consumption on lung cancer in Thai population. Methods: Between 1990 and 2001, lifestyle and demographic data were collected from 24,528 participants in the Khon Kaen Cohort Study (KKCS), who were followed through 2016, by linking to the Khon Kaen Population-based Cancer Registry. A total of 12,668 eligible participants (68.8% females, mean age 51.0 years at baseline) having complete datasets (239,488 person-years of follow up with 138 incident cases of lung cancer observed) were analyzed using a multi-variable adjusted Cox proportional hazard models. Results: Coffee consumption was associated with reduced risk for lung cancer (adj. HR = 0.54; 95% CI: 0.35-0.84) after adjusting for age and gender. Cigarette smoking (adj. HR = 2.76; 95% CI: 1.32-5.78) and family history of cancer (adj. HR = 1.65; 95% CI: 1.10-2.48) were associated with higher risk. Conclusion: This study suggests coffee consumption may be a protective factor for lung cancer in among this cohort.
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Affiliation(s)
- Wongklang Kudwongsa
- Doctor of Philosophy Program in Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.,ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen, Thailand
| | - Supannee Promthet
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen, Thailand
| | - Krittika Suwanrungruang
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen, Thailand.,Cancer Registry Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Anakapong Phunmanee
- Division of Pulmonology and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Patravoot Vatanasapt
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen, Thailand.,Cancer Registry Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Usui Y, Ito H, Koyanagi Y, Shibata A, Matsuda T, Katanoda K, Maeda Y, Matsuo K. Changing trend in mortality rate of multiple myeloma after introduction of novel agents: A population-based study. Int J Cancer 2020; 147:3102-3109. [PMID: 32506433 DOI: 10.1002/ijc.33135] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/28/2020] [Indexed: 11/07/2022]
Abstract
Previously, the main treatment for multiple myeloma (MM) was cytotoxic chemotherapies, including autologous stem-cell transplantation (ASCT), but survival benefit in the elderly was limited. More recently, clinical trials and practical experience with novel agents with superior efficacy have shown improved survival, including in the elderly. However, this improvement cannot be simply interpreted as a decline in mortality rate that is an important public health measure of progress against cancer. Here, we assessed the trends in mortality rates of MM in parallel with incidence rates in Japan and the U.S. We used national mortality data and population-based cancer registry data in both countries from 1995 to 2015, during which 74 972 patients in Japan and 229 290 patients in the U.S. died of MM. Trends in mortality and incidence rates were characterized using joinpoint regression analysis. Despite upward trends in incidence, mortality rates showed a significant decrement after 2005 in Japan, with an annual percent change [APC (95% confidence interval)] of -2.5% (-2.9% to -2.1%), and after 2002 in the U.S., with an APC of -2.0% (-2.6% to -1.5%). In both countries, the change in mortality trend coincided with the introduction of the novel agents. Moreover, improvements in mortality were particularly large in patients aged 70 to 79 years, who cannot receive ASCT. Our results indicate that the benefits of novel agents for MM are appreciable at the population level and may encourage further development of novel agents for malignancies that can be widely applied to the patients.
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Affiliation(s)
- Yoshiaki Usui
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center, Nagoya, Japan
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceuticals Sciences, Okayama, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center, Nagoya, Japan
- Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuriko Koyanagi
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center, Nagoya, Japan
| | - Akiko Shibata
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Tomohiro Matsuda
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Kota Katanoda
- Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Yoshinobu Maeda
- Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceuticals Sciences, Okayama, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center, Nagoya, Japan
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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20
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Granda-Orive JID, Solano-Reina S, de Granda-Beltrán C, Jiménez-Ruiz CA. Talking About Cigarette Filters. OPEN RESPIRATORY ARCHIVES 2020. [DOI: 10.1016/j.opresp.2020.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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21
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Poorolajal J, Assari MJ, Mohammadi Y, Gohari-Ensaf F. Impact of cigarettes’ filter length and diameter on cigarette smoke emissions. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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22
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Sun Y, Wang B, Bi K, Meng X, Zhang L, Sun X. The combined nomogram based on the CT features may be used as a complementary method of frozen sections to predict invasive lung adenocarcinoma manifesting as ground-glass nodules. J Thorac Dis 2020; 12:2361-2371. [PMID: 32642141 PMCID: PMC7330398 DOI: 10.21037/jtd.2020.03.75] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Frozen sections (FS) deferral sometimes occurs in the intraoperative pathological classification of early lung adenocarcinoma, which is not conducive to the decision-making of surgical treatment. Here, we compared the predictive performance of the combined nomogram based on the computer tomography (CT) features with FS to investigate whether the nomogram could be used as a complementary method for FS when FS deferral occurs to predict invasive adenocarcinoma (IAC) manifesting as ground-glass nodules (GGNs) during surgery. Methods In this study, 205 early lung adenocarcinomas manifesting as GGNs from 178 patients who had undergone surgical treatment were included and divided into a training set (n=123) and a validation set (n=82). The training set defined a hybrid nomogram incorporating CT features and intraoperative measured tumor size based on multivariate logistic regression to predict IAC, and the validation set was used to verified the predictive performance. We also collected the diagnostic results of FS and compared the predictive performance of the established nomogram with FS. Results The accuracy of combined nomogram in predicting IAC in the training and validation sets was 91.1% and 89.0%, respectively, and the predictive accuracy of FS in the training set and validation set was 87.0% and 86.6%, respectively. The predictive accuracy between the combined nomogram and FS have no significant difference. Conclusions Compared with FS, the performance of the combined nomogram in predicting the lung IAC manifesting as GGNs is satisfactory, which has the potential to be used as a complementary method for FS when FS deferrals during surgery.
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Affiliation(s)
- Yangyang Sun
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Bin Wang
- Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Ke Bi
- Department of Pathology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Xue Meng
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Lei Zhang
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Xiwen Sun
- Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
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Joint use of the radiomics method and frozen sections should be considered in the prediction of the final classification of peripheral lung adenocarcinoma manifesting as ground-glass nodules. Lung Cancer 2020; 139:103-110. [DOI: 10.1016/j.lungcan.2019.10.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/10/2019] [Accepted: 10/29/2019] [Indexed: 12/24/2022]
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24
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Oze I, Ito H, Nishino Y, Hattori M, Nakayama T, Miyashiro I, Matsuo K, Ito Y. Trends in Small-Cell Lung Cancer Survival in 1993-2006 Based on Population-Based Cancer Registry Data in Japan. J Epidemiol 2019; 29:347-353. [PMID: 30449770 PMCID: PMC6680055 DOI: 10.2188/jea.je20180112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 08/16/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Lung cancers are classified into small-cell lung cancer (SCLC) and non-small-cell lung cancer due to their different treatment and prognosis. Although many studies have reported the specific survival of SCLC patients treated at cancer hospitals, survival from population-based data has rarely been reported. METHODS We analyzed survival of SCLC cases diagnosed from 1993 through 2006 from a population-based cancer registry of six prefectures. To assess trends in SCLC survival, we defined three periods that mirrored developments in SCLC treatment: period 1, 1993-1998; period 2, 1999-2001; and period 3, 2002-2006. Assessments were based on relative survival (RS), excess hazard, and conditional survival. RESULTS A total of 10,911 SCLC patients were analyzed. Five-year RS among limited disease SCLC (LD-SCLC) in periods 1 to 3 was 16.8%, 21.1%, and 21.4%, respectively. Five-year RS among extensive disease SCLC (ED-SCLC) in periods 1 to 3 was 2.3%, 2.8%, and 2.7%, respectively. Improvement in 5-year RS in periods 2 and 3 compared with period 1 was significant among both LD- and ED-SCLC patients (all P < 0.001). Conditional 5-year RS of LD-SCLC increased from 21% at year 0 to 73% at year 5, while that of ED-SCLC was 3% at year 0 and 53% at year 5. CONCLUSIONS The prognosis of SCLC patients improved from 1999-2001 but plateaued in 2002-2006, after which no further significant improvement was seen. Continuous survey based on population-based data is helpful in monitoring the impact of developments in treatment.
