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Enjo-Barreiro JR, Ruano-Ravina A, Pérez-Ríos M, Kelsey K, Barros-Dios JM, Varela-Lema L. Genome Wide Association Studies in Small-Cell Lung Cancer. A Systematic Review. Clin Lung Cancer 2024; 25:9-17. [PMID: 37940411 DOI: 10.1016/j.cllc.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/28/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023]
Abstract
Small cell lung cancer (SCLC) is one of the deadliest forms of lung cancer, but few information exists regarding the role of genetics, particularly on Genome Wide Association Studies (GWAS). The aim of the study is to explore the evidence available obtained through GWAS studies for SCLC using a systematic review. We performed a literature search in the main databases until July 31st, 2023. We included all human based studies on GWAS for lung cancer which presented results for SCLC. Only studies with participants diagnosed of SCLC with anatomopathological confirmation were included. Fourteen studies were identified; 8 studies showed a relationship between ASCL1 overexpression and SCLC, which may regulate CHRNA5/A3/B4 cluster, producing a consequent nAChR overexpression. Nine papers, including 8 of the previous, found a positive association between SNPs located in chromosome 15 and SCLC. The most important cluster of genes found is CHRNA5/A3/B4 but the mechanism for the role of these genes is unclear. Kyoto Encyclopaedia of Genes and Genome (KEGG) shows that these receptors were found to be overexpressed where nicotine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and N'-Nitrosonornicotine (NNN) acts, involving different routes in SCLC carcinogenesis.
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Affiliation(s)
- José Ramón Enjo-Barreiro
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Service of Preventive Medicine, A Coruña University Teaching Hospital Complex, A Coruña, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain.
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
| | - Karl Kelsey
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
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Martin-Gisbert L, Ruano-Ravina A, Barros-Dios JM, Varela-Lema L, Pérez-Ríos M. An Innovative Tool to Control Occupational Radon Exposure. Int J Environ Res Public Health 2022; 19:11280. [PMID: 36141555 PMCID: PMC9517103 DOI: 10.3390/ijerph191811280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 06/16/2023]
Abstract
After smoking, indoor radon is the main contributor to lung cancer in many countries. The European Union (EU) Directive 2013/59/Euratom establishes a maximum reference level of 300 Bq/m3 of radon concentration in the workplace, and an effective dose limit of 20 mSv per year for workers. If the radon concentration in a workplace exceeds the reference level, constructive mitigation applies. When constructive mitigation is not feasible, we propose to keep workers' effective dose below 6 mSv per year (category B of exposed workers) by controlling occupancy time. Setting the maximum annual dose at 6 mSv protects workers' health and eases the regulatory requirements for employers. If multisite workers are present, each worker has to be monitored individually by tracking the time spent and the radon concentration at each worksite. This paper shows a software tool for employers to perform this complex tracking in an accurate, conservative, and transparent manner, and in compliance with the EU by-laws.
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Affiliation(s)
- Lucía Martin-Gisbert
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Cross-Disciplinary Research in Environmental Technologies (CRETUS), University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Cross-Disciplinary Research in Environmental Technologies (CRETUS), University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), 28029 Madrid, Spain
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), 28029 Madrid, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), 28029 Madrid, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), 28029 Madrid, Spain
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3
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Mauriz-Barreiro V, Barreiro-de Acosta M, Bastón-Rey I, Ferreiro-Iglesias R, Calviño-Suárez C, Barros-Dios JM, Domínguez-Munoz JE, Ruano-Raviña A. Radon exposure and inflammatory bowel disease in a radon prone area. Rev Esp Enferm Dig 2021; 114:405-409. [PMID: 34781685 DOI: 10.17235/reed.2021.8239/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Inflammatory Bowel Disease (IBD) is a multifactorial pathology with an increasing incidence. There is no study having assessed a possible relationship with residential radon exposure, very high in the study area. The aim of the study was to analyze if residential radon concentration is associated with a higher incidence of IBD. MATERIAL AND METHODS An ecological study has been performed. All incident cases of Inflammatory Bowel Disease in the area of Santiago de Compostela were included between January and December 2017. Radon levels at a municipal level were correlated with demographic factors and type of IBD. RESULTS 96 patients were included, 63 (65.6%) with ulcerative colitis, 29 (30.25) with Crohn's disease and 4 (4.2%) with indeterminate colitis. The incidence rate per 100,000 inhabitants-year was 21.6 cases. There were no statistically significant differences on the type of disease developed regarding radon levels (p>0.05). No correlation between radon levels and cumulative incidence of Inflammatory Bowel Disease at municipal level was observed (Spearman's rho = 0.13, p-value 0.5). CONCLUSION In the area of Santiago de Compostela there is a higher incidence of IBD in comparison with previous studies taking western countries as reference, but in this study we have not found any correlation with municipal average radon concentration and incidence of IBD or any of its types.
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4
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Ruano-Ravina A, Cameselle-Lago C, Torres-Durán M, Pando-Sandoval A, Dacal-Quintas R, Valdés-Cuadrado L, Hernández-Hernández J, Consuegra-Vanegas A, Tenes-Mayén JA, Varela-Lema L, Fernández-Villar A, Barros-Dios JM, Pérez-Ríos M. Indoor Radon Exposure and COPD, Synergic Association? A Multicentric, Hospital-Based Case-Control Study in a Radon-Prone Area. Arch Bronconeumol 2021; 57:630-636. [PMID: 35699045 DOI: 10.1016/j.arbr.2020.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/23/2020] [Indexed: 06/15/2023]
Abstract
BACKGROUND COPD is a multifactorial disease which causes considerable mortality and morbidity worldwide. Previous studies assessing the possible relationship between indoor radon exposure and COPD have shown inconclusive results. METHODS A multicentric, hospital-based, case-control study was conducted in a Spanish radon-prone area. COPD cases were confirmed by spirometry and controls were selected due to trivial surgery or procedures not related to tobacco consumption. All participants had to have lived for at least 15 years in the same dwelling. Radon measurements were conducted individually in dwellings using alpha-track detectors. Results were obtained using multivariate logistic regression. RESULTS 189 cases and 747 controls took part. There was no significant association between residential radon concentrations and COPD onset with a OR of 1.12 (95%CI 0.41-3.06) for individuals exposed to more than 200Bq/m3 compared to those exposed to less than 50Bq/m3. Heavy smokers seem to increase their COPD risk if exposed to higher radon concentrations vs those exposed to lower concentrations. There was a statistically significant synergy index between radon exposure and tobacco consumption, S-index 11.60 (95%CI 3.71-36.26). Indoor radon concentration was higher in never/light smokers with COPD compared to controls. CONCLUSIONS No association between indoor radon and COPD has been observed. However, there might be some effect modification on the COPD risk in heavy smokers when high radon exposure is present. This is supported by the additive synergy observed. Also, a possible association between indoor radon and COPD onset in never and light smokers needs to be further studied.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain.
| | - Candela Cameselle-Lago
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
| | | | | | | | - Luis Valdés-Cuadrado
- Service of Neumology, Clinic University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | | | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
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5
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García-Lavandeira JA, Ruano-Ravina A, Torres-Durán M, Parente-Lamelas I, Provencio M, Varela-Lema L, Fernández-Villar A, Piñeiro M, Barros-Dios JM, Pérez-Ríos M. Fruits and Vegetables and Lung Cancer Risk in Never Smokers. A Multicentric and Pooled Case-Control Study. Nutr Cancer 2021; 74:613-621. [PMID: 34431436 DOI: 10.1080/01635581.2021.1918732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The etiology of lung cancer in never smokers is partly unknown. We aimed to assess the effect of fruits and vegetables consumption on lung cancer risk in never smokers. METHODS We pooled five multicenter case-control studies performed in Northwestern Spain. Cases and controls were all never smokers. All lung cancer cases had anatomopathological confirmed diagnoses. We performed a multivariate logistic regression to analyze the effect of different types of fruits and vegetables consumption on lung cancer risk. RESULTS A total of 438 cases and 781 controls were included. We observed that a consumption from one to six times per week shows a negative association with lung cancer risk for: kiwis (OR 0.67; 95%CI 0.46-0.95), oranges (OR 0.55; 95%CI 0.37-0.80), turnip tops (OR 0.48; 95%CI 0.34-0.66), "berza gallega" (OR 0.70; 95%CI 0.51-0.97) and broccoli (OR 0.55; 95%CI 0.35-0.83) compared to less than once a week consumption. On the other hand, we found an increased risk for lung cancer with a daily consumption of tomatoes, carrots and potatoes. CONCLUSIONS Oranges, kiwis, turnip tops, berza gallega and broccoli may play a protective role on lung cancer development in never smokers while tomatoes, carrots and potatoes might have some association with this disease.
