Indoor air pollution and risk of lung cancer among Chinese female non-smokers. Cancer Causes Control. 2013;24:439-450. [PMID: 23314675 DOI: 10.1007/s10552-012-0130-8]

[Results of Lung Cancer Screening with Low-dose Computed Tomography and Exploration of Risk Factors in Guangzhou]

BACKGROUND

Both of lung cancer incidence and mortality rank first among all cancers in China. Previous lung cancer screening trials were mostly selective screening for high-risk groups such as smokers. Non-smoking women accounted for a considerable proportion of lung cancer cases in Asia. This study aimed to evaluate the outcome of community-based mass screening in Guangzhou and identify the high-risk factors for lung cancer.

METHODS

Residents aged 40-74 years in Guangzhou were screened with low-dose computed tomography (LDCT) for lung cancer and the pulmonary nodules were classified and managed according to China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2018 version). The detection rate of positive nodules was calculated. Before the LDCT examination, residents were required to complete a "lung cancer risk factors questionnaire". The risk factors of the questionnaire were analyzed by least absolute shrinkage and selection operator (LASSO) penalized Logistic regression analysis.

RESULTS

A total of 6256 residents were included in this study. 1228 positive nodules (19.63%) and 117 lung cancers were confirmed, including 6 cases of Tis, 103 cases of stage I (accounting for 88.03% of lung cancer). The results of LASSO penalized Logistic regression analysis indicated that age ≥50 yr (OR=1.07, 95%CI: 1.06-1.07), history of cancer (OR=3.29, 95%CI: 3.22-3.37), textile industry (OR=1.10, 95%CI: 1.08-1.13), use coal for cooking in childhood (OR=1.14, 95%CI: 1.13-1.16) and food allergy (OR=1.10, 95%CI: 1.07-1.13) were risk factors of lung cancer for female in this district.

CONCLUSIONS

This study highlighted that numerous early stages of lung cancer cases were detected by LDCT, which could be applied to screening of lung cancer in women. Besides, age ≥50 yr, personal history of cancer, textile industry and use coal for cooking in childhood are risk factors for women in this district, which suggested that it's high time to raise the awareness of early lung cancer screening in this group.

Efficacy of treating bacterial bioaerosols with weakly acidic hypochlorous water: A simulation chamber study

The COVID-19 pandemic highlighted the dangers of airborne transmission and the risks of pathogen-containing small airborne droplet inhalation as an infection route. As a pathogen control, Weakly Acidic Hypochlorous Water (WAHW) is used for surface disinfection. However, there are limited assessments of air disinfection by WAHW against airborne pathogens like bioaerosols. This was an empirical study evaluating the disinfection efficacy of WAHW in an atmospheric simulation chamber system against four selected model bacteria. The strains tested included Staphylococcus aureus (SA), Escherichia coli (EC), Pseudomonas aeruginosa (PA), and Pseudomonas aeruginosa (PAO1). Each bacterial solution was nebulized into the chamber system as the initial step, and bioaerosol was collected into the liquid medium by a bio-sampler for colony forming units (CFU) determination. Secondly, the nebulized bacterial bioaerosol was exposed to nebulized double distilled water (DDW) as the control and nebulized 150 ppm of WAHW as the experimental groups. After the 3 and 30-min reaction periods, the aerosol mixture inside the chamber was sampled in liquid media and then cultured on agar plates with different dilution factors to determine the CFU. Survival rates were calculated by a pre-exposed CFU value as a reference point. The use of WAHW decreased bacterial survival rates to 1.65-30.15% compared to the DDW control. PAO1 showed the highest survival rates and stability at 3 min was higher than 30 min in all experiments. Statistical analysis indicated that bacteria survival rates were significantly reduced compared to the controls. This work verifies the bactericidal effects against Gram-positive/negative bioaerosols of WAHW treatment. As WAHW contains chlorine in the acid solution, residual chlorine air concentration is a concern and the disinfection effect at different concentrations also requires investigation. Future studies should identify optimal times to minimize the treated time range and require measurements in a real environment.

Impact of indoor air pollution from cooking fuel usage and practices on self-reported health among older adults in India: Evidence from LASI

This research aims to explore the impact of various components of Indoor air pollution (IAP) on the Self-Reported Health (SRH) of older adults in India. Using a sample of 27,090 from the Longitudinal Aging Study in India (LASI) Wave-1, a multiple binary logistic regression model was employed to identify specific risk factors associated with poor SRH among older adults. Adjusting for demographic, socioeconomic, and IAP-related components, it was revealed that IAP significantly contributes to poor SRH. The adjusted model indicated that individuals using solid cooking fuels face a higher risk of poor SRH compared to those using liquid fuels. Additionally, individuals not using electric chimneys and cooking near windows are associated with an elevated risk of poor SRH, highlighting the importance of adequate ventilation. Health risk factors, including lung disease, diabetes, cough, and depression, further contribute to poor SRH among older adults exposed to IAP. Overall, the study offers crucial insights for policymakers, healthcare professionals, and environmentalists to improve the well-being of the vulnerable older population in India.

Clinic information, pathological, and imaging characteristics in 2 058 surgical patients with lung cancer from a single center

OBJECTIVES

Lung cancer is characterized by its high incidence and case fatality rate. Factors related to population composition and cancer prevention programme policy have an effect on the incidence and diagnosis of lung cancer. This study aims to provide scientific support for early diagnosis and treatment of lung cancer by investigating the clinic information, pathological, and imaging characteristics of surgical patients with lung cancer.

METHODS

The data of 2 058 patients, who underwent surgery for lung cancer in the Department of Thoracic Surgery of Xiangya Hospital of Central South University from 2016 to 2019, were retrospectively collected to analyze changes in clinic information, pathological, and imaging characteristics.

RESULTS

From 2016 to 2019, the number of patients per year was 280, 376, 524, and 878, respectively. Adenocarcinoma (68.1%) was the most common pathological type of surgical patients with lung cancer. From 2016 to 2019, the proportion of adenocarcinoma was increased from 55.5% to 74.1%. The proportion lung cancer patients in stage IA was increased from 38.9% to 62.3%, and the proportion of patients who underwent sublobar resection was increased from 1.8% to 8.6%. The proportion of lymph node sampling was increased in 2019. Compared with the rate in 2016, the detection rate of nodules with diameter≤1 cm detected by CT before surgery in 2019 was significantly improved (2.0% vs 18.2%), and the detection rate of nodules with diameter>3 cm was decreased (34.7% vs 18.3%). From 2016 to 2019, the proportion of lesions with pure ground-glass density and partial solid density detected by CT was increased from 2.0% and 16.6% to 20.0% and 37.3%, respectively. The proportion of solid density was decreased from 81.4% to 42.7%.

CONCLUSIONS

The number of lung cancer surgery patients is rapidly increasing year by year, the proportion of CT-detected purely ground-glass density and partially solid density lesions are increasing, the proportion of patients with adenocarcinoma is rising, the proportion of early-stage lung cancer is increasing, smaller lung cancers are detected in earlier clinical stage leading to a more minimally invasive approach to the surgical methods.

[Effectiveness Evaluation of Low-dose Spiral Computed Tomography for Lung Cancer Screening in Minhang District of Shanghai]

BACKGROUND

Low-dose spiral computed tomography (LDCT) has been recommended for lung cancer screening in high-risk populations. However, evidence from Chinese populations was limited due to the different criteria for high-risk populations and the short-term follow-up period. This study aimed to evaluate the effectiveness in Chinese adults based on the Lung Cancer Screening Program in Minhang District of Shanghai initiated in 2013.

METHODS

A total of 26,124 subjects aged 40 years or above were enrolled in the Lung Cancer Screening Program during the period of 2013 and 2017. Results of LDCT examination, and screen-detected cancer cases in all participants were obtained from the Reporting System of the Lung Cancer Screening Program. The newly-diagnosed cases and their vital status up to December 31, 2020 were identified through a record linkage with the Shanghai Cancer Registry and the Shanghai Vital Statistics. Standardized incidence ratio (SIR) and 95%CI were calculated using the local population at ages of 40 or above as the reference. Proportions of early-stage cancer (stage 0-I), pathological types, and 5-year observed survival rates of lung cancer cases were estimated and compared between the cases derived from the screened and non-screened populations. Cox regression models were applied to evaluate the hazard ratio (HR) and 95%CI of LDCT screening with all-cause death of the lung cancer cases.

RESULTS

The crude and age-standardized incidence of lung cancer in screened population were 373.3 (95%CI: 343.1-406.1) and 70.3 per 100,000 person-years, respectively, with an SIR of 1.8 (95%CI: 1.6-1.9), which was observed to decrease with following-up time. The early-stage cancer accounted for 49.4% of all lung cancer cases derived from the screened population, significantly higher than 38.4% in cases from the non-screened population during the same period (P<0.05). The proportion of lung adenocarcinoma (40.7% vs 35.9%) and 5-year survival rate (53.7% vs 41.5%) were also significantly higher in the cases from the screened population (all P<0.05). LDCT screening was associated with 30% (HR=0.7, 95%CI: 0.6-0.8) reduced all-cause deaths of the cases.