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Affiliation(s)
- Isao Oze
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshikazu Nishino
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | - Masakazu Hattori
- Department of Cancer Therapy Center, Fukui Prefectural Hospital, Fukui, Japan
| | - Tomio Nakayama
- Division of Screening Assessment and Management, Screening Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center, Osaka Medical College, Takatsuki, Osaka, Japan
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Koyanagi YN, Ito H, Matsuo K, Sugawara Y, Hidaka A, Sawada N, Wada K, Nagata C, Tamakoshi A, Lin Y, Takeuchi T, Kitamura Y, Utada M, Sadakane A, Mizoue T, Naito M, Tanaka K, Shimazu T, Tsugane S, Inoue M. Smoking and Pancreatic Cancer Incidence: A Pooled Analysis of 10 Population-Based Cohort Studies in Japan. Cancer Epidemiol Biomarkers Prev 2019; 28:1370-1378. [PMID: 31113869 DOI: 10.1158/1055-9965.epi-18-1327] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/25/2019] [Accepted: 05/16/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Detailed prospective evaluation of cigarette smoking associated with pancreatic cancer risk in large Asian populations is limited. The aim of this study was to examine this association in a Japanese population, with a particular focus on evaluating sex differences. METHODS We performed a pooled analysis of 10 population-based cohort studies. We calculated study-specific HRs and 95% confidence intervals (CI) using Cox proportional hazards regression, and then estimated summary HRs by pooling these estimates with a random effects model. RESULTS During 4,695,593 person-years of follow-up in 354,154 participants, 1,779 incident pancreatic cancer cases were identified. We observed an increased pancreatic cancer risk for current smoking compared with never smoking in both males [HR (95% CI), 1.59 (1.32-1.91)] and females [HR (95% CI), 1.81 (1.43-2.30)]. Significant risk elevations for former smoking and small cumulative dose of ≤20 pack-years (PY) were observed only among females, regardless of environmental tobacco smoke exposure. Trend analysis indicated significant 6% and nonsignificant 6% increases in pancreatic cancer risk for every 10 PYs in males and females, respectively. Risk became comparable with never smokers after 5 years of smoking cessation in males. In females, however, we observed no risk attenuation by smoking cessation. CONCLUSIONS This study supports the well-known association between smoking and pancreatic cancer and indicates potential sex differences in a Japanese population. Quitting smoking would be beneficial for pancreatic cancer prevention, especially in males. IMPACT Pancreatic cancer risk is increased with cumulative smoking exposure and decreased with smoking cessation, with potential sex differences.
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Affiliation(s)
- Yuriko N Koyanagi
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Research Institute, Nagoya, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Research Institute, Nagoya, Japan. .,Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keitaro Matsuo
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yingsong Lin
- Department of Public Health, Aichi Medical University School of Medicine, Aichi, Japan
| | - Taro Takeuchi
- Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuri Kitamura
- Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mai Utada
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Atsuko Sadakane
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Tetsuya Mizoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Taichi Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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Yang L, Wang N, Yuan Y, Liu S, Li H, Tian J, Ji J, Ren A. Secular trends in incidence of lung cancer by histological type in Beijing, China, 2000 -2016. Chin J Cancer Res 2019; 31:306-315. [PMID: 31156301 PMCID: PMC6513742 DOI: 10.21147/j.issn.1000-9604.2019.02.05] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective The objective of this study was to characterize secular trends in the sex-specific, age-standardized incidence of lung cancer by histological type in Beijing, China, from 2000 to 2016 based on data from a population-based cancer registry. Methods Data on the incidence of cancer from 2000 to 2016 were obtained from the Beijing Cancer Registry. We examined trends in the sex-specific, age-standardized incidence of lung cancer by histological type using a Joinpoint regression model. Results A total of 117,409 cases of lung cancer were diagnosed from 2000 to 2016. Overall, 73,062 (62.23%) patients were males. The most common histological type among both sexes was adenocarcinoma; however, the proportion of adenocarcinoma differed significantly between males and females (45.36% vs. 77.14%, respectively, P<0.0001). The age-standardized incidence of total lung cancer increased from 2000 to 2010 with an annual percent change (APC) of 2.2% [95% confidence interval (95% CI), 1.5% to 2.9%] and stabilized thereafter. Among males, the incidence of total lung cancer peaked in 2008 and then decreased slightly, with an APC of −1.1% (95% CI, −2.1% to −0.1%). Among females, the incidence increased continuously during the study period, with an APC of 1.4% (95% CI, 0.9% to 1.9%). The incidence of squamous cell carcinoma decreased significantly in recent years among both sexes, with APCs of −2.6% (95% CI, −4.5% to −0.6%) from 2007 to 2016 for males and −5.4% (95% CI, −7.2% to −3.6%) from 2004 to 2016 for females. In contrast, the incidence of adenocarcinoma increased continuously throughout the study period, by APCs of 4.0% (95% CI, 2.6% to 5.4%) for males and 6.2% (95% CI, 4.8% to 7.6%) for females. The incidence of small cell carcinoma peaked in 2007 and stabilized thereafter among males, whereas it peaked in 2012 and then decreased with an APC of −14.7% (95% CI, −25.3% to −2.6%) among females. The incidence of large cell carcinoma and other specified malignant neoplasm did not change much, whereas the incidence of unspecified type decreased among both sexes during the study period.
Conclusions Although the incidence of squamous cell carcinoma decreased significantly among both sexes in recent years in Beijing, China, adenocarcinoma increased continuously throughout the study period among both sexes. Knowledge of differences in trends is useful for surveillance and control of lung cancer. However, the reason for the increase in adenocarcinoma remains unclear and warrants investigation.