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Affiliation(s)
- José Antonio García-Lavandeira
- Admission and Documentation Service, University Hospital Complex of A Coruña Santiago de Compostela, Spain.,Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago de Compostela, Spain
| | | | | | - Mariano Provencio
- Service of Oncology, Puerta de Hierro University Hospital. Madrid, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - María Piñeiro
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago de Compostela, Spain
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago de Compostela, Spain.,Service of Preventive Medicine, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago de Compostela, Spain
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6
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Giraldo-Osorio A, Ruano-Ravina A, Pérez-Ríos M, Varela-Lema L, Barros-Dios JM, Arias-Ortiz NE. Residential Radon in Manizales, Colombia: Results of a Pilot Study. Int J Environ Res Public Health 2021; 18:ijerph18031228. [PMID: 33573028 PMCID: PMC7908556 DOI: 10.3390/ijerph18031228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/20/2021] [Accepted: 01/23/2021] [Indexed: 11/16/2022]
Abstract
Radon is a colorless, odorless, and tasteless noble gas, causally related with the onset of lung cancer. We aimed to describe the distribution of radon exposure in the municipality of Manizales, Colombia, in order to estimate the population's exposure and establish the percentage of dwellings that surpass reference levels. A cross-sectional study representing all geographical areas was carried out by measuring indoor radon concentrations. Participants answered a short questionnaire. Alpha-track type radon detectors were installed in all residences for six months. The detectors were subsequently processed at the Galician Radon Laboratory, an accredited laboratory at the University of Santiago de Compostela. A total of 202 homes were measured. Seventy-seven percent of the sampled houses were three stories high, their median age was 30 years, and half were inhabited by three people or fewer. For most dwellings, the building materials of walls and flooring were brick and covered cement, respectively. Results showed a geometric mean of radon concentration of 8.5 Bq/m3 and a maximum value of 50 Bq/m3. No statistically significant differences were found either between the geometric mean of the dwelling's site, the height at which detectors were placed inside the home, or the wall and flooring materials, or between mean 222Rn concentrations in rural and urban areas. No dwelling surpassed the 222Rn reference level established by the WHO. This study shows that residential radon levels in Manizales, Colombia, seem to be low, though a more in-depth approach should be carried out. Despite these results, it is essential to create a national radon program and establish a radon concentration reference level for Colombia in line with international recommendations.
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Affiliation(s)
- Alexandra Giraldo-Osorio
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.G.-O.); (M.P.-R.); (L.V.-L.); (J.M.B.-D.)
- Grupo de Investigación Promoción de la Salud y Prevención de la Enfermedad (GIPSPE), Departamento de Salud Pública, Universidad de Caldas, Manizales 170002, Colombia;
- Scholarship Holder of Fundación Carolina (C.2020), 28071 Madrid, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.G.-O.); (M.P.-R.); (L.V.-L.); (J.M.B.-D.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública/CIBERESP), 15782 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
- Correspondence:
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.G.-O.); (M.P.-R.); (L.V.-L.); (J.M.B.-D.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública/CIBERESP), 15782 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.G.-O.); (M.P.-R.); (L.V.-L.); (J.M.B.-D.)
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; (A.G.-O.); (M.P.-R.); (L.V.-L.); (J.M.B.-D.)
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública/CIBERESP), 15782 Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela—IDIS), 15706 Santiago de Compostela, Spain
| | - Nelson Enrique Arias-Ortiz
- Grupo de Investigación Promoción de la Salud y Prevención de la Enfermedad (GIPSPE), Departamento de Salud Pública, Universidad de Caldas, Manizales 170002, Colombia;
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7
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Casal-Mouriño A, Ruano-Ravina A, Lorenzo-González M, Rodríguez-Martínez Á, Giraldo-Osorio A, Varela-Lema L, Pereiro-Brea T, Barros-Dios JM, Valdés-Cuadrado L, Pérez-Ríos M. Epidemiology of stage III lung cancer: frequency, diagnostic characteristics, and survival. Transl Lung Cancer Res 2021; 10:506-518. [PMID: 33569332 PMCID: PMC7867742 DOI: 10.21037/tlcr.2020.03.40] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Stage III non-small cell lung cancer (NSCLC) includes a highly heterogeneous group of patients with differences in the extent and localization of disease. Many aspects of stage III disease are controversial. The data supporting treatment approaches are often subject to a number of limitations, due to the heterogeneous patient populations involved in the trials. Furthermore, the definition of stage III disease has changed over time, and early studies were frequently inadequately powered to detect small differences in therapeutic outcome, were not randomized, or had a limited follow-up times. Major improvements in therapy, including the use of more active chemotherapy agents and refinements in radiation and surgical techniques, also limit the interpretation of earlier clinical trials. Lastly, improvements in pretreatment staging have led to reclassification of patients with relatively minimal metastatic disease as stage IV rather than stage III, leading to an apparent increase in the overall survival of both stage III and IV patients. Median overall stage III NSCLC survival ranges from 9 to 34 months. Higher survival rates are observed in younger Caucasian women with good performance status, adenocarcinoma, mutations, stage IIIA, and in patients with multidisciplinary-team-based diagnoses.
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Affiliation(s)
- Ana Casal-Mouriño
- Department of Pneumology, Santiago de Compostela University Clinical Teaching Hospital, Galicia, Spain.,Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruña, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruña, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública/CIBERESP), Madrid, Spain
| | - María Lorenzo-González
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruña, Spain.,Population Screening Unit, Galician Regional Health Authority, Santiago de Compostela, Spain
| | - Ángeles Rodríguez-Martínez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruña, Spain.,Department of Oncology, Pontevedra University Hospital Complex, Pontevedra, Spain
| | - Alexandra Giraldo-Osorio
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruña, Spain.,Research Group for Health Promotion and Disease Prevention, Department of Public Health, University of Caldas, Manizales, Colombia
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruña, Spain.,Scientific-Technical Advisory Unit, Galician Health Technology Assessment Agency, Health Knowledge Management Agency (Unidade de Asesoramento Científico-técnico/avalia-t, Axencia de Coñecemento en Saúde/ACIS), Galician Regional Health Authority, Galicia, Spain
| | - Tara Pereiro-Brea
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruña, Spain.,Department of Pneumology, A Coruña University Teaching Hospital Complex, A Coruña, Spain
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruña, Spain
| | - Luis Valdés-Cuadrado
- Department of Pneumology, Santiago de Compostela University Clinical Teaching Hospital, Galicia, Spain.,Interdisciplinary Group of Research in Pulmonology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruña, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública/CIBERESP), Madrid, Spain
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8
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Ruano-Ravina A, Cameselle-Lago C, Torres-Durán M, Pando-Sandoval A, Dacal-Quintas R, Valdés-Cuadrado L, Hernández-Hernández J, Consuegra-Vanegas A, Tenes-Mayén JA, Varela-Lema L, Fernández-Villar A, Barros-Dios JM, Pérez-Ríos M. Indoor Radon Exposure and COPD, Synergic Association? A Multicentric, Hospital-Based Case-Control Study in a Radon-Prone Area. Arch Bronconeumol 2020; 57:S0300-2896(20)30539-1. [PMID: 33446344 DOI: 10.1016/j.arbres.2020.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/07/2020] [Accepted: 11/23/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND COPD is a multifactorial disease which causes considerable mortality and morbidity worldwide. Previous studies assessing the possible relationship between indoor radon exposure and COPD have shown inconclusive results. METHODS A multicentric, hospital-based, case-control study was conducted in a Spanish radon-prone area. COPD cases were confirmed by spirometry and controls were selected due to trivial surgery or procedures not related to tobacco consumption. All participants had to have lived for at least 15 years in the same dwelling. Radon measurements were conducted individually in dwellings using alpha-track detectors. Results were obtained using multivariate logistic regression. RESULTS 189 cases and 747 controls took part. There was no significant association between residential radon concentrations and COPD onset with a OR of 1.12 (95%CI 0.41-3.06) for individuals exposed to more than 200Bq/m3 compared to those exposed to less than 50Bq/m3. Heavy smokers seem to increase their COPD risk if exposed to higher radon concentrations vs those exposed to lower concentrations. There was a statistically significant synergy index between radon exposure and tobacco consumption, S-index 11.60 (95%CI 3.71-36.26). Indoor radon concentration was higher in never/light smokers with COPD compared to controls. CONCLUSIONS No association between indoor radon and COPD has been observed. However, there might be some effect modification on the COPD risk in heavy smokers when high radon exposure is present. This is supported by the additive synergy observed. Also, a possible association between indoor radon and COPD onset in never and light smokers needs to be further studied.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain.