CONCLUSIONS

The participants of the screening program are at high-risk of lung cancer. LDCT favors the early-detection of lung cancer and improves 5-year survival of the screened cases, indicating a great potential of LDCT in reducing the disease burden of lung cancer in Chinese populations.

Shrinking the battlefield in cancer therapy: Nanotechnology against cancer stem cells

Cancer remains one of the leading causes of mortality worldwide, presenting a significant healthcare challenge owing to the limited efficacy of current treatments. The application of nanotechnology in cancer treatment leverages the unique optical, magnetic, and electrical attributes of nanomaterials to engineer innovative, targeted therapies. Specifically, manipulating nanomaterials allows for enhanced drug loading efficiency, improved bioavailability, and targeted delivery systems, reducing the non-specific cytotoxic effects characteristic of conventional chemotherapies. Furthermore, recent advances in nanotechnology have demonstrated encouraging results in specifically targeting CSCs, a key development considering the role of these cells in disease recurrence and resistance to treatment. Despite these breakthroughs, the clinical approval rates of nano-drugs have not kept pace with research advances, pointing to existing obstacles that must be addressed. In conclusion, nanotechnology presents a novel, powerful tool in the fight against cancer, particularly in targeting the elusive and treatment-resistant CSCs. This comprehensive review delves into the intricacies of nanotherapy, explicitly targeting cancer stem cells, their markers, and associated signaling pathways.

Air Pollution and Lung Cancer: A Review by International Association for the Study of Lung Cancer Early Detection and Screening Committee

INTRODUCTION

The second leading cause of lung cancer is air pollution. Air pollution and smoking are synergistic. Air pollution can worsen lung cancer survival.

METHODS

The Early Detection and Screening Committee of the International Association for the Study of Lung Cancer formed a working group to better understand issues in air pollution and lung cancer. These included identification of air pollutants, their measurement, and proposed mechanisms of carcinogenesis. The burden of disease and the underlying epidemiologic evidence linking air pollution to lung cancer in individuals who never and ever smoked were summarized to quantify the problem, assess risk prediction models, and develop recommended actions.

RESULTS

The number of estimated attributable lung cancer deaths has increased by nearly 30% since 2007 as smoking has decreased and air pollution has increased. In 2013, the International Agency for Research on Cancer classified outdoor air pollution and particulate matter with aerodynamic diameter less than 2.5 microns in outdoor air pollution as carcinogenic to humans (International Agency for Research on Cancer group 1) and as a cause of lung cancer. Lung cancer risk models reviewed do not include air pollution. Estimation of cumulative exposure to air pollution exposure is complex which poses major challenges with accurately collecting long-term exposure to ambient air pollution for incorporation into risk prediction models in clinical practice.

CONCLUSIONS

Worldwide air pollution levels vary widely, and the exposed populations also differ. Advocacy to lower sources of exposure is important. Health care can lower its environmental footprint, becoming more sustainable and resilient. The International Association for the Study of Lung Cancer community can engage broadly on this topic.

Vaping, Environmental Toxicants Exposure, and Lung Cancer Risk

Lung cancer (LC) is the second-most prevalent tumor worldwide. According to the most recent GLOBOCAN data, over 2.2 million LC cases were reported in 2020, with an estimated new death incident of 1,796,144 lung cancer cases. Genetic, lifestyle, and environmental exposure play an important role as risk factors for LC. E-cigarette, or vaping, products (EVPs) use has been dramatically increasing world-wide. There is growing concern that EVPs consumption may increase the risk of LC because EVPs contain several proven carcinogenic compounds. However, the relationship between EVPs and LC is not well established. E-cigarette contains nicotine derivatives (e.g., nitrosnornicotine, nitrosamine ketone), heavy metals (including organometal compounds), polycyclic aromatic hydrocarbons, and flavorings (aldehydes and complex organics). Several environmental toxicants have been proven to contribute to LC. Proven and plausible environmental carcinogens could be physical (ionizing and non-ionizing radiation), chemicals (such as asbestos, formaldehyde, and dioxins), and heavy metals (such as cobalt, arsenic, cadmium, chromium, and nickel). Air pollution, especially particulate matter (PM) emitted from vehicles and industrial exhausts, is linked with LC. Although extensive environmental exposure prevention policies and smoking reduction strategies have been adopted globally, the dangers remain. Combined, both EVPs and toxic environmental exposures may demonstrate significant synergistic oncogenicity. This review aims to analyze the current publications on the importance of the relationship between EVPs consumption and environmental toxicants in the pathogenesis of LC.

Where there are fumes, there may be lung cancer: a systematic review on the association between exposure to cooking fumes and the risk of lung cancer in never-smokers

PURPOSE

Lung cancer in never-smokers (LCINS) is the seventh leading cause of cancer, and exposure to cooking fumes has recently emerged as a potential risk factor. This systematic review is the first to summarize and evaluate the relationship between exposure to cooking fumes and the risk of LCINS.

METHODS

This study conducted an online literature search of PubMed, CINAHL, and PsychInfo databases. Inclusion criteria were original research articles published in English, that assessed the relationship between exposure to cooking fumes and the risk of lung cancer between 1 January 2012 and 6 December 2022, and that included never-smokers.

RESULTS

Thirteen case-control studies and three prospective cohort studies, focusing mostly on women with LCINS, met the inclusion criteria. Seven case-control studies reported an association between exposure to cooking oil fumes and an increased risk of LCINS. Two case-control studies found that using a fume extractor was associated with a decreased risk of LCINS. In other case-control studies, coal use was linked to an increased risk of LCINS, and participants who did not use a ventilator in their kitchens had a higher risk for LCINS. Poor ventilation [Adjusted Hazard Ratio (AHR) = 1.49; 95% CI: 1.15, 1.95] and poor ventilation in combination with coal use (AHR = 2.03; 95% CI: 1.35, 3.05) were associated with an increased risk for LCINS in one prospective cohort study.

CONCLUSION

The evidence reviewed underscores the need to develop culturally-tailored interventions that improve access to affordable and clean fuel through engaging relevant stakeholders.

Path planning for percutaneous lung biopsy based on the loose-Pareto and adaptive heptagonal optimization method

Lung cancer has is highly prevalent worldwide and is the leading cause of cancer-related deaths. In the clinic, a biopsy sample of the lesion is taken to determine whether a lung mass is benign or malignant. CT-guided percutaneous lung biopsy is a minimally invasive intervention and is commonly used to diagnose lung cancer. Path planning before surgery plays a crucial role in percutaneous lung biopsy. Traditionally, path planning for lung biopsy is performed manually by physicians based on CT images of the patient, which demands knowledge and extensive clinical experience of the operating physicians. In this work, a computer-assisted path planning system for percutaneous lung biopsy is proposed based on clinical objectives. Five constraints are presented to remove unqualified skin entry points and determine a feasible entry region based on clinical criteria. Inspired by the Pareto principle and the concept of geometric weighting, the loose-Pareto and adaptive heptagonal optimization (LPHO) method is introduced to plan the optimal puncture path. CT images of 29 patients were collected from Zigong First People's Hospital. Retrospective experiments and test experiments were conducted to evaluate the effectiveness of the algorithm. The planning paths obtained using the proposed method were clinically feasible for 89.7% of patients, demonstrating the applicability and robustness of the system in surgical path planning for lung biopsy.

A new filterless indoor air purifier for particulate matter and bioaerosol based on heterogeneous condensation

Using an indoor air purifier is an important solution for improving indoor air quality and protecting people from the harmful effects of air pollution on their health. The filter air purifiers can remove particulate matter including bioaerosols, but their filter media can cause secondary pollution. To fulfill this need, a new filterless indoor air purifier, the Cloud-Air-Purifying (CAP) air purifier, is presented in this study. Using heterogeneous condensation and supergravity technology, the CAP air purifier grows and collects fine particles, while rapidly disinfecting bioaerosols with chemical disinfection and ultraviolet (UV) disinfection. Furthermore, the purifying performance of the CAP air purifier was tested in a simulated cabin. The results showed the clean air delivery rate (CADR) of the CAP air purifier was approximately 150 m³/h, and the effective coefficient was 0.93. The CAP air purifier was highly efficient in purifying fine particulate matter, 93% for PM₁₀ and 91% for particle size of 0.5-1 μm in 60 min, which was 13-58 times more than natural decay. The reason for the efficient removal of fine particles is that they can condense and grow in water vapor supersaturated environment and be collected in a supergravity field. Moreover, the CAP air purifier has significant bactericidal effects on bioaerosols. It achieved a disinfection efficiency of 99.99997% by decreasing bioaerosols from 10⁸ CFU/m³ to less than 30 CFU/m³ in only 20 min when particle purification in combination with UV disinfection and disinfectant (ClO₂). Furthermore, ClO₂ release concentrations, noise, and power consumption were investigated for application purposes, with results showing that they were within acceptable limits. The study presents an innovative idea and design for preventing airborne microorganisms and particulate matter through heterogeneous condensation technology.