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Affiliation(s)
- Lei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.,Institute of Reproductive and Child Health, Peking University/National Health Commission, Key Laboratory of Reproductive Health (Peking University), Beijing 100191, China.,Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Ning Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yannan Yuan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Shuo Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Huichao Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Jing Tian
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Jiafu Ji
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China.,Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Center of Gastrointestinal Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Aiguo Ren
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.,Institute of Reproductive and Child Health, Peking University/National Health Commission, Key Laboratory of Reproductive Health (Peking University), Beijing 100191, China
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Deng J, Deng H, Liu C, Liang Y, Wang S. Long non-coding RNA OIP5-AS1 functions as an oncogene in lung adenocarcinoma through targeting miR-448/Bcl-2. Biomed Pharmacother 2018; 98:102-110. [DOI: 10.1016/j.biopha.2017.12.031] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/29/2017] [Accepted: 12/07/2017] [Indexed: 12/19/2022] Open
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Wallbank LA, MacKenzie R, Beggs PJ. Environmental impacts of tobacco product waste: International and Australian policy responses. AMBIO 2017; 46:361-370. [PMID: 27844421 PMCID: PMC5347528 DOI: 10.1007/s13280-016-0851-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/27/2016] [Accepted: 10/31/2016] [Indexed: 05/19/2023]
Abstract
The health risks of tobacco consumption are well established, but there is less awareness of the global environmental impacts of smoking. The by-products of the 6.3 trillion cigarettes smoked annually are filters (butts) that contain benzene, nicotine, cadmium, and dozens of other chemicals. It is estimated that between one- and two-thirds of all filters are discarded on roads, pavements, and green spaces. Butt litter as an environmental and public health hazard is a relatively new field of study, but recent research and findings have clear global implications. While this article focuses specifically on the situation in Australia, where cigarette butts are consistently the most littered item identified in national clean-up campaigns, the material reviewed has clear international environmental implications. The article first reviews existing literature on filter composition and toxicology, clean-up costs, regulatory response, and key policy actors. It then describes the scale of the butt litter problem in Australia using existing data, and analyses potential remedies at both the domestic and international levels.
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Affiliation(s)
- Lucinda A. Wallbank
- Department of Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109 Australia
| | - Ross MacKenzie
- Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, NSW 2109 Australia
| | - Paul J. Beggs
- Department of Environmental Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109 Australia
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30
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Jung KJ, Jeon C, Jee SH. The effect of smoking on lung cancer: ethnic differences and the smoking paradox. Epidemiol Health 2016; 38:e2016060. [PMID: 28092929 PMCID: PMC5309724 DOI: 10.4178/epih.e2016060] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 12/20/2016] [Indexed: 01/30/2023] Open
Abstract
The objectives of this review were to determine whether the smoking paradox still exists and to summarize possible explanations for the smoking paradox. Based on published data, we compared the risk of cigarette smoking for lung cancer in Western and Asian countries. We extracted data from the relevant studies about annual tobacco consumption, lung cancer mortality rates according to smoking status from each country, and possible explanations for the smoking paradox. A significantly greater risk of lung cancer death was found among current smokers in Asian countries than among nonsmokers, with relative risks (RRs) of 4.0 to 4.6 for Koreans, 3.7 to 5.1 for Japanese, and 2.4 to 6.5 for Chinese. Although a significantly greater risk of lung cancer was present among current smokers in Asian countries, the RRs in Asian countries were much lower than those reported in Western countries (range, 9.4 to 23.2). Possible explanations for the smoking paradox included epidemiologic characteristics, such as the smoking amount, age at smoking initiation, and the use of filtered or mild tobacco. The smoking paradox definitely exists, but may be explained by major epidemiologic characteristics. Therefore, the smoking paradox should not be interpreted as indicating that tobacco is safer or less harmful for Asians.
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Affiliation(s)
- Keum Ji Jung
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Christina Jeon
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea.,Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
| | - Sun Ha Jee
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
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31
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Kinoshita FL, Ito Y, Nakayama T. Trends in Lung Cancer Incidence Rates by Histological Type in 1975-2008: A Population-Based Study in Osaka, Japan. J Epidemiol 2016; 26:579-586. [PMID: 27150013 PMCID: PMC5083321 DOI: 10.2188/jea.je20150257] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Monitoring trends in lung cancer incidence and mortality is important for the evaluation of cancer control activities. We investigated recent trends in age-standardized incidence rates by histological type of lung cancer in Osaka, Japan. Methods Cancer incidence data for 1975–2008 were obtained from the Osaka Cancer Registry. Lung cancer mortality data with population data in Osaka during 1975–2012 were obtained from vital statistics. We examined trends in age-standardized incidence and mortality rates for all histological types and age-standardized incidence rates by histological type and age group using a joinpoint regression model. Results The age-standardized incidence rate of lung cancer levelled off or slightly increased from 1975–2008, with an annual percentage change of 0.3% (95% confidence interval [CI], 0.1%–0.4%) for males and 1.1% (95% CI, 0.9%–1.3%) for females, and the mortality rate decreased by 0.9% (95% CI, 1.2%–0.7%) for males and 0.5% (95% CI, 0.8%–0.3%) for females. The incidence rates of squamous cell carcinoma (SQC) and small cell carcinoma (SMC) significantly decreased for both genders, whereas that of adenocarcinoma (ADC) significantly increased among almost all age groups in both genders. Conclusions The incidence rates of SQC and SMC decreased with the decline in smoking prevalence, which probably explains the change in trends in the incidence rates of lung cancer from the mid-1980s. However, the reason for the increase in ADC remains unclear. Therefore, trends in incidence rates of lung cancer should be carefully monitored, especially for ADC, and the associations between ADC and its possible risk factors should be studied.
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Schulz M, Gerber A, Groneberg DA. Are Filter-Tipped Cigarettes Still Less Harmful than Non-Filter Cigarettes?--A Laser Spectrometric Particulate Matter Analysis from the Non-Smokers Point of View. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:429. [PMID: 27092519 PMCID: PMC4847091 DOI: 10.3390/ijerph13040429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 04/09/2016] [Accepted: 04/11/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Environmental tobacco smoke (ETS) is associated with human morbidity and mortality, particularly chronic obstructive pulmonary disease (COPD and lung cancer. Although direct DNA-damage is a leading pathomechanism in active smokers, passive smoking is enough to induce bronchial asthma, especially in children. Particulate matter (PM) demonstrably plays an important role in this ETS-associated human morbidity, constituting a surrogate parameter for ETS exposure. METHODS Using an Automatic Environmental Tobacco Smoke Emitter (AETSE) and an in-house developed, non-standard smoking regime, we tried to imitate the smoking process of human smokers to demonstrate the significance of passive smoking. Mean concentration (C(mean)) and area under the curve (AUC) of particulate matter (PM2.5) emitted by 3R4F reference cigarettes and the popular filter-tipped and non-filter brand cigarettes "Roth-Händle" were measured and compared. The cigarettes were not conditioned prior to smoking. The measurements were tested for Gaussian distribution and significant differences. RESULTS C(mean) PM2.5 of the 3R4F reference cigarette: 3911 µg/m³; of the filter-tipped Roth-Händle: 3831 µg/m³; and of the non-filter Roth-Händle: 2053 µg/m³. AUC PM2.5 of the 3R4F reference cigarette: 1,647,006 µg/m³·s; of the filter-tipped Roth-Händle: 1,608,000 µg/m³·s; and of the non-filter Roth-Händle: 858,891 µg/m³·s. CONCLUSION The filter-tipped cigarettes (the 3R4F reference cigarette and filter-tipped Roth-Händle) emitted significantly more PM2.5 than the non-filter Roth-Händle. Considering the harmful potential of PM, our findings note that the filter-tipped cigarettes are not a less harmful alternative for passive smokers. Tobacco taxation should be reconsidered and non-smoking legislation enforced.