| | - Candela Cameselle-Lago
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
| | | | | | | | - Luis Valdés-Cuadrado
- Service of Neumology, Clinic University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
| | | | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
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9
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Casal-Mouriño A, Ruano-Ravina A, Torres-Durán M, Parente-Lamelas I, Provencio-Pulla M, Castro-Añón O, Vidal-García I, Abal-Arca J, Piñeiro-Lamas M, Fernández-Villar A, Valdés-Cuadrado L, Barros-Dios JM, Pérez-Ríos M. Polymorphisms in the BER and NER pathways and their influence on survival and toxicity in never-smokers with lung cancer. Sci Rep 2020; 10:21147. [PMID: 33273562 PMCID: PMC7713126 DOI: 10.1038/s41598-020-78051-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/11/2020] [Indexed: 01/05/2023] Open
Abstract
Polymorphisms in DNA repair pathways may play a relevant role in lung cancer survival in never-smokers. Furthermore, they could be implicated in the response to chemotherapy and toxicity of platinum agents. The aim of this study was to evaluate the influence of various genetic polymorphisms in the BER and NER DNA repair pathways on survival and toxicity in never-smoker LC patients. The study included never-smokers LC cases diagnosed from 2011 through 2019, belonging to the Lung Cancer Research In Never Smokers study. A total of 356 never-smokers cases participated (79% women; 83% adenocarcinoma and 65% stage IV). Survival at 3 and 5 years from diagnosis was not associated with genetic polymorphisms, except in the subgroup of patients who received radiotherapy or chemo-radiotherapy, and presented with ERCC1 rs3212986 polymorphism. There was greater toxicity in those presenting OGG1 rs1052133 (CG) and ERCC1 rs11615 polymorphisms among patients treated with radiotherapy or chemo-radiotherapy, respectively. In general, polymorphisms in the BER and NER pathways do not seem to play a relevant role in survival and response to treatment among never-smoker LC patients.
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Affiliation(s)
- Ana Casal-Mouriño
- Department of Pneumology, Santiago de Compostela University Clinical Teaching Hospital, Santiago de Compostela, Spain.,Department of Preventive Medicine and Public Health, University of Santiago de Compostela, C/San Francisco s/n, 15782, Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, C/San Francisco s/n, 15782, Santiago de Compostela, Spain. .,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología and Salud Pública-CIBERESP), Madrid, Spain. .,C013 Group-Health Research Institute of Santiago de Compostela (Instituto Investigación Sanitaria de Santiago de Compostela/IDIS), Santiago de Compostela, Spain.
| | - María Torres-Durán
- Department of Pneumology, Vigo University Teaching Hospital Complex, Vigo, Spain
| | | | | | | | - Iria Vidal-García
- Department of Pneumology, A Coruña University Teaching Hospital Complex, Vigo, Spain
| | - José Abal-Arca
- Department of Pneumology, Ourense University Teaching Hospital Complex, Ourense, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología and Salud Pública-CIBERESP), Madrid, Spain
| | | | - Luis Valdés-Cuadrado
- Department of Pneumology, Santiago de Compostela University Clinical Teaching Hospital, Santiago de Compostela, Spain.,Interdisciplinary Neumology Research Group, Health Research Institute of Santiago de Compostela (Instituto Investigación Sanitaria de Santiago de Compostela/IDIS), Santiago de Compostela, Spain
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, C/San Francisco s/n, 15782, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología and Salud Pública-CIBERESP), Madrid, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, C/San Francisco s/n, 15782, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología and Salud Pública-CIBERESP), Madrid, Spain.,C013 Group-Health Research Institute of Santiago de Compostela (Instituto Investigación Sanitaria de Santiago de Compostela/IDIS), Santiago de Compostela, Spain
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10
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Gómez-Anca S, Barros-Dios JM. Radon Exposure and Neurodegenerative Disease. Int J Environ Res Public Health 2020; 17:ijerph17207439. [PMID: 33066046 PMCID: PMC7600778 DOI: 10.3390/ijerph17207439] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/05/2020] [Accepted: 10/10/2020] [Indexed: 12/28/2022]
Abstract
Background: To carry out a systematic review of scientific literature about the association between radon exposure and neurodegenerative diseases. Methods: We performed a bibliographic search in the following databases: Pub med (Medline), Cochrane, BioMed Central and Web of Science. We collected the data by following a predetermined search strategy in which several terms werecombined. After an initial search, 77 articles were obtained.10 of which fulfilled the inclusion criteria. Five of these 10 studies were related to multiple sclerosis (MS), 2 were about motor neuron diseases (MND), in particular amyotrophic lateral sclerosis (ALS) and 3 were related to both Alzheimer's disease (AD) and Parkinson's disease (PD). Results: The majority of the included articles, suggested a possible association between radon exposure and a subsequent development of neurodegenerative diseases. Some of the studies that obtained statistically significant resultsrevealed a possible association between radon exposure and an increase in MS prevalence. Furthermore, it was also suggested that radon exposure increases MND and AD mortality. Regarding AD and PD, it was observed that certainde cay products of radon-222 (222Rn), specifically polonium-210 (210Po) and bismuth-210 (210Bi), present a characteristic distributionpattern within the brain anatomy. However, the study with the highest scientific evidence included in this review, which investigated a possible association between the concentration of residential radon gas and the MS incidence, revealed no significant results. Conclusions: It cannot be concluded, although it is observed, that there is a possible causal association between radon exposure and neurodegenerative diseases. Most of the available studies are ecological so, studies of higher statistical evidence are needed to establish a causal relationship. Further research is needed on this topic.
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Affiliation(s)
- Silvia Gómez-Anca
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago, Spain;
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15782 Santiago, Spain;
- Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital Complex, Santiago de Compostela, 15706 Santiago, Spain
- Center for Biomedical Research on the Network of Epidemiology and Public Health (Centro DE Investigacion Biomédica en Red DE Epidemiología Y Salud Pública), 15706 Santiago de Compostela, Spain
- Correspondence:
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11
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Casal-Mouriño A, Ruano-Ravina A, Torres-Durán M, Parente-Lamelas I, Provencio-Pulla M, Castro-Añón O, Vidal-García I, Pena-Álvarez C, Abal-Arca J, Piñeiro-Lamas M, Fuente-Merino I, Fernández-Villar A, Abdulkader I, Valdés-Cuadrado L, Barros-Dios JM, Pérez-Ríos M. Corrigendum to "Lung cancer survival in never-smokers and exposure to residential radon: Results of the LCRINS study" [Canc. Lett. 487 (2020) 21-26]. Cancer Lett 2020; 493:10. [PMID: 32810636 DOI: 10.1016/j.canlet.2020.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Ana Casal-Mouriño
- Department of Pneumology, Santiago de Compostela University Clinical Teaching Hospital, Santiago de Compostela, Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública - CIBERESP), Spain.
| | - María Torres-Durán
- Department of Pneumology, Vigo University Teaching Hospital Complex, Vigo, Spain
| | | | | | | | - Iria Vidal-García
- Department of Pneumology, A Coruña University Teaching Hospital Complex, Spain
| | | | - José Abal-Arca
- Department of Pneumology, Ourense University Teaching Hospital Complex, Ourense, Spain
| | - María Piñeiro-Lamas
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública - CIBERESP), Spain
| | - Ismael Fuente-Merino
- Environmental Radioactivity Laboratory (Laboratorio de Radiactividad Ambiental - LARUC), University of Cantabria, Spain
| | | | - Ihab Abdulkader
- Department of Pathology, Clinic University Hospital of Santiago de Compostela, Spain
| | - Luis Valdés-Cuadrado
- Department of Pneumology, Santiago de Compostela University Clinical Teaching Hospital, Santiago de Compostela, Spain; Interdisciplinary Neumology Research Group, Health Research Institute of Santiago de Compostela (Instituto Investigación Sanitaria de Santiago de Compostela/IDIS), Spain
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública - CIBERESP), Spain; Department of Preventive Medicine, Santiago de Compostela University Teaching Hospital Complex, Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología and Salud Pública - CIBERESP), Spain
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12
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Conde-Sampayo A, Lorenzo-González M, Fernández-Villar A, Barros-Dios JM, Ruano-Ravina A. Exposure to Residential Radon and COPD: A Systematic Review. Int J Chron Obstruct Pulmon Dis 2020; 15:939-948. [PMID: 32425519 PMCID: PMC7196197 DOI: 10.2147/copd.s245982] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/21/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction The aim of this study was to analyse the relationship between exposure to residential radon and chronic obstructive pulmonary disease (COPD) by means of a systematic review. Material and Methods A search was conducted in PubMed and OVID for papers making reference to the radon–COPD relationship. No search filters were applied, whether by date of publication, study type or sample size. All studies not written in English or Spanish were discarded. Results A total of 174 and 57 papers were found in PubMed and OVID, respectively: of these, 13 (11 on miners and 2 on the general population) fulfilled the inclusion criteria. Only four of the studies on cohorts of miners analysed COPD as a specific disease, and only one reported statistically significant results. In addition, many of these studies lacked information on tobacco use among miners. In contrast, studies conducted on the general public showed an association between mortality and hospital admissions, on the one hand, and residential radon on the other. Conclusion There are not enough studies to provide a basis for confirming or ruling out an association between radon exposure and COPD. Nonetheless, the most recent general population studies point to evidence of a possible association. In view of the heterogeneity of available studies, it is impossible to say whether this gas may or may not affect COPD morbidity and mortality, until such a time as further studies are carried out.