Effects of quercetin on emissions of aldehydes from heated docosahexaenoic acid (DHA)-fortified soybean oil

Home cooking has been considered as an indoor pollution problem since cooking oil fumes contain various toxic chemicals such as aldehydes. Fortifying edible oils with docosahexaenoic acid (DHA) has been applied to enhance the nutritional value of oils. This study designed a frying simulation system and examined the effect of oil type, DHA fortification, heating time, and addition of natural antioxidant on the emissions of aldehydes from heated oils. Results showed that linseed oil had the highest total aldehyde emissions, followed by soybean oil, peanut oil, and palm oil. Fortifying soybean oil with DHA increased the toxic aldehydes emitted. Quercetin, a flavonoid, significantly reduced aldehydes emitted from DHA-fortified soybean oil (by up to 39.80%) to levels similar to those of normal soybean oil. Further analysis showed that DHA-fortified soybean oil with quercetin had a significantly higher DHA and unsaturated fatty acids (UFAs) content than the control oil at each heating time point. The result indicated that quercetin inhibited emissions of aldehydes, at least in part, by protecting UFAs from oxidation. Collectively, quercetin could be used as a natural additive in DHA-fortified and normal cooking oils to reduce aldehyde emissions, indoor air pollution, and preserve functional DHA and other UFAs.

The Introduction of Low-Dose CT Imaging and Lung Cancer Overdiagnosis in Chinese Women

BACKGROUND

Overdiagnosis of lung cancer by low-dose CT (LDCT) screening has raised concerns globally. LDCT screening has been used widely in employee health examinations in China since 2011.

RESEARCH QUESTION

Has the increasing use of LDCT in low-risk populations in China led to lung cancer overdiagnosis?

STUDY DESIGN AND METHODS

A total of 34,152 incident cases of and 27,208 deaths resulting from lung cancer in a population of approximately 3 million were derived from the Cancer Surveillance of Shanghai between 2002 and 2017. Changes in stage-specific and histologic type-specific incidence and mortality and incidence rate ratio (IRR) relative to the base year 2002 or to the period 2002 through 2005 were calculated by sex and were used to evaluate potential overdiagnosisve of lung cancer.

RESULTS

In men, both age-adjusted incidence of and mortality as a result of lung cancer decreased significantly up to 2008 and thereafter remained stable; in women, the incidence increased rapidly from 2011 (annual percentage change, 11.98%; 95% CI, 9.57%-14.45%), whereas the mortality declined persistently. The upward trend of incidence mainly was observed in lung adenocarcinoma in both sexes, with a sharper increase from 2012 through 2017. In men, the incidence of early-stage cancer increased 6.9 per 100,000 (95% CI, 5.1-8.7 per 100,000) and was accompanied by 5.5 per 100,000 (95% CI, -9.2 to -1.7 per 100,000) decline in late-stagecancer from 2002 through 2017. In women, early-stage incidence rose 16.1 per 100,000 (95% CI, 14.0-18.3 per 100,000), but no significant decline in late-stage cancer was found (absolute difference, -0.6 per 100,000; 95% CI, -2.8 to 1.7 per 100,000). The IRR was highest in most recent period and increased most in young women, mainly for early-stage cancer or lung adenocarcinoma.

INTERPRETATION

The results provide evidence at a population level for lung cancer overdiagnosis in Chinese women resulting from increasing LDCT screening in the low-risk populations. Criteria for LDCT screening and management of screening-detected nodules need to be addressed fully for expanded application of LDCT screening in China.

Do Storage Conditions Affect Collected Cookstove Emission Samples? Implications for Field Studies

Cookstove emissions are a significant source of indoor air pollution in developing countries and rural communities world-wide. Considering that many research sites for evaluating cookstove emissions and interventions are remote and require potentially lengthy periods of particulate matter (PM) filter sample storage in sub-optimal conditions (e.g., lack of cold storage), an important question is whether samples collected in the field are stable over time. To investigate this, red oak was burned in a natural-draft stove, and fine PM (PM2.5) was collected on polytetrafluoroethylene filters. Filters were stored at either ambient temperature or more optimal conditions (-20°C or -80°C) for up to 3 months and extracted. The effects of storage temperature and length on stability were evaluated for measurements of extractable organic matter (EOM), PM2.5, and polycyclic aromatic compound (PAC) levels in the filter extracts. A parallel, controlled laboratory condition was also evaluated to further explore sources of variability. In general, PM2.5 and EOM in both simulated field and laboratory samples were similar regardless of the storage condition or duration. The extracts were also analyzed by gas chromatography to quantify 22 PACs and determine similarities and/or differences between the conditions. PAC levels were a more sensitive stability measure in differentiating between storage conditions. The findings suggest that measurements are relatively consistent across storage duration/temperatures for filter samples with relatively low EOM levels. This study aims to inform protocols and filter storage procedures for exposure and intervention research conducted in low- and middle-income countries where studies may be budget- and infrastructure-limited.

Incidence and Risk of Lung Cancer in Tuberculosis Patients, and Vice Versa: A Literature Review of the Last Decade

Background

The incidence and risk of both lung cancer (LC) and tuberculosis (TB) are increasing rapidly. These two diseases frequently exist together and can influence the incidence and risk of each other. The aim of the current review was to summarize the incidence and risk of LC in TB patients, and vice versa, short out research gap, and contemplate future research perspectives. Methodology. PubMed and Scopus databases, and Google Scholar search engine were searched for epidemiological studies that investigated the incidence and risk of TB and LC, published since January 2011 to April 2022, and written in English. We used the searching keyword "tuberculosis" combined with "lung cancer" and associated medical subject heading (MeSH) to retrieve eligible research articles. We retrieved information's regarding the diagnosis of TB and LC, confounders, the associations of TB and LC, and incidence and risks of each other.

Results

We found higher incidence rate and risks (1.64 to 6 times higher) of LC in TB patients in comparison to non-TB participants. However, the incidence rate and risks of TB in LC patients were comparatively low. Male patients were exhibited higher risks than female. The medical comorbidities, smoking habits, and age can also influence the associations and risks of LC in TB patients or vice versa.

Conclusion

Our summarized studies might suggest that existing active TB may increase the incidence and risk of LC. However, large prospective cohort study is warranted to explore the real scenario worldwide.

KBTBD7 promotes non-small cell lung carcinoma progression by enhancing ubiquitin-dependent degradation of PTEN

The Kelch repeat and BTB domain containing 7 (KBTBD7) was first cloned in 2010. Its function as a transcriptional activator and a substrate adaptor during the ubiquitination process was soon found. KBTBD7 was shown to be involved in excessive inflammation after myocardial infarction, brain development, and neurofibromin stability. However, studies on the role of KBTBD7 in solid tumors, especially lung cancer, are still lacking. Therefore, in this study, we investigate the role of KBTBD7 in non-small cell lung cancer (NSCLC). Immunohistochemical staining of 102 paired NSCLC and peritumoral normal specimens indicated that KBTBD7 was highly expressed in NSCLC tissues and positively correlated with the histological type, P-TNM stage, lymph node metastasis, and tumor size. KBTBD7 was also well-expressed in NSCLC cell lines, and downregulation of KBTBD7 resulted in inhibition of NSCLC cell proliferation and invasion. Further investigation showed that KBTBD7 enhanced ubiquitin-dependent degradation of PTEN, thus activating EGFR/PI3K/AKT signaling and promoting NSCLC cell proliferation and invasion by regulating CCNE1, CDK4, P27, ZEB-1, Claudin-1, ROCK1, MMP-9, and E-cadherin protein levels. Our results indicate that KBTBD7 may be a potential therapeutic target for the treatment of NSCLC.

Lifestyle, Epstein-Barr virus infection, and other factors could impede nasopharyngeal cancer survivorship: a five-year cross-sectional study in North Eastern India

Nasopharyngeal Carcinoma (NPC) is one of the leading cancers in India's north-eastern (NE) region affecting a section of the population each year. A proportion of the NPC cases are observed to recur even after therapy, indicating the involvement of other factors. We aimed to explore the NPC and Epstein-Barr virus (EBV) burden in the NE region and investigate the prognostic factors for the NPC patients' poor survival and recurrence. NPC patients' information was obtained from different state hospitals between 2014 and 2019. PCR and Sanger sequencing were performed to detect EBV types. Statistical analysis, including forest plot analysis, Kaplan-Mayer survival plot, Log-rank test, cox hazard regression, and Aalen's additive regression model, were performed to determine prognostic factors for the NPC patients' lower survival and recurrence. We observed an increased incidence of NPC and EBV infection in the past five years. Step-wise statistical analyses pointed out that variable such as non-professionals (B = 1.02, HR = 2.8, 95%CI = 1.5,4.9) workers (B = 0.92, HR = 2.5, 95%CI = 1.4,4.4), kitchen cum bedroom (B = 0.61, HR = 1.8, 95%CI = 1.2,2.8), mosquito repellent (B = 0.60, HR = 1.7, 95%CI = 1.1,2.7), nasal congestion (B = 0.60, HR = 1.8, 95%CI = 1.2,2.8), lower haemoglobin level (B = 0.92, HR = 2.5, 95%CI = 1.3,4.9), tumor stage IV (B = 2.8, HR = 1.8, 95%CI = 1.6,14.3), N2 (B = 1.4, HR = 4.0, 95%CI = 1.8,9.1), N3 (B = 1.9, HR = 6.4, 95%CI = 2.8,15.3), and M+ (B = 2.02, HR = 7.5, 95%CI = 4.1,13.7) revealed significant correlation with NPC patients' poor prognosis (p < 0.05). The presence of viral factors also showed a significant association with NPC patients' decreased survival. We concluded that factors related to day-to-day life with EBV infection could be the individual predictor for NPC incidence, lower survival, and disease recurrence.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13337-022-00789-5.