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Affiliation(s)
- Maria Schulz
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Theodor-Stern-Kai 7, Haus 9b, Frankfurt am Main 60590, Germany.
| | - Alexander Gerber
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Theodor-Stern-Kai 7, Haus 9b, Frankfurt am Main 60590, Germany.
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Theodor-Stern-Kai 7, Haus 9b, Frankfurt am Main 60590, Germany.
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Masaoka H, Matsuo K, Ito H, Wakai K, Nagata C, Nakayama T, Sadakane A, Tanaka K, Tamakoshi A, Sugawara Y, Mizoue T, Sawada N, Inoue M, Tsugane S, Sasazuki S. Cigarette smoking and bladder cancer risk: an evaluation based on a systematic review of epidemiologic evidence in the Japanese population. Jpn J Clin Oncol 2016; 46:273-83. [PMID: 26941372 DOI: 10.1093/jjco/hyv188] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 11/13/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Although several epidemiological studies have demonstrated that cigarette smoking is an important risk factor for bladder cancer, no systematic review in the Japanese population has yet been performed. Accurate evaluation of bladder cancer risk in relation to smoking for Japanese populations can provide necessary information for Japanese policy-makers and doctors to enlighten the importance of smoking cessation. We reviewed epidemiologic data to estimate the strength of the association between cigarette smoking and bladder cancer in the Japanese population. METHODS We identified previous cohort and case-control studies, extracting data from databases in the MEDLINE (PubMed) and Ichushi. The magnitude of association and strength of evidence were evaluated in each study, and a meta-analysis was conducted to obtain summary estimates for the overall magnitude of association. RESULTS Three cohort and eight case-control studies were identified. Except for one case-control study, all studies showed a strong positive association between cigarette smoking and bladder cancer. The summary relative risk for ever smokers relative to never smokers was 2.14 (95% confidence interval 1.87-2.44) in a fixed-effect model. CONCLUSIONS We conclude that cigarette smoking is a convincing risk factor for bladder cancer among Japanese.
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Affiliation(s)
- Hiroyuki Masaoka
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya
| | - Hidemi Ito
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu
| | - Tomio Nakayama
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka
| | - Atsuko Sadakane
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo
| | - Yumi Sugawara
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai
| | - Tetsuya Mizoue
- Department of Epidemiology and International Health, International Clinical Research Center, National Center for Global Health and Medicine, Tokyo
| | - Norie Sawada
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo
| | - Manami Inoue
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo AXA Department of Health and Human Security, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo
| | - Shizuka Sasazuki
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo
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Lortet-Tieulent J, Renteria E, Sharp L, Weiderpass E, Comber H, Baas P, Bray F, Coebergh JW, Soerjomataram I. Convergence of decreasing male and increasing female incidence rates in major tobacco-related cancers in Europe in 1988-2010. Eur J Cancer 2015; 51:1144-63. [PMID: 24269041 DOI: 10.1016/j.ejca.2013.10.014] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/18/2013] [Accepted: 10/22/2013] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Smoking prevalence has been declining in men all over Europe, while the trend varies in European regions among women. To study the impact of past smoking prevalence, we present a comprehensive overview of the most recent trends in incidence, during 1988-2010, in 26 countries, of four of the major cancers in the respiratory and upper gastro-intestinal tract associated with tobacco smoking. METHODS Data from 47 population-based cancer registries for lung, laryngeal, oral cavity and pharyngeal, and oesophageal cancer cases were obtained from the newly developed data repository within the European Cancer Observatory (http://eco.iarc.fr/). Truncated age-standardised incidence rates (35-74 years) by calendar year, average annual percentage change in incidence over 1998-2007 were calculated. Smoking prevalence in selected countries was extracted from the Organisation for Economic Co-operation and Development and the World Health Organization databases. RESULTS There remained great but changing variation in the incidence rates of tobacco-related cancers by European region. Generally, the high rates among men have been declining, while the lower rates among women are increasing, resulting in convergence of the rates. Female lung cancer rates were above male rates in Denmark, Iceland and Sweden (35-64 years). In lung and laryngeal cancers, where smoking is the main risk factor, rates were highest in central and eastern Europe, southern Europe and the Baltic countries. Despite a lowering of female smoking prevalence, female incidence rates of lung, laryngeal and oral cavity cancers increased in most parts of Europe, but were stable in the Baltic countries. Mixed trends emerged in oesophageal cancer, probably explained by differing risk factors for the two main histological subtypes. CONCLUSIONS This data repository offers the opportunity to show the variety of incidence trends by sex among European countries. The diverse patterns of trends reflect varied exposure to risk factors. Given the heavy cancer burden attributed to tobacco and the fact that tobacco use is entirely preventable, tobacco control remains a top priority in Europe. Prevention efforts should be intensified in central and eastern Europe, southern Europe and the Baltic countries.
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Affiliation(s)
- Joannie Lortet-Tieulent
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France; Surveillance & Health Services Research, American Cancer Society, Atlanta, United States
| | - Elisenda Renteria
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France
| | | | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Samfundet Folkhälsan, Helsinki, Finland
| | | | - Paul Baas
- Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Freddie Bray
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France
| | - Jan Willem Coebergh
- Erasmus University Medical Centre, Department of Public Health, Rotterdam, The Netherlands; Eindhoven Cancer Registry, Comprehensive Cancer Centre South, Eindhoven, The Netherlands
| | - Isabelle Soerjomataram
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France.
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Kong J, Xu F, He M, Chen K, Qian B. The incidence of lung cancer by histological type: A population-based study in Tianjin, China during 1981-2005. Respirology 2014; 19:1222-8. [PMID: 25168588 DOI: 10.1111/resp.12373] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 01/21/2014] [Accepted: 07/04/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Jinyu Kong
- Department of Cancer Epidemiology and Biostatistics; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer; Key Laboratory of Cancer Prevention and Therapy, Ministry of Education; Tianjin China
| | - Fangxiu Xu
- Department of Cancer Epidemiology and Biostatistics; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer; Key Laboratory of Cancer Prevention and Therapy, Ministry of Education; Tianjin China
| | - Min He
- Department of Cancer Epidemiology and Biostatistics; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer; Key Laboratory of Cancer Prevention and Therapy, Ministry of Education; Tianjin China
| | - Kexin Chen
- Department of Cancer Epidemiology and Biostatistics; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer; Key Laboratory of Cancer Prevention and Therapy, Ministry of Education; Tianjin China
| | - Biyun Qian
- Department of Cancer Epidemiology and Biostatistics; Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer; Key Laboratory of Cancer Prevention and Therapy, Ministry of Education; Tianjin China
- School of Public Health; Shanghai Jiao Tong University; Shanghai China
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Lortet-Tieulent J, Soerjomataram I, Ferlay J, Rutherford M, Weiderpass E, Bray F. International trends in lung cancer incidence by histological subtype: adenocarcinoma stabilizing in men but still increasing in women. Lung Cancer 2014; 84:13-22. [PMID: 24524818 DOI: 10.1016/j.lungcan.2014.01.009] [Citation(s) in RCA: 253] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 12/09/2013] [Accepted: 01/13/2014] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Trends in overall lung cancer incidence in different countries reflect the maturity of the smoking epidemic. Further understanding of the underlying causes for trends over time can be gained by assessing the trends by sex and histological subtype. We provide a temporal analysis of lung cancer incidence in 12 populations (11 countries), with a focus on cohort-specific trends for the main histological subtypes (squamous cell carcinomas (SCC), adenocarcinomas (AdC), and small cell carcinoma). MATERIAL AND METHODS We restrict the analysis to population-based registry data of sufficient quality to provide meaningful interpretation, using data in Europe, North America and Oceania, extracted from successive Cancer Incidence in Five Continents Volumes. Poorly specified morphologies were reallocated to a specified grouping on a population, 5-year period and age group basis. RESULTS In men, lung cancer rates have been declining overall and by subtype, since the beginning of the study period, except for AdC. AdC incidence rates have risen and surpassed those of SCC (historically the most frequent subtype) in the majority of these populations, but started to stabilize during the mid-1980s in North America, Australia and Iceland. In women, AdC has been historically the most frequent subtype and rates continue to increase in most populations studied. Early signs of a decline in AdC can however be observed in Canada, Denmark and Australia among very recent female cohorts, born after 1950. CONCLUSIONS The continuing rise in lung cancer among women in many countries reinforces the need for targeted smoking cessation efforts alongside preventive actions.