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Affiliation(s)
| | | | | | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Preventive Medicine Unit, Santiago de Compostela University Teaching Hospital Complex, Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
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13
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Lorenzo-González M, Ruano-Ravina A, Torres-Durán M, Provencio-Pulla M, Kelsey K, Parente-Lamelas I, Vidal-García I, Leiro-Fernández V, Martínez C, Hernández J, Castro-Añón O, García-García S, Sales-Fidalgo P, Abal-Arca J, Montero-Martínez C, Pérez-Ríos M, Fernández-Villar A, Barros-Dios JM. Lung cancer risk and do-it-yourself activities. A neglected risk factor for lung cancer. Environ Res 2019; 179:108812. [PMID: 31698297 DOI: 10.1016/j.envres.2019.108812] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/06/2019] [Accepted: 10/07/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of this study was to assess the relationship between do-it-yourself activities entailing the exposure to carcinogenic substances and the risk of lung cancer. METHODS We pooled individual data from different case-control studies conducted in Northwestern Spain which investigated residential radon and lung cancer. Cases had an anatomopathologically confirmed primary lung cancer and controls were selected at the pre-surgery unit with uncomplicated surgeries. Both cases and controls were older than 30 years with no previous cancer history. All participants were interviewed face-to-face using a specific questionnaire. Painting, model building, furniture refinishing and woodworking or home carpentry were the do-it-yourself activities considered risky due to exposure to carcinogenic agents. RESULTS We included 1528 cases and 1457 controls. Practicing do-it-yourself risk activities was more frequent among cases: 16.0% were exposed to carcinogenic exposures during leisure time, compared to 11.8% for controls. The overall adjusted OR for lung cancer risk among individuals who practiced do-it-yourself risk activities, was 1.77 (95% CI: 1.36-2.31); this was 2.17 (95% CI: 1.51-3.11) when the analysis was restricted to individuals who performed these activities for at least 10 years. These risks were greater when the analyses were carried out exclusively among never-smokers, with the respective ORs being 2.04 (95% CI: 1.38-3.01) and 3.10 (95% CI: 1.78-5.40). CONCLUSION These results support the hypothesis that do-it-yourself activities involving exposure to certain carcinogens are associated with an increased risk of lung cancer, both in ever and never-smokers.
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Affiliation(s)
- María Lorenzo-González
- Service of Preventive Medicine, University Hospital Complex of Ourense, Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública CIBERESP, Spain.
| | | | | | - Karl Kelsey
- Department of Epidemiology, Brown University, USA
| | | | - Iria Vidal-García
- Service of Neumology, University Hospital Complex of A Coruña, Spain
| | | | - Cristina Martínez
- National Institute of Silicosis, University Hospital of Asturias, Oviedo, Spain
| | - Jesús Hernández
- Service of Neumology, University Hospital Complex of Ávila, Spain
| | | | | | | | - José Abal-Arca
- Service of Neumology, University Hospital Complex of Ourense, Spain
| | | | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública CIBERESP, Spain
| | | | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública CIBERESP, Spain; Service of Preventive Medicine, University Hospital Complex of Santiago de Compostela, Spain
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14
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Lorenzo-González M, Torres-Durán M, Barbosa-Lorenzo R, Provencio-Pulla M, Barros-Dios JM, Ruano-Ravina A. Radon exposure: a major cause of lung cancer. Expert Rev Respir Med 2019; 13:839-850. [DOI: 10.1080/17476348.2019.1645599] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- María Lorenzo-González
- Service of Preventive Medicine, University Hospital Complex of Ourense, Ourense, Spain
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- 5CIBER de Epidemiología y Salud Pública CIBERESP, Santiago de Compostela, Spain
- Service of Preventive Medicine, University Hospital Complex of Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- 5CIBER de Epidemiología y Salud Pública CIBERESP, Santiago de Compostela, Spain
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15
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Ruano-Ravina A, Dacosta-Urbieta A, Barros-Dios JM, Kelsey KT. Radon exposure and tumors of the central nervous system. Gaceta Sanitaria 2018; 32:567-575. [DOI: 10.1016/j.gaceta.2017.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/02/2017] [Accepted: 01/05/2017] [Indexed: 01/20/2023]
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16
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Lorenzo-González M, Torres-Duran M, Parente-Lamelas I, Leiro-Fernandez V, Abal-Arca J, Montero-Martínez C, Castro-Añon O, Provencio-Pulla M, Vidal-García I, Golpe-Gomez A, Martinez C, Guzman-Taveras R, Amenedo-Gancedo M, Fernandez-Villar A, Barros-Dios JM, Ruano-Ravina A. Genetic susceptibility, residential radon an lung cancer risk in never smokers. Results from the LCRINS Study. Lung Cancer 2018. [DOI: 10.1183/13993003.congress-2018.pa1755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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17
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Ruano-Ravina A, Narocki C, López-Jacob MJ, García Oliver A, Calle Tierno MDLC, Peón-González J, Barros-Dios JM. Indoor radon in Spanish workplaces. A pilot study before the introduction of the European Directive 2013/59/Euratom. Gac Sanit 2018; 33:563-567. [PMID: 30131204 DOI: 10.1016/j.gaceta.2018.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To explore whether there is a possible problem regarding indoor radon concentration surpassing the new European Directive 2013/59/Euratom threshold in Spanish workplaces. We also aim to find out whether radon concentration might be associated with certain characteristics of workplaces. METHOD We performed a cross-sectional study to measure indoor radon concentrations in Spanish workplaces including five different sectors (education, public administration, the health sector, the tourist sector and the private sector). To be measured, the workplace should be occupied permanently by at least one worker. Alpha-track type radon detectors were placed for at least three months and read at the Galician Radon Laboratory at the University of Santiago de Compostela. A descriptive analysis was performed on radon distribution by sector, building characteristics and number of workers affected. RESULTS We faced enormous difficulties in finding volunteers for this study. Galicia and Madrid had the highest number of measurements. Of a total of 248 measurements, 27% had concentrations above 300 Bq/m3. Median radon concentration was 251 Bq/m3 in Galicia, followed by Madrid, with 61.5 Bq/m3. Forty-six percent of the workplaces measured in Galicia had radon concentrations higher than 300 Bq/m3 followed by 10.6% in Madrid. Nineteen percent of all workers were exposed to more than 300 Bq/m3 and 6.3% were exposed to radon concentrations higher than 500 Bq/m3. CONCLUSION Indoor radon exposure might be a relevant problem in Spanish workplaces and the number of affected workers could be high. The prevalence of workers exposed to high radon concentrations probably depends on the geographical area.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (La Coruña), Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Galician Radon Laboratory, University of Santiago de Compostela, Santiago de Compostela (La Coruña), Spain.