Cancer situation in China: what does the China cancer map indicate from the first national death survey to the latest cancer registration?

BACKGROUND

Over the past four decades, the Chinese government has conducted three surveys on the distribution of causes of death and built cancer registration. In order to shine a new light on better cancer prevention strategies in China, we evaluated the profile of cancer mortality over the forty years and analyzed the policies that have been implemented.

METHODS

We described spatial and temporal changes in both cancer mortality and the ranking of major cancer types in China based on the data collected from three national surveys during 1973-1975, 1990-1992, 2004-2005, and the latest cancer registration data published by National Central Cancer Registry of China. The mortality data were compared after conversion to age-standardized mortality rates based on the world standard population (Segi's population). The geographical distribution characteristics were explored by marking hot spots of different cancers on the map of China.

RESULTS

From 1973 to 2016, China witnessed an evident decrease in mortality rate of stomach, esophageal, and cervical cancer, while a gradual increase was recorded in lung, colorectal, and female breast cancer. A slight decrease of mortality rate has been observed in liver cancer since 2004. Lung and liver cancer, however, have become the top two leading causes of cancer death for the last twenty years. From the three national surveys, similar profiles of leading causes of cancer death were observed among both urban and rural areas. Lower mortality rates from esophageal and stomach cancer, however, have been demonstrated in urban than in rural areas. Rural areas had similar mortality rates of the five leading causes of cancer death with the small urban areas in 1973-1975. Additionally, rural areas in 2016 also had approximate mortality rates of the five leading causes with urban areas in 2004-2005. Moreover, stomach, esophageal, and liver cancer showed specific geographical distributions. Although mortality rates have decreased at most of the hotspots of these cancers, they were still higher than the national average levels during the same time periods.

CONCLUSIONS

Building up a strong primary public health system especially among rural areas may be one critical step to reduce cancer burden in China.

A review of critical residential buildings parameters and activities when investigating indoor air quality and pollutants

Indoor air in residential dwellings can contain a variety of chemicals, sometimes present at concentrations or in combinations which can have a negative impact on human health. Indoor Air Quality (IAQ) surveys are often required to characterize human exposure or to investigate IAQ concerns and complaints. Such surveys should include sufficient contextual information to elucidate sources, pathways, and the magnitude of exposures. The aim of this review was to investigate and describe the parameters that affect IAQ in residential dwellings: building location, layout, and ventilation, finishing materials, occupant activities, and occupant demography. About 180 peer-reviewed articles, published from 01/2013 to 09/2021 (plus some important earlier publications), were reviewed. The importance of the building parameters largely depends on the study objectives and whether the focus is on a specific pollutant or to assess health risk. When considering classical pollutants such as particulate matter (PM) or volatile organic compounds (VOCs), the building parameters can have a significant impact on IAQ, and detailed information of these parameters needs to be reported in each study. Research gaps and suggestions for the future studies together with recommendation of where measurements should be done are also provided.

Trends of cancer incidence among Chinese older adults from 2005 to 2016: A log-linear regression and age-period-cohort analysis

Background

To study the corresponding strategies for controlling cancer in older adults aged 60 and above in China, a comprehensive assessment of disease burden is required. Therefore, we will introduce the cancer epidemiological characteristics of older adults in China over a recent 12 year period.

Methods

The age-period-cohort model was constructed using the cancer incidence data from the Chinese Cancer Registry Annual Report published in 2008-2019. The annual change percentage (APC) was estimated by log-linear regression to reflect the time trend. The data from the GLOBOCAN 2020 database was selected for worldwide comparative analysis.

Results

The cancer incidence in older adults aged 60 and above in China showed a decreasing trend (APC = -0.73%, P = 0.009). The urban/rural ratio of cancer incidence increased from 0.94 to 1.07 (t = 3.52, P < 0.05), while the sex ratio (male/female) showed a significant decreasing trend only in rural areas (t = -6.77, P < 0.05), and the ratio decreased from 2.02 to 1.72. The results of the age-period-cohort model showed that the cancer incidence increased with age in both males and females, urban and rural areas. The RR of period effect increased from 2005 to 2010, then decreased from 2010 to 2015, and the downward trend was more obvious. The RR of the later-born cohort was lower than that of the earlier-born cohort in rural areas. Lung, gastric, colorectal, esophageal, liver, and breast cancers were common cancers in Chinese older adults. Lung cancer incidence ranked first in males, and it decreased with time in the 75-79 and 80-84 age groups (APC_{75 - 79} = -1.10%, APC_{80 - 84} = -0.88%, all P < 0.05). Breast cancer incidence ranked first among female in the 60-64 age group and showed an increasing trend (APC_{60 - 64} = 1.52%, P < 0.05).

Conclusions

The cancer incidence in Chinese older adults aged 60 and above showed a decreasing trend, but it was still at a relatively high level. The key targets of prevention and treatment should be males, urban areas, younger people, older adults aged 60-69, lung, gastrointestinal, and breast cancers in the future.

Prevalence of lung cancer in chronic obstructive pulmonary disease: A systematic review and meta-analysis

Background

There is growing evidence that chronic obstructive pulmonary disease (COPD) can increase the risk of lung cancer, which poses a serious threat to treatment and management. Therefore, we performed a meta-analysis of lung cancer prevalence in patients with COPD with the aim of providing better prevention and management strategies.

Methods

We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library databases from their inception to 20 March 2022 to collect studies on the prevalence of lung cancer in patients with COPD. We evaluated the methodological quality of the included studies using the tool for assessing the risk of bias in prevalence studies. Meta-analysis was used to determine the prevalence and risk factors for lung cancer in COPD. Subgroup and sensitivity analyses were conducted to explore the data heterogeneity. Funnel plots combined with Egger’s test were used to detect the publication biases.

Results

Thirty-one studies, covering 829,490 individuals, were included to investigate the prevalence of lung cancer in patients with COPD. Pooled analysis demonstrated that the prevalence of lung cancer in patients with COPD was 5.08% (95% confidence interval [CI]: 4.17–6.00%). Subgroup analysis showed that the prevalence was 5.09% (95% CI: 3.48–6.70%) in male and 2.52% (95% CI: 1.57–4.05%) in female. The prevalence of lung cancer in patients with COPD who were current and former smokers was as high as 8.98% (95% CI: 4.61–13.35%) and 3.42% (95% CI: 1.51–5.32%); the incidence rates in patients with moderate and severe COPD were 6.67% (95% CI: 3.20–10.14%) and 5.57% (95% CI: 1.89–16.39%), respectively, which were higher than the 3.89% (95% CI: 2.14–7.06%) estimated in patients with mild COPD. Among the types of lung cancer, adenocarcinoma and squamous cell carcinoma were the most common, with incidence rates of 1.59% (95% CI: 0.23–2.94%) and 1.35% (95% CI: 0.57–3.23%), respectively. There were also differences in regional distribution, with the highest prevalence in the Western Pacific region at 7.78% (95% CI: 5.06–10.5%), followed by the Americas at 3.25% (95% CI: 0.88–5.61%) and Europe at 3.21% (95% CI: 2.36–4.06%).

Conclusions

This meta-analysis shows that patients with COPD have a higher risk of developing lung cancer than those without COPD. More attention should be given to this result in order to reduce the risk of lung cancer in these patients with appropriate management and prevention.

Systematic review registration

International prospective register of systematic reviews, identifier CRD42022331872.

Expression and clinical significance of CD31, CD34, and CD105 in pulmonary ground glass nodules with different vascular manifestations on CT

Blood vessel passage on CT exerts a vital part in early diagnosis as well as treatment of carcinoma of the lungs. Intratumoral microvascular density (iMVD) has gradually become the focus of research on biological behavior, appearance, and evolution of malignant tumors nowadays. The aim of this paper was to verify whether there is a correlation between the iMVD and the vascular morphology of ground glass nodules (GGNs). A total of 109 patients with pulmonary GGN were classified into three groups (I,II, and III) according to the vascular morphology on CT, and their expression of CD31-, CD34-, and CD105-labeled iMVD was detected by the streptoavidin–biotin method, statistically analyzing the iMVD values of each group. The expression of CD31, CD34, and CD105 in different lung tissues was significantly different, with remarkably higher iMVD in lung cancer tissues than in adjacent normal lung tissues. In the imaging sort of types I, II, and III according to the means of vascular passage, the iMVD expression of CD31, CD34, and CD105 was significantly different between groups. These data suggest that the presence and the abnormal morphology of vessels seen within GGNs indicate the occurrence and progression of lung cancer in pathology. It offers a strong theoretical foundation for early diagnosis of carcinoma of the lungs, thus providing a more precise clinical diagnosis and prognosis of early-stage lung cancer.