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Affiliation(s)
- J Lortet-Tieulent
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France
| | - I Soerjomataram
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France
| | - J Ferlay
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France
| | - M Rutherford
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - E Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Research, Cancer Registry of Norway, Oslo, Norway; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway; Samfundet Folkhälsan, Helsinki, Finland
| | - F Bray
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France.
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Kubota K, Hida T, Ishikura S, Mizusawa J, Nishio M, Kawahara M, Yokoyama A, Imamura F, Takeda K, Negoro S, Harada M, Okamoto H, Yamamoto N, Shinkai T, Sakai H, Matsui K, Nakagawa K, Shibata T, Saijo N, Tamura T. Etoposide and cisplatin versus irinotecan and cisplatin in patients with limited-stage small-cell lung cancer treated with etoposide and cisplatin plus concurrent accelerated hyperfractionated thoracic radiotherapy (JCOG0202): a randomised phase 3 study. Lancet Oncol 2013; 15:106-13. [PMID: 24309370 DOI: 10.1016/s1470-2045(13)70511-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Four cycles of etoposide plus cisplatin and accelerated hyperfractionated thoracic radiotherapy (AHTRT) is the standard of care for limited-stage small-cell lung cancer (SCLC). Irinotecan plus cisplatin significantly improved overall survival compared with etoposide plus cisplatin for extensive-stage SCLC. We compared these regimens for overall survival of patients with limited-stage SCLC. METHODS We did this phase 3 study in 36 institutions in Japan. Eligibility criteria included age 20-70 years, Eastern Cooperative Oncology Group (ECOG) performance status of 0-1, and adequate organ functions. Eligible patients with previously untreated limited-stage SCLC received one cycle of etoposide plus cisplatin (intravenous etoposide 100 mg/m(2) on days 1-3; intravenous cisplatin 80 mg/m(2) on day 1) plus AHTRT (1.5 Gy twice daily, 5 days a week, total 45 Gy over 3 weeks). Patients without progressive disease following induction therapy were randomised (1:1 ratio, using a minimisation method with biased-coin assignment balancing on ECOG performance status [0 vs 1], response to induction chemoradiotherapy [complete response plus near complete response vs partial response and stable disease], and institution) to receive either three further cycles of consolidation etoposide plus cisplatin or irinotecan plus cisplatin (intravenous irinotecan 60 mg/m(2) on days 1, 8, 15; intravenous cisplatin 60 mg/m(2) on day 1). Patients, physicians, and investigators were aware of allocation. The primary endpoint was overall survival after randomisation; primary analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00144989, and the UMIN Clinical Trials Registry, number C000000095. FINDINGS 281 patients were enrolled between Sept 1, 2002, and Oct 2, 2006. After induction etoposide plus cisplatin and AHTRT, 258 patients were randomised to consolidation etoposide plus cisplatin (n=129) or irinotecan plus cisplatin (n=129). In the etoposide plus cisplatin group, median overall survival was 3.2 years (95% CI 2.4-4.1). In the irinotecan and cisplatin group, median overall survival was 2.8 years (95% CI 2.4-3.6); overall survival did not differ between the two groups (hazard ratio 1.09 [95% CI 0.80-1.46], one-sided stratified log-rank p=0.70). The most common adverse events of grade 3 or 4 were neutropenia (120 [95%] in the etoposide plus cisplatin group vs 101 [78%] in the irinotecan plus cisplatin group), anaemia (44 [35%] vs 50 [39%]), thrombocytopenia (26 [21%] vs six [5%]), febrile neutropenia (21 [17%] vs 18 [14%]), and diarrhoea (two [2%] vs 13 [10%]). There was one treatment-related adverse event leading to death in each group (radiation pneumonitis in the etoposide plus cisplatin group; brain infarction in the irinotecan plus cisplatin group). INTERPRETATION Four cycles of etoposide plus cisplatin and AHTRT should continue to be the standard of care for limited-stage SCLC. FUNDING National Cancer Center and the Ministry of Health, Labour, and Welfare of Japan.
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Affiliation(s)
- Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
| | - Toyoaki Hida
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Satoshi Ishikura
- Department of Radiation Oncology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | | | - Makoto Nishio
- Department of Thoracic Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masaaki Kawahara
- Department of Thoracic Oncology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Akira Yokoyama
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Fumio Imamura
- Department of Thoracic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Koji Takeda
- Department of Clinical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Shunichi Negoro
- Department of Thoracic Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Masao Harada
- Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Nobuyuki Yamamoto
- Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi, Japan
| | - Tetsu Shinkai
- Department of Medicine and Thoracic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Hiroshi Sakai
- Department of Thoracic Oncology, Saitama Cancer Center, Ina, Japan
| | - Kaoru Matsui
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kinki University Faculty of Medicine, Osaka, Japan
| | - Taro Shibata
- JCOG Data Center, National Cancer Center, Tokyo, Japan
| | | | - Tomohide Tamura
- Division of Thoracic Oncology, National Cancer Center, Tokyo, Japan
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Tanaka H. Advances in cancer epidemiology in Japan. Int J Cancer 2013; 134:747-54. [PMID: 24105756 DOI: 10.1002/ijc.28519] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 09/04/2013] [Accepted: 09/20/2013] [Indexed: 12/23/2022]
Abstract
Epidemiologists in Japan have been performing calculations to estimate nationwide cancer incidence rates as well as 5-year survival rates using population-based cancer registry data. There have been remarkable changes in cancer incidence and/or mortality in cancers of the lung, liver and stomach, which were thought to be attributed to the changing impact of exposure to cigarette smoking, chronic hepatitis C virus infection and Helicobacter pylori infection, respectively. In systematic reviews providing evidence in risk/protective factors for cancer sites using case-control and cohort studies of the Japanese population, there were associations between cancer sites (esophagus, stomach, colo-rectum, liver, pancreas, lung and breast) and various lifestyle factors. In the past 10 years, a hospital-based case-control study at Aichi Cancer Center provided valuable evidence of gene-environment interaction on the development of cancer [i.e., the effects of aldehyde dehydrogenase-2 (ALDH2) polymorphism and heavy alcohol drinking on esophageal cancer, ALDH2 polymorphism and smoking on lung cancer, methylenetetrahydrofolate reductase polymorphism and heavy alcohol drinking on pancreatic cancer]. The database with stored DNA was also used and identified seven loci containing significant but low-penetrance polymorphisms associated with the development of breast cancer. These findings together with established risk factors are likely to be useful to predict personalized breast cancer risk in East Asian women. In 2005, the Japan Multi-Institution Collaborative Cohort (J-MICC) study was launched to elucidate gene-environment interactions as well as to confirm preclinical diagnostic biomarkers of cancer. J-MICC, which has recruited 92,000 healthy individuals by the end of 2012, will follow the individuals until 2025.