| | - Claudia Narocki
- Instituto Sindical de Trabajo, Ambiente y Salud (ISTAS), Comisiones Obreras, Madrid, Spain
| | - María José López-Jacob
- Instituto Sindical de Trabajo, Ambiente y Salud (ISTAS), Comisiones Obreras, Madrid, Spain
| | | | | | - Joaquín Peón-González
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (La Coruña), Spain; Galician Radon Laboratory, University of Santiago de Compostela, Santiago de Compostela (La Coruña), Spain
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela (La Coruña), Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Galician Radon Laboratory, University of Santiago de Compostela, Santiago de Compostela (La Coruña), Spain; Service of Preventive Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela (La Coruña), Spain
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18
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Ruano-Ravina A, García-Basteiro AL, Pérez-Ríos M, Gómez-Mosquera A, Cerdeira-Caramés S, Barros-Dios JM. Lung cancer survival and deletion of GSTM1 and GSTT1 genes. A case-series from Spain. Tumori 2018; 99:445-51. [DOI: 10.1177/030089161309900401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background Lung cancer has a high incidence, and only 15% of all cases are alive 5 years after the diagnosis. Identifying the role of the genes implicated in the success of chemotherapy agents is crucial to predict survival. The objective of the study was to assess the effect of GSTM1 and GSTT1 gene deletion on lung cancer survival. Methods and study design A consecutive sampling of lung cancer cases was performed in 1999–2000 at the University Hospital of Santiago de Compostela, Spain, and GSTM1 and GSTT1 genes were genotyped. The effect of GSTM1 and GSTT1 deletion on survival was analyzed with the logrank test and with Cox regression. Results A total of 132 individuals were included, and more than half of them had stage IV lung cancer at diagnosis. Survival was similar irrespective of the presence or absence of the GSTM1 gene, whereas those with deleted GSTT1 had a significantly shorter survival. In multivariate Cox regression analysis, no significant effect was observed for the deletion of any of the genes, although there was a tendency towards a worse survival for those with deletion of GSTT1. The main limitation was that stage at diagnosis could not be considered in the analysis since most of the patients were diagnosed at stage IV. Conclusions GSTT1 appears to influence lung cancer survival whereas GSTM1 seems to have no effect.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela
- CIBER de Epidemiología y Salud Pública, Madrid
| | | | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela
- CIBER de Epidemiología y Salud Pública, Madrid
| | - Antón Gómez-Mosquera
- Service of Obstetrics and Gynecology, University Hospital of Vigo, Galician Health Service, Vigo
| | - Sara Cerdeira-Caramés
- Service of Epidemiology, Department of Health, Xunta de Galicia, Santiago de Compostela
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela
- CIBER de Epidemiología y Salud Pública, Madrid
- Service of Preventive Medicine, Clinic University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
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Rodríguez-Martínez Á, Ruano-Ravina A, Torres-Durán M, Vidal-García I, Leiro-Fernández V, Hernández-Hernández J, García-García S, Provencio M, Castro-Añón O, Parente-Lamelas I, Abdulkader I, Abal-Arca J, Montero-Martínez C, Amenedo M, Guzmán-Taveras R, Fernández-Villar A, Barros-Dios JM. Cáncer de pulmón microcítico. Metodología y resultados preliminares del estudio SMALL CELL. Arch Bronconeumol 2017. [DOI: 10.1016/j.arbres.2017.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Lorenzo-González M, Ruano-Ravina A, Peón J, Piñeiro M, Barros-Dios JM. Residential radon in Galicia: a cross-sectional study in a radon-prone area. J Radiol Prot 2017; 37:728-741. [PMID: 28608782 DOI: 10.1088/1361-6498/aa7922] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Residential radon exposure is a major public health problem. It is the second greatest cause of lung cancer, after smoking, and the greatest in never-smokers. This study shows the indoor radon exposure distribution in Galicia and estimates the percentage of dwellings exceeding reference levels. It is based on 3245 residential radon measurements obtained from the Galician Radon Map project and from controls of two previous case-control studies on residential radon and lung cancer. Results show a high median residential radon concentration in Galicia (99 Bq m-3), with 49.3% of dwellings having a radon concentration above 100 Bq m-3 and 11.1% having a concentration above 300 Bq m-3. Ourense and Pontevedra, located in South Galicia, are the provinces with the highest median indoor radon concentrations (137 Bq m-3 and 123.5 Bq m-3, respectively). Results also show lower radon levels in progressively higher building storeys. These high residential radon concentrations confirm Galicia as a radon-prone area. A policy on radon should be developed and implemented in Galicia to minimize the residential radon exposure of the population.
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Ruano-Ravina A, Torres-Durán M, Kelsey KT, Parente-Lamelas I, Leiro-Fernández V, Abdulkader I, Abal-Arca J, Montero-Martínez C, Vidal-García I, Amenedo M, Castro-Añón O, Golpe-Gómez A, González-Barcala J, Martínez C, Guzmán-Taveras R, Provencio M, Mejuto-Martí MJ, Fernández-Villar A, Barros-Dios JM. Residential radon, EGFR mutations and ALK alterations in never-smoking lung cancer cases. Eur Respir J 2016; 48:1462-1470. [PMID: 27799390 DOI: 10.1183/13993003.00407-2016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/26/2016] [Indexed: 11/05/2022]
Abstract
The aim of this study was to assess if residential radon exposure might cause EGFR mutations or ALK rearrangements in never-smokers.We designed a multicentre case-control study in a radon-prone area (Galicia, Spain); only lung cancer cases were included in the study. We obtained residential radon measurements and clinical information for all the participants. We compared the median values of residential radon between patients with EGFR mutations or ALK rearrangements versus those without them.323 patients were included. Median age was 70 years and 19.5% were males. 42 and 15% of patients were EGFR- and ALK-positive, respectively. The most frequent EGFR alterations were exon 19 deletions and exon 21 (L858R) single-point substitution mutations. ALK-positive patients were 10 years younger than ALK-negative patients. Residential radon levels were two-fold higher in patients with exon 19 deletions compared with patients with exon 21 (L858R) single-point substitution mutations (216 versus 118 Bq·m-3; p=0.057). There were no differences in residential radon levels by EGFR mutation status. ALK-positive patients (n=12) essentially had two-fold residential radon levels compared with ALK-negative patients (290 versus 164 Bq·m-3, respectively).Residential radon may have a role in the molecular signature of lung cancer in never-smokers, although more studies with larger sample sizes are needed to support this hypothesis.
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Affiliation(s)
- Alberto Ruano-Ravina
- Dept of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain .,CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.,Dept of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, USA
| | | | - Karl T Kelsey
- Dept of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, USA
| | | | | | - Ihab Abdulkader
- Service of Pathology, Santiago de Compostela University Clinic Hospital, Santiago de Compostela, Spain
| | - José Abal-Arca
- Service of Pneumology, Ourense Hospital Complex, Ourense, Spain
| | | | - Iria Vidal-García
- Service of Pneumology, University Hospital Complex of A Coruña, A Coruña, Spain
| | | | | | - Antonio Golpe-Gómez
- Service of Pneumology, Santiago de Compostela University Clinic Hospital, Santiago de Compostela, Spain
| | - Javier González-Barcala
- Service of Pneumology, Santiago de Compostela University Clinic Hospital, Santiago de Compostela, Spain
| | - Cristina Martínez
- National Institute of Silicosis, University Hospital of Asturias, Oviedo, Spain
| | | | - Mariano Provencio
- Service of Oncology, Puerta de Hierro University Hospital, Madrid, Spain
| | | | | | - Juan Miguel Barros-Dios
- Dept of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.,CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.,Service of Preventive Medicine, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
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García-Lavandeira JA, Ruano-Ravina A, Barros-Dios JM. Alcohol consumption and lung cancer risk in never smokers. Gac Sanit 2016; 30:311-7. [PMID: 27266513 DOI: 10.1016/j.gaceta.2016.03.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/31/2016] [Accepted: 03/31/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The main objective of this study is to analyse the role of alcohol consumption on lung cancer risk in people who have never smoked. METHODS We conducted a systematic review of the scientific literature following the PRISMA statement. We searched Medline, EMBASE and CINAHL using different combinations of MeSH terms and free text. We included cohort studies, pooled cohort studies and case-control studies comprising at least 25 anatomopathologically-confirmed diagnoses of lung cancer cases, a sample size larger than 100 individuals and more than five years of follow-up for cohort studies. We excluded studies that did not specifically report results for never smokers. We developed a quality score to assess the quality of the included papers and we ultimately included 14 investigations with a heterogeneous design and methodology. RESULTS Results for alcohol consumption and lung cancer risk in never smokers are inconclusive; however, several studies showed a dose-response pattern for total alcohol consumption and for spirits. Heterogeneous results were found for wine and beer. CONCLUSION No clear effect is observed for alcohol consumption. Due to the limited evidence, no conclusion can be drawn for beer or wine consumption. There is little research available on the effect of alcohol on lung cancer risk for people who have never smoked, and more studies are urgently needed on this topic.