Polyurethane Foam Face Masks as a Dosimeter for Quantifying Personal Exposure to Airborne Volatile and Semi-Volatile Organic Compounds

Airborne volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs) are commonly quantitated by collecting the analytes on solid sorbent tubes or passive air samplers, followed by solvent extraction and instrumental analysis, or by grab bag/canister measurements. We report herein a user-friendly sampling method by breathing through polyurethane foam (PUF) face masks to collect airborne VOCs and SVOCs for chemical analysis. Specifically, dibasic esters, phthalate esters, polycyclic aromatic hydrocarbons, linalool, and nicotine trapped on PUF masks were quantitated by gas chromatography-mass spectrometry analysis as model VOCs and SVOCs. Results showed that the amount of these model VOCs and SVOCs trapped on PUF masks is proportional to the exposure duration. After cross-validation by parallel sampling using XAD-2 packed sorbent tubes, the method was used to quantitate VOCs and SVOCs in a variety of indoor and outdoor environments with varying air concentrations of analytes, temperature, humidity, and wind speed. Because air pollution is considered a major cause of many human diseases and premature deaths and the developed PUF mask sampling method showed high trapping efficiencies for both VOCs and SVOCs, it is believed that the developed sampling method will find wide application in assessing air pollution-associated disease risks with possible extension to more classes of VOCs and SVOCs when coupled with suitable instrumental detection methods.

Lung Cancer in the Course of COPD-Emerging Problems Today

Tobacco smoking remains the main cause of tobacco-dependent diseases like lung cancer, chronic obstructive pulmonary disease (COPD), in addition to cardiovascular diseases and other cancers. Whilst the majority of smokers will not develop either COPD or lung cancer, they are closely related diseases, occurring as co-morbidities at a higher rate than if they were independently triggered by smoking. A patient with COPD has a four- to six-fold greater risk of developing lung cancer independent of smoking exposure, when compared to matched smokers with normal lung function. The 10 year risk is about 8.8% in the COPD group and only 2% in patients with normal lung function. COPD is not a uniform disorder: there are different phenotypes. One of them is manifested by the prevalence of emphysema and this is complicated by malignant processes most often. Here, we present and discuss the clinical problems of COPD in patients with lung cancer and against lung cancer in the course of COPD. There are common pathological pathways in both diseases. These are inflammation with participation of macrophages and neutrophils and proteases. It is known that anticancer immune regulation is distorted towards immunosuppression, while in COPD the elements of autoimmunity are described. Cytotoxic T cells, lymphocytes B and regulatory T cells with the important role of check point molecules are involved in both processes. A growing number of lung cancer patients are treated with immune check point inhibitors (ICIs), and it was found that COPD patients may have benefits from this treatment. Altogether, the data point to the necessity for deeper analysis and intensive research studies to limit the burden of these serious diseases by prevention and by elaboration of specific therapeutic options.

Organic pollutant exposure and health effects of cooking emissions on kitchen staff in food services

This study was conducted to determine the exposure and health risk to cooking fumes of a total of 88 volunteer kitchen staff aged between 18 and 65 years working in five different kitchens in Ankara. Gas- and particle-phase polycyclic aromatic hydrocarbons (PAHs), and volatile organic compound (VOCs) concentrations were evaluated in the indoor air of 5 kitchens. Serum malondialdehyde (MDA) and superoxide dismutase (SOD) levels were analyzed to determine the oxidative damage as a result of the exposure to cooking fumes among the cooks and waiters. Significant positive relationships were found between serum MDA levels of the hot kitchen workers and indoor chrysene (Chr), indeno(1,2,3-c,d)pyrene (Ind), and total VOC levels. Although the carcinogenic risks estimated for the exposed population were between the acceptable/tolerable levels, the hazard quotient (HQ) estimated for the exposure to indoor benzene exceeded the safe level. The results of the study revealed that exposure to organic pollutants in indoor air may be a risk factor for the development of oxidative stress, especially in hot kitchen workers. The importance of efficient ventilation in the kitchen has been pointed out to reduce health risks caused by cooking fumes.

Air pollution: A culprit of lung cancer

Air pollution is a global health problem, especially in the context of rapid economic development and the expansion of urbanization. Herein, we discuss the harmful effects of outdoor and indoor pollution on the lungs. Ambient particulate matters (PMs) from industrial and vehicle exhausts is associated with lung cancer. Workers exposed to asbestos, polycyclic aromatic hydrocarbons (PAHs), and toxic metals are also likely to develop lung cancer. Indoors, cooking fumes, second-hand smoke, and radioactive products from house decoration materials play roles in the development of lung cancer. Bacteria and viruses can also be detrimental to health and are important risk factors in lung inflammation and cancer. Specific effects of lung cancer caused by air pollution are discussed in detail, including inflammation, DNA damage, and epigenetic regulation. In addition, advanced materials for personal protection, as well as the current government policies to prevent air pollution, are summarized. This review provides a basis for future research on the relationship between lung cancer and air pollution.

A protective role of autophagy in fine airborne particulate matter-induced apoptosis in LN-229 cells

Air pollution is a public health threat and global epidemiological studies have shown that ambient air pollutants are closely related to various poor health conditions, including neurodegenerative diseases. Here, we evaluated the toxic effects and the underlying mechanisms of fine airborne particulate matter (PM2.5) on human glioblastoma LN-229 cells. Our results showed that exposure of LN-229 cells to PM2.5 (≥ 200 μg/mL) significantly reduced cell viability. PM2.5 exposure increased autophagy, apoptosis, and ROS production in the cells. Pre-treatment with a ROS scavenger, catalase, or depletion of mtDNA (ρ0 cells) abolished PM2.5-induced autophagy and apoptosis. PM2.5 exposure also activated MAPK signals in cells, which were blocked by catalase pre-treatment or mtDNA depletion. Furthermore, inhibition of JNK, but not ERK1/2 or p38, attenuated PM2.5-induced autophagy and apoptosis in cells. Finally, suppression of autophagy with Bafilomycin A1 or Beclin 1 siRNA exacerbated PM2.5-induced apoptosis, indicating a protective role of autophagy against PM2.5-induced apoptosis. Our results demonstrated that exposure of LN-229 cells to PM2.5 caused autophagy and apoptosis through PM2.5-induced ROS generation, mainly by mitochondria, and JNK activation. Autophagy may have a transient protective response in PM2.5-induced apoptosis. These findings have important implications for understanding the potential neurotoxicity of PM2.5.

Human Papillomavirus Is Associated With Adenocarcinoma of Lung: A Population-Based Cohort Study

Background

Recent trends in the incidence of lung cancer have been reported despite the decreasing rate of smoking. Lung cancer is ranked among the top causes of cancer-related deaths. The ratio of adenocarcinoma to squamous cell carcinoma, as well as the ratio of women to men, is still increasing. Human papillomavirus (HPV) has been discovered in lung cancer tissues and blood specimens, particularly in Eastern countries. However, the association between HPV infection and lung adenocarcinoma remains unclear.

Methods

This population-based cohort study was conducted using data from Taiwan's single-payer national health insurance and cancer registry databases. Data on HPV infection, cancer, sex, age, comorbidities, urbanization, and occupation were collected. The cumulative incidence rates were generated using Kaplan–Meier curves and log-rank tests. COX regression analysis was used to estimate the hazard ratios of factors associated with cancer occurrence. We used data from 2007 and 2015. The cases were matched with sex and age in a 1:2 manner with 939,874 HPV+ and 1,879,748 HPV– individuals, respectively.

Results

The adjusted hazard ratios [95% confidence interval (CI)] for HPV infection in all lung cancers were 1.539 (1.436–1.649), male lung cancer 1.434 (1.312–1.566), female lung cancer 1.742 (1.557–1.948), squamous cell carcinoma (SCC) 1.092 (0.903–1.320), male SCC 1.092 (0.903–1.320), female SCC 0.949 (0.773–1.164), adenocarcinoma 1.714 (1.572–1.870), male adenocarcinoma 1.646 (1.458–1.858), and female adenocarcinoma 1.646 (1.458–1.858). The highest adjusted hazard ratio for lung cancer was chronic obstructive pulmonary disease (COPD) 1.799 (1.613–2.007), followed by male sex 1.567 (1.451–6.863) and HPV infection. The highest adjusted hazard ratio for adenocarcinoma was HPV infection 1.714 (1.572–1.870), followed by COPD 1.300 (1.102–1.533), and for SCC, male sex 5.645 (4.43–3.37), followed by COPD 2.528 (2.002–3.192).

Conclusion

Our study showed that HPV infection was associated with the occurrence of adenocarcinoma of the lung in both men and women but was not associated with SCC of the lung.

Trends of cancer mortality in Xi'an City, China: 2005-2020

PURPOSE

Describe and predict the malignant tumor deaths in Xi'an so as to provide evidence for the government to formulate the prevention and treatment plans.

METHODS

Overall malignant tumor death in Xi'an in the past 16 years was described. The multi-decrease life table was used to calculate cumulative mortality risk by cause and life expectancy reduction years by cause of malignant tumors in 2020. The join point regression models were used to analyze the change trend of standard mortality of malignant tumors in Xi'an from 2005 to 2020. The appropriate gray models were selected to predict the death of malignant tumors in Xi'an in the next decade.

RESULTS

The mortality of total malignant tumors in Xi'an showed that men are higher than women and the elderly are higher than other groups. As for 2020, lung cancer had the highest risk of death for both men and women, while leukemia had the highest life expectancy reduction years by cause. From 2005 to 2020, standardized mortality of majority malignant tumors showed downward trends, which were particularly obvious in recent years. The prediction results of several major malignant tumors showed that in the next decade, the mortality of most malignant tumors had downward trends, but combined with the increase of population in the future, the number of malignant tumor deaths in Xi'an will continue to increase.