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Affiliation(s)
- Hideo Tanaka
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Chikusa-ku, Nagoya, 464-8618, Japan; Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, 466-8550, Japan
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Stinchcombe TE. Targeted Therapies for Locally Advanced or Metastatic Squamous Cell Carcinoma of the Lung. Curr Treat Options Oncol 2013; 14:568-79. [DOI: 10.1007/s11864-013-0256-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Crosbie PAJ, Harrison K, Shah R, Watson AJ, Agius R, Barber PV, Margison GP, Povey AC. Topographical study of O(6)-alkylguanine DNA alkyltransferase repair activity and N7-methylguanine levels in resected lung tissue. Chem Biol Interact 2013; 204:98-104. [PMID: 23665414 DOI: 10.1016/j.cbi.2013.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 04/15/2013] [Accepted: 04/22/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Tobacco specific nitrosamines such as 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) are genotoxic alkylating agents found within cigarette smoke that induce lung adenocarcinomas in animal models. In humans, adenocarcinomas originate most frequently in the lung periphery. The aim of this study was to determine whether peripheral lung has increased susceptibility to the genotoxic effects of alkylating agents by comparing DNA alkylation damage (N7-methylguanine: N7-meG) and repair (O(6)-alkylguanine DNA alkyltransferase: MGMT) in peripheral relative to central lung tissue. METHODS Macroscopically normal lung tissue, resected from patients undergoing surgery for lung cancer, was sampled at equidistant points from central to peripheral lung along a bronchus. N7-meG levels were determined using an immunoslotblot technique and MGMT activity with a [32P]-labelled oligodeoxynucleotide cleavage assay. RESULTS A total of 20 subjects were recruited, 12 males and 8 females with a mean age of 68.7±5.8years. There were 14 former and 6 current smokers with a mean smoking exposure of 34.0±18.3packyears. N7-meG (mean 0.75±0.57/10(6)dG, n=65 samples from 14 patients) and MGMT repair (geometric mean 9.57±1.62fmol/μg DNA, n=79 samples from 16 patients) were detected in all samples assayed. MGMT activity increased towards the lung periphery (r=0.28, p=0.023; n=16) with a highly significant association in current (r=0.53, p=0.008; n=6) but not former smokers (r=0.13; p=0.41; n=10). No correlation was seen with N7-meG levels and lung position (r=-0.18; p=0.21; n=14). N7-meG levels were higher in current compared to former smokers reaching significance in two lung positions including peripheral lung (p=0.047). CONCLUSIONS The findings in this study do not support the hypothesis that peripheral tissue is more susceptible to the genotoxic effects of alkylating agents than central lung tissue. In addition exposure to cigarette smoke reduced the level of MGMT in central bronchial tissue possibly through increased alkylating agent exposure.
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Affiliation(s)
- Philip A J Crosbie
- Cancer Research UK Carcinogenesis Group, Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK.
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The Changing Epidemic of Lung Cancer and Occupational and Environmental Risk Factors. Thorac Surg Clin 2013; 23:113-22. [DOI: 10.1016/j.thorsurg.2013.01.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Park JH, Lee KS, Choi KS. Burden of cancer in Korea during 2000-2020. Cancer Epidemiol 2013; 37:353-9. [PMID: 23643195 DOI: 10.1016/j.canep.2013.03.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 02/10/2013] [Accepted: 03/19/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study estimates the burden of cancer in Korea during 2000-2020, ameliorating the Global Burden of Disease Study Group (GBD) method with the Incidence-Prevalence-Mortality (IPM) Model. METHODS Besides using the GBD approach to calculate the Years of Life Lost in Korea during 2000-2020, this research calculates the Years Lived with Disability (YLDs) of major cancers based on the combination of the GBD method and the IPM Model. RESULTS Colon, breast and thyroid cancers became more significant in terms of Disability Adjusted Life Years during 2000-2010 and this will continue during 2010-2020, colon cancer leading the pack instead of stomach cancer in 2020. The rise of colon cancer is more evident for the older age group and the opposite is true for breast and thyroid cancers. Indeed, stomach and liver cancers were resilient in terms of DALYs during 2000-2010 and this will continue during 2010-2020. Overall, the burden of cancer in Korea is characterized by an increasing centrality of YLDs (chronic components) as in other advanced nations. CONCLUSIONS Korea's convergence with other advanced nations in cancer burden might reflect their convergence in living standards, the age structure, health behavior and medical technology during the past four decades. These transitions have been reflected in the Second 10-Year Plan for Cancer Control in Korea during 2006-2015, government policy consisting of four main programs, i.e., primary prevention, early detection, diagnosis/treatment and palliative care.
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Affiliation(s)
- Jae-Hyun Park
- Department of Preventive Medicine and Samsung Biomedical Research Institute, Sungkyunkwan University, Suwon, South Korea
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Gaikwad A, Gupta A, Hare S, Gomes M, Sekhon H, Souza C, Inacio J, Lad S, Seely J. Primary adenocarcinoma of lung: a pictorial review of recent updates. Eur J Radiol 2012; 81:4146-55. [PMID: 23000187 DOI: 10.1016/j.ejrad.2012.08.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 08/23/2012] [Accepted: 08/29/2012] [Indexed: 10/27/2022]
Abstract
Primary adenocarcinoma of lung has replaced squamous cell carcinoma as the commonest histological subtype of lung cancer and the incidence of primary lung adenocarcinoma appears to be rising. Although the main factors behind this 'epidemic-like' situation are largely undiscovered, filter cigarettes appear to significantly contribute to this shift in the histopathological spectrum. The new multidisciplinary classification of adenocarcinoma of lung was introduced to address advances in clinical, pathological, radiological and molecular sciences. The purpose of this essay is to discuss various classes of lung adenocarcinoma in the new classification with their classical imaging features on computed tomography and summarise the recent advances in the field of radiology and review radiology recommendations.