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Affiliation(s)
- José Antonio García-Lavandeira
- Service of Preventive Medicine, University Hospital Complex of A Coruña, Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela (A Coruña), Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela (A Coruña), Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela (A Coruña), Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Service of Preventive Medicine, University Hospital Complex of Santiago de Compostela (A Coruña), Spain
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Villamarín-Bello B, Piñeiro-Lamas M, Barros-Dios JM, Ruano-Ravina A, García-Otero MJ, Fernández-Villanueva JR. Bacteremia nosocomial asociada a catéter vascular central en unidades de cuidados intensivos en 2 hospitales en Galicia (España). Infectio 2016. [DOI: 10.1016/j.infect.2015.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Torres-Durán M, Ruano-Ravina A, Kelsey KT, Parente-Lamelas I, Provencio M, Leiro-Fernández V, Abal-Arca J, Montero-Martínez C, Vidal-Garcia I, Pena C, Castro-Añón O, Golpe-Gómez A, Martínez C, Guzmán-Taveras R, Mejuto-Martí MJ, Fernández-Villar A, Barros-Dios JM. Small cell lung cancer in never-smokers. Eur Respir J 2015; 47:947-53. [DOI: 10.1183/13993003.01524-2015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 11/12/2015] [Indexed: 11/05/2022]
Abstract
Our aim was to describe the characteristics of a case-series of never-smoker small cell lung cancer (SCLC) cases.Cases of SCLC were selected from a prospective, multicenter, hospital-based case–control study performed in Spain. Participants were never-smokers older than 30 years with an anatomo-pathological confirmation of primary lung cancer. We collected clinical and epidemiological variables according to the study's protocol.We included 19 SCLC cases, 18 females (94.7%), median age 75 years (interquartile range (IQR) 70–80 years). Median residential radon concentration was 195 Bq·m−3(IQR 130–229 Bq·m−3). 10 patients had limited disease and nine had extended disease. Median survival was 242 days (IQR 94–496 days); 1- and 2-year survival were 36.8% and 17.6%, respectively. Survival was much higher for individuals with limited disease than for those with extended disease (median 336versus235 days; 1-year survival 50%versus22.2% and 2-year survival 27%versus0%, respectively). Performance status at diagnosis was closely related to survival.SCLC is an infrequent, highly aggressive disease in never-smokers. Survival is poor, even for limited disease. Age at diagnosis in SCLC is higher than that observed for never-smokers with adenocarcinoma. Residential radon exposure is higher than the action levels recommended by the World Health Organization.
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Torres-Durán M, Ruano-Ravina A, Parente-Lamelas I, Leiro-Fernández V, Abal-Arca J, Montero-Martínez C, Pena-Álvarez C, Castro-Añón O, Golpe-Gómez A, Martínez C, Guzmán-Taveras R, Mejuto-Martí MJ, Provencio M, Fernández-Villar A, Barros-Dios JM. Residential radon and lung cancer characteristics in never smokers. Int J Radiat Biol 2015; 91:605-10. [DOI: 10.3109/09553002.2015.1047985] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Ruano-Ravina A, Pereyra MF, Castro MT, Pérez-Ríos M, Abal-Arca J, Barros-Dios JM. Genetic susceptibility, residential radon, and lung cancer in a radon prone area. J Thorac Oncol 2015; 9:1073-80. [PMID: 24852519 DOI: 10.1097/jto.0000000000000205] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Radon exposure has been classified as the second cause of lung cancer, after tobacco, and the first in never smokers. GSTM1 and GSTT1 genes deletion increase the risk of lung cancer. We aim to know whether the risk of lung cancer because of residential radon is modulated by these genetic polymorphisms. METHODS Hospital-based, case-control study where cases had confirmed lung cancer. Cases and controls did not have previous neoplasm and were older than 30. Controls attended hospital for noncomplex surgery. We analyzed the results for the whole sample and separately for never/light smokers and moderate/heavy smokers. RESULTS Seven-hundred and ninety-two participants were analyzed. GSTM1 and GSTT1 deletion conferred an odds ratio (OR) of 1.38 (95% confidence interval [CI] 0.93-2.04) and 1.13 (95% CI 0.70-1.82), respectively. Individuals with GSTM1 present and residential radon concentrations higher than 148 Bq/m had an OR of 1.48 (95% CI 0.73-3.00), whereas those with GSTM1 deleted had an OR of 2.64 (95% CI 1.18-5.91) when compared with participants with GSTM1 present and radon concentrations below 50 Bq/m3. Similar results were observed for GSTT1 deletion. These results were basically the same for the moderate/heavy smokers' subgroup. CONCLUSIONS The absence of GSTM1 and GSTT1 genes increases the risk of lung cancer because of radon exposure. These genes might modulate the carcinogenic pathway of alpha radiation. Further studies are warranted analyzing this association in never smokers.
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Affiliation(s)
- Alberto Ruano-Ravina
- *Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña; †CIBER de Epidemiología y Salud Pública, CIBERESP; ‡Service of Neumology, Clinic University Hospital; §Department of Physiology, School of Medicine-CIMUS-Instituto de Investigaciones Sanitarias, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; ‖Metabolic Research Laboratories, Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, United Kingdom; ¶Service of Neumology, Ourense Hospital Complex, Ourense; and #Service of Preventive Medicine, Clinic University Hospital Complex of Santiago de Compostela, A Coruña, Spain
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Barbosa-Lorenzo R, Ruano-Ravina A, Cerdeira Caramés S, Barros-Dios JM. Radón residencial y cáncer de pulmón. Un estudio ecológico en Galicia. Med Clin (Barc) 2015; 144:304-8. [PMID: 24485165 DOI: 10.1016/j.medcli.2013.11.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 11/12/2013] [Accepted: 11/14/2013] [Indexed: 11/27/2022]
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Tarrazo-Antelo AM, Ruano-Ravina A, Abal Arca J, Barros-Dios JM. Fruit and vegetable consumption and lung cancer risk: a case-control study in Galicia, Spain. Nutr Cancer 2014; 66:1030-7. [PMID: 25085257 DOI: 10.1080/01635581.2014.936951] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Lung cancer has multiple risk factors and tobacco is the main one. Diet plays a role, but no clear effect has been consistently observed for different fruit and vegetable consumption. We aim to assess the association between fruit and vegetable consumption and lung cancer risk through a hospital-based case-control study in Spanish population. We recruited incident lung cancer cases in 2 Spanish hospitals from 2004 to 2008. Controls were individuals attending hospital for trivial surgery. Cases and controls were older than 30 and did not have a neoplasic history. We collected information on lifestyle with special emphases on tobacco and dietary habits. We included 371 cases and 496 controls. We found no protective effect for overall fruit consumption. For green leafy vegetables, the odds ratio (OR) was 0.92 [95% confidence interval (CI) = 0.32-2.69), and for other vegetables the OR was 0.77 (95% CI = 0.40-1.48) for the categories compared. We observed a reduced risk for broccoli and pumpkin intake. Although fruit consumption does not seem to be associated with a lower lung cancer risk, only the frequent consumption of specific green leafy vegetables and other vegetables might be associated with a reduced risk of lung cancer.
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Affiliation(s)
- Ana Marina Tarrazo-Antelo
- a Service of Preventive Medicine , University Hospital Complex of Santiago de Compostela , Santiago de Compostela , Spain
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Torres-Durán M, Ruano-Ravina A, Parente-Lamelas I, Leiro-Fernández V, Abal-Arca J, Montero-Martínez C, Pena-Álvarez C, González-Barcala FJ, Castro-Añón O, Golpe-Gómez A, Martínez C, Mejuto-Martí MJ, Fernández-Villar A, Barros-Dios JM. Lung cancer in never-smokers: a case-control study in a radon-prone area (Galicia, Spain). Eur Respir J 2014; 44:994-1001. [PMID: 25034571 DOI: 10.1183/09031936.00017114] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The aim of the study was to assess the effect of residential radon exposure on the risk of lung cancer in never-smokers and to ascertain if environmental tobacco smoke modifies the effect of residential radon. We designed a multicentre hospital-based case-control study in a radon-prone area (Galicia, Spain). All participants were never-smokers. Cases had an anatomopathologically confirmed primary lung cancer and controls were recruited from individuals undergoing minor, non-oncological surgery. Residential radon was measured using alpha track detectors. We included 521 individuals, 192 cases and 329 controls, 21% were males. We observed an odds ratio of 2.42 (95% CI 1.45-4.06) for individuals exposed to ≥200 Bq·m(-3) compared with those exposed to <100 Bq·m(-3). Environmental tobacco smoke exposure at home increased lung cancer risk in individuals with radon exposure>200 Bq·m(-3). Individuals exposed to environmental tobacco smoke and to radon concentrations>200 Bq·m(-3) had higher lung cancer risk than those exposed to lower radon concentrations and exposed to environmental tobacco smoke. Residential radon increases lung cancer risk in never-smokers. An association between residential radon exposure and environmental tobacco smoke on the risk of lung cancer might exist.