CONCLUSIONS

Malignant tumors in Xi'an have decreasing mortality trends in recent years, and effective measures to prevent and treat tumors should be strengthened in the future.

Mediterranean Diet Patterns in Relation to Lung Cancer Risk: A Meta-Analysis

Background

We systematically quantified the currently inconclusive association between Mediterranean diet patterns and the risk of lung cancer.

Methods

We searched the PubMed, Cochrane, Database of Abstracts of Reviews of Effects (DARE) and Web of Science electronic databases to identify relevant articles published before October 2021. We used the Newcastle–Ottawa scale to assess the quality of the published research and a random-effects model to estimate the aggregate hazard ratios and 95% CIs. As a result of significant heterogeneity, we performed subgroup analysis, meta-regression analysis, and sensitivity analysis. Where data were available, we also performed a dose–response analysis.

Results

Nine articles were included in the meta-analysis. The meta-analysis showed that there was a significant negative correlation between Mediterranean diet patterns and the risk of lung cancer in the general population with a hazard ratio of 0.82, a 95% CI of 0.74–0.92, and a high heterogeneity (I² = 59.9%, P < 0.05). As a result of the significant heterogeneity, we conducted subgroup analysis, meta-regression analysis, and sensitivity analysis and found that the study design was the source of the heterogeneity. Subgroup analysis and sensitivity analysis showed that the final results did not change very much, the sensitivity was low and the results were relatively stable. The dose–response relationship showed that, based on the lowest Mediterranean diet score (0 points), for every three-point increase, the risk of lung cancer was reduced by 9%.

Conclusion

The evidence in this meta-analysis shows that there is a significant negative correlation between Mediterranean diet patterns and the risk of lung cancer, suggesting that Mediterranean diets are a protective factor in lung cancer.

Indoor solid fuel use and renal function among middle-aged and older adults: A national study in rural China

Solid fuel use is the main source of indoor air pollution, especially in rural areas of developing countries. Nevertheless, the evidence linking indoor solid fuel use and renal function is very limited. Therefore, we investigated the association between indoor solid fuel use and renal function among middle-aged and older adults in rural China. Cystatin C (CysC) concentration of each participant was used to calculate the estimated glomerular filtration rate (eGFR). We used the baseline data to investigate the associations between solid fuel use for cooking and heating and eGFR through a linear-mixed effects model. Then, we applied the generalized linear-mixed effects model with binary distribution to examine the relationship between renal function decline and cooking fuel switching from 2011 to 2015. A total of 4959 participants were included at baseline, and 3536 participants were included in the follow-up analysis. Compared to participants who used clean fuel for both cooking and heating, the eGFR was significantly lower among participants who cooked with solid fuel and heated with clean fuel (β: -2.81; 95% CI: -5.53, -0.09). In the follow-up analysis, the risks of renal function decline for participants using solid fuel for cooking were significantly higher in males (OR: 2.74; 95% CI: 1.68, 4.49), smokers (OR: 5.70; 95% CI: 2.82, 11.55), and drinkers (OR: 7.11; 95% CI: 3.15, 16.02) compared to females, non-smokers, and non-drinkers. Moreover, 45-65 years aged participants (OR: 0.54; 95% CI: 0.33, 0.89) and non-drinkers (OR: 0.61; 95% CI: 0.41, 0.92) who switched from solid to clean cooking fuel had a lower risk of renal function decline. In conclusion, our findings show that household solid fuel use is likely to be an important risk factor for renal function decline in rural China. And switching to cleaner fuel may provide significant public health benefits.

Distribution, Risk Factors, and Temporal Trends for Lung Cancer Incidence and Mortality: A Global Analysis

BACKGROUND

Lung cancer ranks second for cancer incidence and first for cancer mortality. Investigation into its risk factors and epidemiologic trends could help describe geographical distribution and identify high-risk population groups.

RESEARCH QUESTION

What is the global incidence, mortality, associated risk factors, and temporal trends of lung cancer by sex, age, and country?

STUDY DESIGN AND METHODS

Data on incidence and mortality were retrieved from the Global Cancer Observatory (GLOBOCAN), Cancer Incidence in Five Continents series I-X, World Health Organization (WHO) mortality database, the Nordic Cancer Registries (NORDCAN), and the Surveillance, Epidemiology, and End Results Program (SEER). We searched the WHO Global Health Observatory data repository for age-adjusted prevalence of current smoking. The Average Annual Percentage Change (AAPC) of the trends were obtained by Joinpoint Regression.

RESULTS

The age-standardized rate of incidence and mortality were 22.4 and 18.0 per 100,000 globally. The lung cancer incidence and mortality were associated with Human Development Index (HDI), Gross Domestic Products (GDP), and prevalence of smoking. For incidence, more countries had increasing trends in females but decreasing trends in males (AAPC, 1.06 to 6.43 for female; -3.53 to -0.64 for male). A similar pattern was found in those 50 years or older, whereas those aged younger than 50 years had declining incidence trends in both sexes in most countries. For mortality, similar to incidence, 17 of 48 countries showed decreasing trends in males and increasing trends in females (AAPC, -3.28 to -1.32 for male, 0.63 to 3.96 for female).

INTERPRETATION

Most countries had increasing trends in females but decreasing trends in males and in lung cancer incidence and mortality. Tobacco related measures and early cancer detection should be implemented to control the increasing trends of lung cancer in females, and in regions identified as having these trends. Future studies may explore the reasons behind these epidemiological transitions.

Oxidative Stress and Gender Disparity in Cancer

Oxidative stress is caused by homeostasis disrupted by excessively increased reactive oxygen species (ROS) due to intrinsic or extrinsic causes. Among diseases caused by the abnormal induction of ROS, cancer is a representative disease that shows gender specificity in the development and malignancy. Females have the advantage of longer life expectancy than males because of the genetic advantages derived from X chromosomes, the antioxidant protective function by estrogen, and the decrease in exposure to extrinsic risk factors such as alcohol and smoking. This study first examines the ordinary biological responses to oxidative stress and the effects of ROS on the cancer progression and describes the differences in cancer incidence and mortality by gender and the differences in oxidative stress affected by sex hormones. This paper summarized how several important transcription factors regulate ROS-induced stress and in vivo responses, and how their expression is changed by sex hormones. Estrogen is associated with disease resistance and greater mitochondrial function, and reduces mitochondrial damage and ROS production in females than in males. In addition, estrogen affects the activation of nuclear factor-erythroid 2 p45-related factor (NRF) 2 and the regulation of other antioxidant-related transcription factors through NRF2, leading to benefits in females. Because ROS have a variety of molecular targets in cells, the effective cancer treatment requires understanding the potential of ROS and focusing on the characteristics of the research target such as patient's gender. Therefore, this review intends to emphasize the necessity of discussing gender specificity as a new therapeutic approach for efficient regulation of ROS considering individual specificity.

Indoor Air Pollution Increases the Risk of Lung Cancer

(1) Background: Cooking and burning incense are important sources of indoor air pollutants. No studies have provided biological evidence of air pollutants in the lungs to support this association. Analysis of pleural fluid may be used to measure the internal exposure dose of air pollutants in the lung. The objective of this study was to provide biological evidence of indoor air pollutants and estimate their risk of lung cancer. (2) Methods: We analyzed 14 common air pollutants in the pleural fluid of 39 cases of lung adenocarcinoma and 40 nonmalignant controls by gas chromatography-mass spectrometry. (3) Results: When we excluded the current smokers and adjusted for age, the adjusted odds ratios (ORs) were 2.22 (95% confidence interval CI = 0.77-6.44) for habitual cooking at home and 3.05 (95% CI = 1.06-8.84) for indoor incense burning. In females, the adjusted ORs were 5.39 (95% CI = 1.11-26.20) for habitual cooking at home and 6.01 (95% CI = 1.14-31.66) for indoor incense burning. In pleural fluid, the most important exposure biomarkers for lung cancer were naphthalene, ethylbenzene, and o-xylene. (4) Conclusions: Habitual cooking and indoor incense burning increased the risk of lung adenocarcinoma.

Global, regional, and national cancer incidence and death for 29 cancer groups in 2019 and trends analysis of the global cancer burden, 1990-2019

Background and aims

Cancer will soon become the leading cause of death in every country in the twenty-first century. This study aimed to analyze the mortality and morbidity of 29 types of cancer in 204 countries or regions from 1990 to 2019 to guide global cancer prevention and control.

Methods

Detailed information for 29 cancer groups was collected from the Global Burden of Disease Study in 2019. The age-standardized incidence rate (ASIR) and age-standardized death rate (ASDR) of the 29 cancer groups were calculated based on sex, age, region, and country. In addition, separate analyses were performed for major cancer types.