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Affiliation(s)
- Anand Gaikwad
- Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
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Pesch B, Kendzia B, Gustavsson P, Jöckel KH, Johnen G, Pohlabeln H, Olsson A, Ahrens W, Gross IM, Brüske I, Wichmann HE, Merletti F, Richiardi L, Simonato L, Fortes C, Siemiatycki J, Parent ME, Consonni D, Landi MT, Caporaso N, Zaridze D, Cassidy A, Szeszenia-Dabrowska N, Rudnai P, Lissowska J, Stücker I, Fabianova E, Dumitru RS, Bencko V, Foretova L, Janout V, Rudin CM, Brennan P, Boffetta P, Straif K, Brüning T. Cigarette smoking and lung cancer--relative risk estimates for the major histological types from a pooled analysis of case-control studies. Int J Cancer 2012; 131:1210-9. [PMID: 22052329 PMCID: PMC3296911 DOI: 10.1002/ijc.27339] [Citation(s) in RCA: 335] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 08/17/2011] [Indexed: 12/12/2022]
Abstract
Lung cancer is mainly caused by smoking, but the quantitative relations between smoking and histologic subtypes of lung cancer remain inconclusive. By using one of the largest lung cancer datasets ever assembled, we explored the impact of smoking on risks of the major cell types of lung cancer. This pooled analysis included 13,169 cases and 16,010 controls from Europe and Canada. Studies with population controls comprised 66.5% of the subjects. Adenocarcinoma (AdCa) was the most prevalent subtype in never smokers and in women. Squamous cell carcinoma (SqCC) predominated in male smokers. Age-adjusted odds ratios (ORs) were estimated with logistic regression. ORs were elevated for all metrics of exposure to cigarette smoke and were higher for SqCC and small cell lung cancer (SCLC) than for AdCa. Current male smokers with an average daily dose of >30 cigarettes had ORs of 103.5 (95% confidence interval (CI): 74.8-143.2) for SqCC, 111.3 (95% CI: 69.8-177.5) for SCLC and 21.9 (95% CI: 16.6-29.0) for AdCa. In women, the corresponding ORs were 62.7 (95% CI: 31.5-124.6), 108.6 (95% CI: 50.7-232.8) and 16.8 (95% CI: 9.2-30.6), respectively. Although ORs started to decline soon after quitting, they did not fully return to the baseline risk of never smokers even 35 years after cessation. The major result that smoking exerted a steeper risk gradient on SqCC and SCLC than on AdCa is in line with previous population data and biological understanding of lung cancer development.
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Affiliation(s)
- Beate Pesch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of Ruhr Universität Bochum (IPA), Bochum, Germany.
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Egawa H, Furukawa K, Preston D, Funamoto S, Yonehara S, Matsuo T, Tokuoka S, Suyama A, Ozasa K, Kodama K, Mabuchi K. Radiation and smoking effects on lung cancer incidence by histological types among atomic bomb survivors. Radiat Res 2012; 178:191-201. [PMID: 22862780 DOI: 10.1667/rr2819.1] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
While the risk of lung cancer associated separately with smoking and radiation exposure has been widely reported, it is not clear how smoking and radiation together contribute to the risk of specific lung cancer histological types. With individual smoking histories and radiation dose estimates, we characterized the joint effects of radiation and smoking on type-specific lung cancer rates among the Life Span Study cohort of Japanese atomic bomb survivors. Among 105,404 cohort subjects followed between 1958 and 1999, 1,803 first primary lung cancer incident cases were diagnosed and classified by histological type. Poisson regression methods were used to estimate excess relative risks under several interaction models. Adenocarcinoma (636 cases), squamous-cell carcinoma (330) and small-cell carcinoma (194) made up 90% of the cases with known histology. Both smoking and radiation exposure significantly increased the risk of each major lung cancer histological type. Smoking-associated excess relative risks were significantly larger for small-cell and squamous-cell carcinomas than for adenocarcinoma. The gender-averaged excess relative risks per 1 Gy of radiation (for never-smokers at age 70 after radiation exposure at age 30) were estimated as 1.49 (95% confidence interval 0.1-4.6) for small-cell carcinoma, 0.75 (0.3-1.3) for adenocarcinoma, and 0.27 (0-1.5) for squamous-cell carcinoma. Under a model allowing radiation effects to vary with levels of smoking, the nature of the joint effect of smoking and radiation showed a similar pattern for different histological types in which the radiation-associated excess relative risk tended to be larger for moderate smokers than for heavy smokers. However, in contrast to analyses of all lung cancers as a group, such complicated interactions did not describe the data significantly better than either simple additive or multiplicative interaction models for any of the type-specific analyses.
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Thompson CA, Waldhör T, Schernhammer ES, Hackl M, Vutuc C, Haidinger G. Smoking and lung cancer: current trends in Austria. Wien Klin Wochenschr 2012; 124:493-9. [PMID: 22815002 PMCID: PMC3782091 DOI: 10.1007/s00508-012-0207-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 06/22/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite a recent decline in smoking behavior in many European countries, lung cancer rates remain high, especially in Central and Eastern Europe. This paper aims to describe trends in smoking behavior and lung cancer incidence and mortality, including histopathological classification of lung cancer, in a Central European country: Austria. METHODS Using data from the Austrian Central Cancer Registry, we calculated age-standardized incidence, histopathology-specific incidence, and age-standardized and birth cohort-specific mortality rates for all lung cancer cases in Austria. Using national survey data, we estimated prevalence of smoking in the Austrian population. Our analysis covers the time period from 1970 to 2009. RESULTS In 2009, lung cancer incidence rates were 41.3/100,000 and 18.5/100,000 and mortality rates were 36.3/100,000 and 14.5/100,000, for males and females, respectively. Male lung cancer rates declined but increased steadily in females over the past three decades. In 2009, the most common histological type is adenocarcinoma, which reflects a shift from predominantly squamous cell carcinoma and large cell carcinoma in the mid 1980s. In 2009, 27 % of men and 19 % of women were smokers, which represent a rise of smoking rates in women, especially in younger women, and a decline in the men. CONCLUSIONS While in Austrian men the lung cancer rates, in accordance with their decreasing prevalence of smoking, declined over the past 30 years, the increasing smoking prevalence and lung cancer rates in women remain a public health concern. Antismoking laws and public health initiatives to curtail smoking habits are needed in Austria, especially targeting younger women.
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Affiliation(s)
- Caroline A Thompson
- Department of Epidemiology, UCLA School of Public Health, 90095, Los Angeles, CA, USA.