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Affiliation(s)
| | - Alberto Ruano-Ravina
- Dept of Preventive Medicine and Public Health, University of Santiago de Compostela. Santiago de Compostela, Spain CIBER de Epidemiología y Salud Pública, CIBERESP, Spain
| | | | | | | | | | | | | | | | - Antonio Golpe-Gómez
- Service of Pneumology, Santiago de Compostela University Clinic Hospital, Santiago de Compostela, Spain
| | - Cristina Martínez
- National Institute of Silicosis, University Hospital of Asturias, Oviedo. Spain
| | | | | | - Juan Miguel Barros-Dios
- Dept of Preventive Medicine and Public Health, University of Santiago de Compostela. Santiago de Compostela, Spain CIBER de Epidemiología y Salud Pública, CIBERESP, Spain Service of Preventive Medicine. University Hospital Complex of Santiago de Compostela, A Coruña Spain
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Ruano-Ravina A, García-Lavandeira JA, Torres-Durán M, Prini-Guadalupe L, Parente-Lamelas I, Leiro-Fernández V, Montero-Martínez C, González-Barcala FJ, Golpe-Gómez A, Martínez C, Castro-Añón O, Mejuto-Martí MJ, Barros-Dios JM. Leisure time activities related to carcinogen exposure and lung cancer risk in never smokers. A case-control study. Environ Res 2014; 132:33-37. [PMID: 24742725 DOI: 10.1016/j.envres.2014.03.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/12/2014] [Accepted: 03/20/2014] [Indexed: 06/03/2023]
Abstract
We aim to assess the relationship between leisure time activities related to exposure to carcinogenic substances and lung cancer risk in a hospital-based case-control study performed in never smokers. We included never smoking cases with anatomopathologically confirmed lung cancer and never smoking controls undergoing trivial surgery, at 8 Spanish hospitals. The study was conducted between January 2011 and June 2013. Participants were older than 30 and had no previous neoplasms. All were personally interviewed focusing on lifestyle, environmental tobacco smoke exposure, occupational history and leisure time activities (including duration of such activities). Results were analyzed through logistic regression and adjusted also by residential radon and education level. We included 513 never smokers, 191 cases and 322 controls. The OR for those performing the studied leisure time activities was 1.43 (95%CI 0.78-2.61). When we restricted the analysis to those performing do-it-yourself activities for more than 10 years the OR was 2.21 (95%CI 0.93-5.27). Environmental tobacco smoke exposure did not modify this association. The effect for the different lung cancer histological types was very close to significance for adenocarcinoma but only when these activities were performed for more than 10 years. We encourage health professionals to recommend protective measures for those individuals while performing these hobbies to reduce the risk of lung cancer.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública CIBERESP, Barcelona, Spain.
| | - José Antonio García-Lavandeira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Department of Preventive Medicine, A Coruña University Hospital Complex, Coruña, Spain
| | - María Torres-Durán
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Service of Neumology, University Hospital Complex of Vigo, Vigo, Spain
| | - Luciana Prini-Guadalupe
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | | | - Antonio Golpe-Gómez
- Service of Neumology, Santiago de Compostela University Clinic Hospital, Santiago de Compostela, Spain
| | - Cristina Martínez
- National Institute of Silicosis, University Hospital of Asturias, Oviedo, Asturias, Spain
| | | | | | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública CIBERESP, Barcelona, Spain; Service of Preventive Medicine, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
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Ruano-Ravina A, García-Basteiro AL, Pérez-Ríos M, Gómez-Mosquera A, Cerdeira-Caramés S, Barros-Dios JM. Lung cancer survival and deletion of GSTM1 and GSTT1 genes. A case-series from Spain. Tumori 2014. [PMID: 24326830 DOI: 10.1700/1361.15092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND Lung cancer has a high incidence, and only 15% of all cases are alive 5 years after the diagnosis. Identifying the role of the genes implicated in the success of chemotherapy agents is crucial to predict survival. The objective of the study was to assess the effect of GSTM1 and GSTT1 gene deletion on lung cancer survival. METHODS AND STUDY DESIGN A consecutive sampling of lung cancer cases was performed in 1999-2000 at the University Hospital of Santiago de Compostela, Spain, and GSTM1 and GSTT1 genes were genotyped. The effect of GSTM1 and GSTT1 deletion on survival was analyzed with the logrank test and with Cox regression. RESULTS A total of 132 individuals were included, and more than half of them had stage IV lung cancer at diagnosis. Survival was similar irrespective of the presence or absence of the GSTM1 gene, whereas those with deleted GSTT1 had a significantly shorter survival. In multivariate Cox regression analysis, no significant effect was observed for the deletion of any of the genes, although there was a tendency towards a worse survival for those with deletion of GSTT1. The main limitation was that stage at diagnosis could not be considered in the analysis since most of the patients were diagnosed at stage IV. CONCLUSIONS GSTT1 appears to influence lung cancer survival whereas GSTM1 seems to have no effect.
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Torres-Durán M, Barros-Dios JM, Fernández-Villar A, Ruano-Ravina A. Residential radon and lung cancer in never smokers. A systematic review. Cancer Lett 2013; 345:21-6. [PMID: 24333737 DOI: 10.1016/j.canlet.2013.12.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 11/13/2013] [Accepted: 12/01/2013] [Indexed: 01/05/2023]
Abstract
Radon exposure is considered the second cause of lung cancer and the first in never smokers. We aim to assess the effect of residential radon exposure on the risk of lung cancer in never smokers through a systematic review applying predefined inclusion and exclusion criteria. 14 Studies were included. Some of them point to a relationship between residential radon and lung cancer while others show no association. Further studies are necessary to test this association and to assess if other risk factors such as environmental tobacco smoke could modify the effect of residential radon exposure on lung cancer.
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Affiliation(s)
- María Torres-Durán
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Service of Neumology, University Hospital Complex of Vigo, Spain
| | - Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Spain; Service of Preventive Medicine, University Hospital Complex of Santiago de Compostela, Spain
| | | | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Spain.
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Ruano-Ravina A, Prini-Guadalupe L, Barros-Dios JM, Abal-Arca J, Leiro-Fernández V, González-Silva AI, Golpe-Gómez A, González-Barcala FJ, Pena C, Montero-Martínez C, Martínez-González C, Mejuto-Martí MJ, Veres-Racamonde A. Exposición a radón residencial y cáncer de pulmón en nunca fumadores. Resultados preliminares del estudio LCRINS. Arch Bronconeumol 2012; 48:405-9. [DOI: 10.1016/j.arbres.2012.05.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 05/18/2012] [Accepted: 05/29/2012] [Indexed: 12/13/2022]
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Barros-Dios JM, Ruano-Ravina A, Pérez-Ríos M, Castro-Bernárdez M, Abal-Arca J, Tojo-Castro M. Residential radon exposure, histologic types, and lung cancer risk. A case-control study in Galicia, Spain. Cancer Epidemiol Biomarkers Prev 2012; 21:951-8. [PMID: 22539606 DOI: 10.1158/1055-9965.epi-12-0146-t] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Lung cancer is an important public health problem, and tobacco is the main risk factor followed by residential radon exposure. Recommended exposure levels have been progressively lowered. Galicia, the study area, has high residential radon concentrations. We aim (i) to assess the risk of lung cancer linked to airborne residential radon exposure, (ii) to ascertain whether tobacco modifies radon risk, and (iii) to know whether there is a lung cancer histologic type more susceptible to radon. METHODS A hospital-based case-control design was conducted in two Spanish hospitals. Consecutive cases with histologic diagnosis of lung cancer and controls undergoing trivial surgery not tobacco-related were included. Residential radon was measured using standard procedures. Results were obtained using logistic regression. RESULTS Three hundred and forty-nine cases and 513 controls were included. Radon exposure posed a risk even with a low exposure, with those exposed to 50 to 100 Bq/m(3) having an OR of 1.87 [95% confidence interval (CI), 1.21-2.88] and of 2.21 (95% CI, 1.33-3.69) for those exposed to 148 Bq/m(3) or more. Tobacco increased appreciably the risk posed by radon, with an OR of 73 (95% CI, 19.88-268.14) for heavy smokers exposed to more than 147 Bq/m(3). Less frequent histologic types (including large cell carcinomas), followed by small cell lung cancer, had the highest risk associated with radon exposure. CONCLUSIONS The presence of airborne radon even at low concentrations poses a risk of developing lung cancer, with tobacco habit increasing considerably this risk. IMPACT Public health initiatives should address the higher risk of lung cancer for smokers exposed to radon.