Results

In 2019, more than 10 million people died from cancer, which was approximately twice the number in 1990. Tracheal, bronchus, and lung (TBL) cancers collectively showed the highest death rate, and the ASDR of pancreatic cancer increased by 24%, which was cancer with the highest case fatality rate (CFR). The global cancer ASIR showed an increasing trend, with testicular cancer, thyroid cancer, and malignant skin melanoma showing a significant increase. The ASDR and ASIR of cancer in males were about 1.5 times higher than that in females. Individuals over 50 years had the highest risk of developing cancer, with incidences and deaths in this age group accounting for more than 85% of cancers in all age groups. Asia has the heaviest cancer burden due to its high population density, with esophageal cancer in this region accounting for 53% of the total fatalities related to this type of cancer in the world. In addition, the mortality and morbidity of most cancers increased with the increase in the development or socio-demographic index (SDI) in the SDI regions based on the World Bank's Human Development Index (HDI), with cancer characteristics varying in the different countries globally.

Conclusions

The global cancer burden continues to increase, with substantial mortality and morbidity differences among the different regions, ages, countries, gender, and cancer types. Effective and locally tailored cancer prevention and control measures are essential in reducing the global cancer burden in the future.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13045-021-01213-z.

The exposures and health effects of benzene, toluene and naphthalene for Chinese chefs in multiple cooking styles of kitchens

Commercial cooking has higher intensity and more severe instantaneous cooking pollution from volatile organic chemicals compared to home cooking, making health risk assessment of occupational exposure for chefs a priority. In this study, chefs from three cooking styles of kitchens, including steaming, frying, and grilling, were selected to investigate the external and internal exposures, health risks and effects of several typical aromatic hydrocarbons (benzene, toluene and naphthalene). Naphthalene was found to be the most concentrated contaminant in air samples among the different kitchens, while benzene had the lowest concentration. The concentration of toluene in frying kitchens was significantly higher than that in steaming kitchens. Air concentrations of toluene in frying kitchens, as well as benzene concentrations in grilling kitchens exceeded the standard level according to indoor air quality standard (GB/T18883-2002). Regarding the metabolites of pollutants in urine, the content of S-benzylmercapturic acids (S-BMA) for frying chefs was significantly higher than that for other cooking styles of chefs, which was consistent with the relatively higher air concentrations of toluene. There was a good correlation between internal and external exposure of the pollutants. The level of oxidative stress was influenced by 2-hydroxynaphthalene (2-OHN) and S-BMA, indicating the potential health risks of these occupational exposed chefs. This study indicates the need to improve the monitoring of typical aromatic hydrocarbons, as well as to investigate their potential health effects in large-scale groups, and improve the ventilation in kitchens.

Identification of NSP3 (SH2D3C) as a Prognostic Biomarker of Tumor Progression and Immune Evasion for Lung Cancer and Evaluation of Organosulfur Compounds from Allium sativum L. as Therapeutic Candidates

The multi-domain non-structural protein 3 (NSP3) is an oncogenic molecule that has been concomitantly implicated in the progression of coronavirus infection. However, its oncological role in lung cancer and whether it plays a role in modulating the tumor immune microenvironment is not properly understood. In the present in silico study, we demonstrated that NSP3 (SH2D3C) is associated with advanced stage and poor prognoses of lung cancer cohorts. Genetic alterations of NSP3 (SH2D3C) co-occurred inversely with Epidermal Growth Factor Receptor (EGFR) alterations and elicited its pathological role via modulation of various components of the immune and inflammatory pathways in lung cancer. Our correlation analysis suggested that NSP3 (SH2D3C) promotes tumor immune evasion via dysfunctional T-cell phenotypes and T-cell exclusion mechanisms in lung cancer patients. NSP3 (SH2D3C) demonstrated a high predictive value and association with therapy resistance in lung cancer, hence serving as an attractive target for therapy exploration. We evaluated the in silico drug-likeness and NSP3 (SH2D3C) target efficacy of six organosulfur small molecules from Allium sativum using a molecular docking study. We found that the six organosulfur compounds demonstrated selective cytotoxic potential against cancer cell lines and good predictions for ADMET properties, drug-likeness, and safety profile. E-ajoene, alliin, diallyl sulfide, 2-vinyl-4H-1,3-dithiin, allicin, and S-allyl-cysteine docked well into the NSP3 (SH2D3C)-binding cavity with binding affinities ranging from -4.3~-6.70 Ă and random forest (RF) scores ranging from 4.31~5.26 pKd. However, S-allyl-cysteine interaction with NSP3 (SH2D3C) is unfavorable and hence less susceptible to NSP3 ligandability. In conclusion, our study revealed that NSP3 is an important onco-immunological biomarker encompassing the tumor microenvironment, disease staging and prognosis in lung cancer and could serve as an attractive target for cancer therapy. The organosulfur compounds from A. sativum have molecular properties to efficiently interact with the binding site of NSP3 and are currently under vigorous preclinical study in our laboratory.

Pulmonary Tuberculosis and the Incidence of Lung Cancer among Patients with Chronic Obstructive Pulmonary Disease

RATIONALE

While the history of pulmonary tuberculosis (PTB) is a risk factor for developing both chronic obstructive pulmonary disease (COPD) and lung cancer, it remains unclear whether the history of PTB affects lung cancer development in COPD patients.

OBJECTIVES

To investigate whether a history of PTB is associated with an increased risk of lung cancer development in a population with COPD.

METHODS

This cohort study included a nationwide representative sample of 13,165 Korean men and women with COPD, aged between 50-84 years. In addition, to assess whether the relationship between PTB and lung cancer risk differs between participants with and without COPD, a matched cohort without COPD was included. Participants were matched 1:3 for age, sex, smoking history, and PTB status based on the index health screening exam of corresponding participants with COPD. The two cohorts were followed up for 13 years (January 1st, 2003, to December 31st, 2015). PTB was diagnosed based on the results of chest radiography, and incident lung cancer was identified from hospitalization and outpatient visit claims (International Classification of Diseases, Tenth Revision diagnosis code C33 or C34).

RESULTS

During 370,617 person-years (PY) of follow-up (median follow-up, 7.7 years), in the COPD group, we observed 430 incident cases of lung cancer in participants without a history of PTB (incidence rate 524 per 100,000 PY) and 148 cases in those with a history of PTB (incidence rate 931 per 100,000 PY). Compared to participants without a PTB history, the fully adjusted subdistribution hazard ratio (95% confidence interval) for lung cancer in those with a history of PTB was 1.24 (1.03, 1.50). The association of PTB history and lung cancer development was more evident in never-smokers with COPD. In contrast, among participants without COPD, the corresponding hazard ratio (95% confidence interval) was 0.98 (0.78, 1.22). There was no interaction between PTB, smoking status, and COPD.

CONCLUSIONS

The history of PTB was associated with an increased risk of developing lung cancer among COPD patients in our country with an intermediate TB burden. COPD patients with a history of PTB, particularly the never-smokers, might benefit from periodical screening or assessment for lung cancer development.

Characterization and exposure assessment of household fine particulate matter pollution in China

Household fine particulate matter (PM_2.5 ) pollution greatly impacts residents' health. To explore the current national situation of household PM_2.5 pollution in China, a study was conducted based on literature published from 1998 to 2018. After extracting data from the literature in conformity with the requirements, the nationwide household-weighted mean concentration of household PM_2.5 (HPL) was calculated. Subgroup analyses of spatial, geographic, and temporal differences were also done. The estimated overall HPL in China was 132.2 ± 117.7 μg/m³ . HPL in the rural area (164.3 ± 104.5 μg/m³ ) was higher than that in the urban area (123.9 ± 122.3 μg/m³ ). For HPLs of indoor sampling sites, the kitchen was the highest, followed by the bedroom and living room. There were significant differences of geographic distributions. The HPLs in the South were higher than the North in four seasons. The inhaled dose of household PM_2.5 among school-age children differed from provinces with the highest dose up to 5.9 μg/(kg·d). Countermeasures should be carried out to reduce indoor pollution and safeguard health urgently.

Probabilistic health risk assessment of exposure to carcinogens of Chinese family cooking and influence analysis of cooking factors

Cooking oil fume (COF) have adverse health effects for people. A probabilistic health risk assessment model with risk parameters as random variables considering the differences in exposure concentration and exposure time of different cooking event was proposed to assess the inhalational incremental lifetime cancer risk (ILCR). The exposure of carcinogens such as benzene, formaldehyde, PM_2.5-bound polycyclic aromatic hydrocarbons (PPAHs) and PM_2.5-bound heavy metals (PHMs) of Chinese family cooking was studied and the exposure concentrations of carcinogens were predicted by computational fluid dynamics (CFD). In addition, the influence of five key cooking factors (cooking method, the weight of ingredients (meat and vegetables), type of meat, ratio of meat to vegetables, and type of oil) that affect the generation of COF was explored. The ILCR of COF is assessed comprehensively in present study by the probabilistic health risk assessment model. The result showed that the sum of the risks of assessed carcinogens (total ILCR of COF) determined by Monte Carlo simulation method with a 95% confidence interval (95%CI) is 2.45 × 10^-4 to 1.61 × 10^-3, which far exceeds the acceptable limit of 1.00 × 10^-6. Generally, the ILCR of assessed carcinogens decreases in the following order: PHMs [ILCR (95%CI): 2.08 × 10^-4 to 1.54 × 10^-3] > formaldehyde [ILCR (95%CI): 9.04 × 10^-6 to 6.87 × 10^-5] and PPAHs [ILCR (95%CI): 5.97 × 10^-6 to 4.51 × 10^-5] > benzene [ILCR (95%CI): 2.99 × 10^-7 to 3.00 × 10^-6]. The results indicated that more attention should be paid to the ILCR of PM_2.5. Cooking method significantly affect the ILCR of carcinogens in COF excluding formaldehyde. The ILCRs of COF from water-based cooking methods are greater than those of oil-based cooking ones.