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Fu JY, Gao J, Zhang ZY, Zheng JW, Zhong LP, Luo JF, Xiang YB. Role of cigarette filter on the risk of oral cancer: a case-control study in a Chinese population. Oral Dis 2012; 19:80-4. [PMID: 22779984 DOI: 10.1111/j.1601-0825.2012.01959.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the role of cigarette filter on the incidence risk of oral squamous cell cancer among male smokers in a Chinese population. SUBJECTS AND METHODS A multicentric hospital-based case-control study was applied. Three hundred and nineteen male cases and 428 male controls matching for age ( ± 3 years) were identified from January 2008 to December 2010. Detailed smoking histories were obtained by interviews. Logistic regression model was used to compare the influence of filter and non-filter cigarettes on oral cancer risk. RESULTS The adjusted odd ratios (ORs) for oral cancer were 1.30 (95% CI 1.15, 1.48) of filter cigarette smokers, 2.06 (95% CI 1.17, 3.62) of non-filter cigarette smokers, and 1.73 (95% CI 1.33, 2.25) of mixed smokers, as compared with non-smokers. When classified current smokers according to smoking pack year, the ORs of mixed smokers were 2.27 (95% CI 1.06, 4.85) in <20 pack year, 0.81 (95% CI 0.57, 1.14) in 20-39 pack year, and 0.86 (95% CI 0.57, 1.29) in ≥ 40 pack year, as compared to filter cigarette smokers. CONCLUSIONS The protective effect against oral cancer of cigarette filter was limited, restricted to smokers of small amount of smoking accumulation. For most smokers, the difference was non-significant between filter and non-filter cigarettes on the risk of developing oral cancer.
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Affiliation(s)
- J Y Fu
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Sharpe KH, McMahon AD, McClements P, Watling C, Brewster DH, Conway DI. Socioeconomic inequalities in incidence of lung and upper aero-digestive tract cancer by age, tumour subtype and sex: a population-based study in Scotland (2000-2007). Cancer Epidemiol 2012; 36:e164-70. [PMID: 22436397 DOI: 10.1016/j.canep.2012.01.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 12/13/2011] [Accepted: 01/30/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Lung and upper aero-digestive tract (UADT) cancer risk is associated with socioeconomic inequality (SEI) but the degree of socioeconomic burden by age, tumour subtype, and sex is not known. METHODS We reviewed 216,305 cases excluding non melanoma skin cancer (All Cancer) comprising 37,274 lung; 8216 head and neck; and 6534 oesophageal cancers from 2000 to 2007 classified into anatomical or morphology subtypes. Deprivation was measured using the Scottish Index of Multiple Deprivation and SEI was measured using the Slope Index of Inequality and the Relative Index of Inequality (RII). Analyses were partitioned by 5-year age group and sex. RII was adapted to rank tumour type contribution to All Cancer SEI and to examine subtype by age and sex simultaneously. Rank was defined as proportion of All Cancer SEI. RESULTS All Cancer SEI was greater for males (RII=0.366; female RII=0.279); the combination of lung and UADT SEI contributed 91% and 81% respectively to All Cancer SEI. For both sexes lung and UADT subtypes showed significant SEI (P<0.001) except oesophageal adenocarcinoma in males (P=0.193); for females, SEI was borderline significant (P=0.048). Although RII rank differed by sex, all lung and larynx subtypes contributed most to All Cancer SEI with RII rank for oral cavity, oesophagus-squamous cell, and oropharynx following. For males 40-44 years, SEI increased abruptly peaking at 55-59 years. For females, SEI gradually peaked 10 years later. In both sexes, the SEI peak preceded peak incidence. CONCLUSION SEI in lung and UADT cancers vary greatly by age, tumour subtype and sex; these variations are likely to largely reflect differences between the sexes in risk behaviours which vary by birth cohort and are socioeconomically patterned.
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Affiliation(s)
- Katharine H Sharpe
- Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, UK.
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Abstract
BACKGROUND When lung cancer fears emerged in the 1950s, cigarette companies initiated a shift in cigarette design from unfiltered to filtered cigarettes. Both the ineffectiveness of cigarette filters and the tobacco industry's misleading marketing of the benefits of filtered cigarettes have been well documented. However, during the 1950s and 1960s, American cigarette companies spent millions of dollars to solve what the industry identified as the 'filter problem'. These extensive filter research and development efforts suggest a phase of genuine optimism among cigarette designers that cigarette filters could be engineered to mitigate the health hazards of smoking. OBJECTIVE This paper explores the early history of cigarette filter research and development in order to elucidate why and when seemingly sincere filter engineering efforts devolved into manipulations in cigarette design to sustain cigarette marketing and mitigate consumers' concerns about the health consequences of smoking. METHODS Relevant word and phrase searches were conducted in the Legacy Tobacco Documents Library online database, Google Patents, and media and medical databases including ProQuest, JSTOR, Medline and PubMed. RESULTS 13 tobacco industry documents were identified that track prominent developments involved in what the industry referred to as the 'filter problem'. These reveal a period of intense focus on the 'filter problem' that persisted from the mid-1950s to the mid-1960s, featuring collaborations between cigarette producers and large American chemical and textile companies to develop effective filters. In addition, the documents reveal how cigarette filter researchers' growing scientific knowledge of smoke chemistry led to increasing recognition that filters were unlikely to offer significant health protection. One of the primary concerns of cigarette producers was to design cigarette filters that could be economically incorporated into the massive scale of cigarette production. The synthetic plastic cellulose acetate became the fundamental cigarette filter material. By the mid-1960s, the meaning of the phrase 'filter problem' changed, such that the effort to develop effective filters became a campaign to market cigarette designs that would sustain the myth of cigarette filter efficacy. CONCLUSIONS This study indicates that cigarette designers at Philip Morris, British-American Tobacco, Lorillard and other companies believed for a time that they might be able to reduce some of the most dangerous substances in mainstream smoke through advanced engineering of filter tips. In their attempts to accomplish this, they developed the now ubiquitous cellulose acetate cigarette filter. By the mid-1960s cigarette designers realised that the intractability of the 'filter problem' derived from a simple fact: that which is harmful in mainstream smoke and that which provides the smoker with 'satisfaction' are essentially one and the same. Only in the wake of this realisation did the agenda of cigarette designers appear to transition away from mitigating the health hazards of smoking and towards the perpetuation of the notion that cigarette filters are effective in reducing these hazards. Filters became a marketing tool, designed to keep and recruit smokers as consumers of these hazardous products.
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Affiliation(s)
- Bradford Harris
- Stanford University, 714 Hayes Street, San Francisco, CA 94102, USA.
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Cigarette smoke, bacteria, mold, microbial toxins, and chronic lung inflammation. JOURNAL OF ONCOLOGY 2011; 2011:819129. [PMID: 21772847 PMCID: PMC3136185 DOI: 10.1155/2011/819129] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 02/28/2011] [Accepted: 03/20/2011] [Indexed: 11/17/2022]
Abstract
Chronic inflammation associated with cigarette smoke fosters malignant transformation and tumor cell proliferation and promotes certain nonneoplastic pulmonary diseases. The question arises as to whether chronic inflammation and/or colonization of the airway can be attributed, at least in part, to tobacco-associated microbes (bacteria, fungi, and spores) and/or microbial toxins (endotoxins and mycotoxins) in tobacco. To address this question, a literature search of documents in various databases was performed. The databases included PubMed, Legacy Tobacco Documents Library, and US Patents. This investigation documents that tobacco companies have identified and quantified bacteria, fungi, and microbial toxins at harvest, throughout fermentation, and during storage. Also characterized was the microbial flora of diverse smoking and smokeless tobacco articles. Evidence-based health concerns expressed in investigations of microbes and microbial toxins in cigarettes, cigarette smoke, and smokeless tobacco products are reasonable; they warrant review by regulatory authorities and, if necessary, additional investigation to address scientific gaps.
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