Quantitative filter forensics: Size distribution and particulate matter concentrations in residential buildings

We applied filter forensics, the analysis of dust from the heating, ventilation, and air-conditioning (HVAC) filters, to measure particle size distribution in 21 residences in Toronto, Canada over a year. Four filters with different nominal efficiencies (Minimum Efficiency Reporting Value (MERV) 8-14 from ASHRAE Standard 52.2) were deployed in each residence each for three months, while the effective filtration volumes (the product of flow rate, runtime, and in-situ filter efficiency) were characterized over each filter lifetime. Using extraction and laser diffraction, we found that approximately 90% of the volumetric distributions were >10 µm and the volume median diameter (VMD) ranged from 23.4 to 75.1 µm. Using quantitative filter forensics (QFF), total suspended particle (TSP) concentrations ranged from 2.9 to 823.7 µg/m³ (median = 89.8 µg/m³ ) with a moderate correlation with the content of TSP on the filters (in terms of g) and with the TSP effective filtration volume (m³ ) indicating the importance of both filter forensics and HVAC metadata parameters to QFF concentration estimates. There was no strong correlation between PM₁₀ or PM_2.5 concentrations and hourly airborne particle number concentrations measured by low-cost sensors suggesting an evaluation of QFF is warranted, particularly for the exploration of smaller particles.

A Narrative Review of the Risk Factors for Cancer and the Preventive Opportunities: Current Status, Future Perspectives, and Implications for India

Introduction Clinical cancer can arise from heterogenous pathways through various genetic mutations. Although we cannot predict the timeline by which an individual will develop cancer, certain risk assessment tools can be used among high-risk groups for focusing the preventive activities. As primary level of cancer prevention, healthy lifestyle approach is being promoted. The etiological factors for lung cancer include by-products of industrialization and air pollution. We need to factor the increase in household air pollution as well.

Methods “PubMed” database and Google search engines were used for searching the relevant articles. Search terms with Boolean operators used include “Cancer prevention,” “Missed opportunities in cancer causation,” and “incidence of risk factors.” This review includes 20 studies and other relevant literature that address the opportunities for cancer prevention.

Body The narrative describes the association between many of the risk factors and development of cancer. This includes tobacco, alcohol, infections, air pollution, physical inactivity, diet, obesity, screening and preventive strategies, chemoprevention, biomarkers of carcinogenesis, and factors that prolong the diagnosis of cancer.

Discussion Reports from basic science research provide evidence on the potential of biologically active food components and pharmacological agents for mitigating the risk of cancer and its progression. However, some reports from observational studies and randomized trials have been inconsistent. We need to recognize the impact of sociodemographic factors such as age, sex, ethnicity, culture, and comorbid illness on preventive interventions. Spiral computed tomographic scan is a robust tool for early detection of lung cancer.

Conclusion Infectious etiology for specific cancers provides opportunities for prevention and treatment. The complex interplay between man and microbial flora needs to be dissected, for understanding the pathogenesis of relevant malignancies. For reducing the morbidity of cancer, we need to focus on prevention as a priority strategy and intervene early during the carcinogenic process.

Impact of air pollution on human activities: Evidence from nine million mobile phone users

To measure the effects of air pollution on human activities, this study applies statistical/econometric modeling to hourly data of 9 million mobile phone users from six cities in China’s Zhejiang Province from December 18 to 21, 2013. Under a change in air quality from “Good” (Air Quality Index, or AQI, between 51 and 100) to “Heavily Polluted” (AQI between 201 to 300), the following effects are demonstrated. (i) Consistent with the literature, for every one million people, 1, 482 fewer individuals are observed at parks, 95% confidence interval or CI (−2, 229, −735), which represents a 15% decrease. (ii) The number of individuals at shopping malls has no statistically significant change. (iii) Home is the most important location under worsening air quality, and for every one million people, 63, 088 more individuals are observed at home, 95% CI (47, 815, 78, 361), which represents a 19% increase. (iv) Individuals are on average 633 meters closer to their home, 95% CI (529, 737); as a benchmark, the median distance from home ranges from 300 to 1900 meters across the cities in our sample. These effects are not due to weather or government regulations. We also provided provisional evidence that individuals engage in inter-temporal activity substitutions within a day, which leads to mitigated (but not nullified) effects of air pollution on daily activities.

Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.

Polycyclic and nitro-polycyclic aromatic hydrocarbon pollution characteristics and carcinogenic risk assessment of indoor kitchen air during cooking periods in rural households in North China

Medium-flow atmospheric samplers were used to collect particulate (PM_2.5) and gaseous samples from the indoor kitchen of each of 35 randomly selected rural houses in North China while a meal was being cooked. The concentrations of 16 polycyclic aromatic hydrocarbons (PAHs) and 9 nitro-PAHs (NPAHs) in the samples were quantified by high-performance liquid chromatography (HPLC). This study provided the real PAH and NPAH pollution characteristics and carcinogenic risk produced by cooking in rural indoor kitchens in North China. The mean PAH and NPAH concentrations in air in the indoor kitchens during cooking periods were 4049.1 and 1741.6 ng/m³, respectively. The PAH and NPAH concentrations were lower in the particulate phase than the gaseous phase. The mean PAH and NPAH concentrations were much higher for cooking using coal than for cooking using liquefied petroleum gas (LPG) or electricity. The PAH and NPAH benzo[a]pyrene toxic equivalent (TEQ_BaP) concentrations for cooking using coal were 1823.3 and 2760.9 ng/m³, respectively. Lower PAH and NPAH concentrations were found in kitchens with than without range hoods. Range hoods decreased the PAH and NPAH TEQ_BaP concentrations by 68.8% and 61.9%, respectively. Appropriate fuel and ventilation choice will improve air pollution in indoor kitchens during cooking. The results provide important evidence for changing cooking habits and developing policies for cooking in rural China.

HVAC filtration of particles and trace metals: Airborne measurements and the evaluation of quantitative filter forensics

Filters installed in the heating, ventilation, and air-conditioning (HVAC) systems can serve as air-cleaning and sampling devices for indoor particles. The purpose of this article is to evaluate these dual roles. An occupied home with a central HVAC system equipped with a Minimum Efficiency Reporting Value (MERV, from ASHRAE Standard 52.2) 11 filter was monitored for six weeks. Weekly airborne gravimetric and real-time sampling was performed to measure the particle size distribution and the concentration of total suspended particles (TSP), PM₁₀, PM_2.5, PM₁, and 12 trace metals. The weekly system runtimes were intentionally changed to provide a wide range of weekly filtration volumes. The quantitative filter forensics (QFF) concentrations of particulate matter (PM) and trace metals were calculated using the analysis of the dust collected on the HVAC filter, the filtration volume, and filter in-situ efficiency. The results indicated that filtration was not influential to remove PM and trace metals as the concentrations during the weeks with continuous HVAC operation were not consistently lower than those during the other weeks. This suggests the dominance of other particle and trace metal source and loss mechanisms weakens the influence of filtration in this home. The QFF evaluation results indicated that the concentration of TSP and over half of the tested trace metals (e.g., Pb, Cd, Ni, V, Sb, K, and Sr) could be estimated by QFF within a factor of two when compared to airborne sampling results. PM₁₀, PM_2.5, and PM₁ concentrations were significantly underestimated by QFF potentially due to the limitations of size distribution analysis by a laser diffraction particle sizer (LDPS) for the detection of <1 μm particles. Overall, while QFF was promising for TSP and some trace metals, improvement in size distribution analysis could extend the application of QFF for airborne sampling.

Evaluation and comparison of the indoor air quality in different areas of the hospital

The levels of indoor air pollutants are increasing. However, the indoor air quality of only operating rooms, intensive care units, and radiology departments is usually monitored in hospitals. Hence, we aimed to evaluate the indoor air quality of an otorhinolaryngology outpatient clinic and compare air quality indices among different areas in a hospital.We prospectively measured indoor air quality using air quality sensors in different areas of a hospital from February 1, 2019 to January 31, 2020. Carbon dioxide (CO2), total volatile organic compounds (VOCs), particulate matter with diameter of <2.5 μm (PM2.5), and nitrogen dioxide concentrations were measured in the otorhinolaryngology clinic, orthopedic clinic, and reception area. The intervention efficacy was compared between otorhinolaryngology clinics employing and not employing air-cleaners.The overall concentrations of CO2, VOCs, and PM2.5 in the otorhinolaryngology clinic were significantly higher than those in the orthopedic clinic or reception area. The indoor air quality was the worst in winter. The intervention effect was observed only in PM2.5 concentrations in otorhinolaryngology clinics employing an air-cleaner.Medical practitioners and patients are frequently exposed to ambient indoor air pollution in otorhinolaryngology clinics. Hence, health-related strategies to protect against ambient indoor air pollution in otorhinolaryngology clinics are warranted.