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Affiliation(s)
- Juan Miguel Barros-Dios
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
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Abstract
OBJECTIVE To compare whether there are differences among hospital and population controls. METHODS Two case-control studies were conducted on lung cancer risk factors in the Santiago de Compostela Public Health District. Whereas one used randomly chosen census-based population controls, the other used consecutive hospital controls that went to the reference hospital for non-smoking-related trivial interventions. The differences were analyzed using logistic regression. The dependent variable was type of control (hospital or population). RESULTS Hospital controls had a similar tobacco habit than population controls, but consumed more alcohol. For those consuming more than 50 ml daily, the risk of being a hospital control was 4.83 (95%CI: 2.55-9.14). CONCLUSIONS There may be some differences between hospital and population-based controls, which must be taken into account in the design of case-control studies. It is necessary to ascertain whether such differences are reproduced at other geographic locations and whether they can affect estimation of exposure-disease.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain.
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Ruano-Ravina A, Castro-Bernárdez M, Sande-Meijide M, Vargas A, Barros-Dios JM. Short- versus long-term radon detectors: a comparative study in Galicia, NW Spain. J Environ Radioact 2008; 99:1121-1126. [PMID: 18313815 DOI: 10.1016/j.jenvrad.2008.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2007] [Revised: 01/02/2008] [Accepted: 01/14/2008] [Indexed: 05/26/2023]
Abstract
As reported in previous studies, Galicia (NW Spain) is an area of high radon concentrations. This study was sought to analyze the correlation between short-term (activated carbon) and long-term (alpha particle track) detectors in this geographic area, and ascertain whether there were differences in their readings that might be influenced by other variables. A comparison study, as part of a case-control study was designed in which two detectors, one of each type, were placed in the selected homes. A total of 391 homes yielded readings with both detectors. The results indicated that there was a relatively good correlation between both types of monitors (correlation coefficient 0.608; p<0.001). The highest correlations between both detectors were observed for unventilated homes, coastal sites, and the oldest buildings. Short-term and long-term detectors do not show a similar performance in all settings or situations. It is advisable to use long-term detectors whenever possible.
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Affiliation(s)
- A Ruano-Ravina
- Department of Preventive Medicine and Public Health, School of Medicine, University of Santiago de Compostela, San Francisco, 15782 Santiago de Compostela, Spain.
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Ruano-Ravina A, Pérez-Becerra R, Fraga M, Kelsey KT, Barros-Dios JM. Analysis of the relationship between p53 immunohistochemical expression and risk factors for lung cancer, with special emphasis on residential radon exposure. Ann Oncol 2007; 19:109-14. [PMID: 17897960 DOI: 10.1093/annonc/mdm395] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Indoor radon exposure has been postulated as the second risk factor of lung cancer after tobacco. The objective of this work is to analyze if there exists any effect on p53 immunohistochemical expression mainly due to radon exposure and other risk factors for lung cancer. PATIENTS AND METHODS The tumor samples of a case series of 163 lung cancer cases were analyzed to know the p53 staining. The staining was classified into four categories from no staining to intense staining (>60%). This staining was correlated with radon exposure, tobacco consumption, having worked in risk occupations for lung cancer and alcohol consumption. RESULTS Only 72 samples could be analyzed for immunohistochemistry and some of these samples were sequenced from exons 4-8. No association was observed for staining intensity and radon exposure and also for tobacco and occupation. A slight association with a more intense staining was observed for high alcohol intake. In the four samples with a staining >60% that could be sequenced from exons 4 to 8, no mutation was observed in the p53 gene. CONCLUSION There is no association between radon exposure and p53 expression, indicating that maybe the effect of radon is not mediated through p53 alterations.
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MESH Headings
- Aged
- Air Pollutants, Radioactive/adverse effects
- Air Pollution, Indoor/adverse effects
- Alcohol Drinking/adverse effects
- Biomarkers, Tumor/analysis
- Carcinoma, Non-Small-Cell Lung/chemistry
- Carcinoma, Non-Small-Cell Lung/epidemiology
- Carcinoma, Non-Small-Cell Lung/etiology
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Small Cell/chemistry
- Carcinoma, Small Cell/epidemiology
- Carcinoma, Small Cell/etiology
- Carcinoma, Small Cell/pathology
- Case-Control Studies
- Cocarcinogenesis
- Female
- Humans
- Lung Neoplasms/chemistry
- Lung Neoplasms/epidemiology
- Lung Neoplasms/etiology
- Lung Neoplasms/pathology
- Male
- Middle Aged
- Neoplasms, Radiation-Induced/chemistry
- Neoplasms, Radiation-Induced/etiology
- Occupational Exposure
- Radon/adverse effects
- Residence Characteristics
- Risk Factors
- Smoking/adverse effects
- Spain/epidemiology
- Tumor Suppressor Protein p53/analysis
- Tumor Suppressor Protein p53/physiology
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Affiliation(s)
- A Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
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Ruano-Ravina A, Barros-Dios JM. Radón y cáncer de pulmón. Implicaciones para profesionales sanitarios, ciudadanos y administraciones públicas. Med Clin (Barc) 2007; 128:545-9. [PMID: 17433210 DOI: 10.1157/13101166] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Alberto Ruano-Ravina
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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Barros-Dios JM, Ruano-Ravina A, Gastelu-Iturri J, Figueiras A. Factors underlying residential radon concentration: results from Galicia, Spain. Environ Res 2007; 103:185-90. [PMID: 16729995 DOI: 10.1016/j.envres.2006.04.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Revised: 04/04/2006] [Accepted: 04/17/2006] [Indexed: 05/09/2023]
Abstract
Radon causes lung cancer when inhaled for prolonged periods of time. A range of factors influence residential radon concentration and this study therefore sought to ascertain which dwelling-related factors exert an influence on radon levels. A cross-sectional study was conducted from 2001 to 2003 which analyzed 983 homes of as many subjects randomly selected from the 1991 census. Sampling was carried out by district and stratified by population density to ensure that more detectors were placed in the most heavily populated areas. Radon concentration and different dwelling characteristics were measured in each of the homes selected. Bivariate and multivariate analyses were performed to ascertain which factors influenced radon concentration. The geometric mean of radon concentration was 69.5 Bq/m3, and 21.3% of homes had concentrations above 148 Bq/m3. Factors shown to influence radon concentration in the bivariate analysis were: age of dwelling; interior building material; exterior building material; and storey on which the detector was placed. Explanatory variables in the multivariate analysis were: age of dwelling; number of storeys; distance off floor; and interior building material. The model was significant, but the variability explained was around 10%. These results highlight the fact that the study area is an area of high radon emission and that factors other than those directly related with the characteristics of the dwelling also influence radon concentration.
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Affiliation(s)
- J M Barros-Dios
- Department of Preventive Medicine and Public Health, School of Medicine, C/San Francisco s/n, University of Santiago de Compostela, and Preventive Medicine Unit, Santiago de Compostela Clinic University Hospital, Spain.
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Dosil-Díaz O, Ruano-Ravina A, Gestal-Otero JJ, Barros-Dios JM. Meat and fish consumption and risk of lung cancer: A case-control study in Galicia, Spain. Cancer Lett 2007; 252:115-22. [PMID: 17240050 DOI: 10.1016/j.canlet.2006.12.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2006] [Revised: 11/14/2006] [Accepted: 12/12/2006] [Indexed: 11/16/2022]
Abstract
Diet is one of the elements that may influence the development of lung cancer. To ascertain the relationship between meat and fish consumption and the appearance of this disease, a case-control study was conducted on a population in Galicia (NW Spain), with a sample of 295 cases and 322 controls. All cases had histologic confirmation, and controls were individuals who were attending the hospital to undergo trivial surgery. All subjects were over 35, and sampling was based on sex frequency. Frequent consumption of meat seemed to have a protective effect, with an OR of 0.24 (95% CI 0.11-0.50), an effect that was maintained for pork consumption (OR 0.35; 95% CI 0.18-0.67). In contrast, consumption of fish showed an association with lung cancer, with an OR of 1.67 (95% CI 0.99-2.81), an association that extended to both white (OR 1.61 95% CI 0.93-2.79) and blue fish (OR 2.03 95% CI 1.23-3.34). Consumption of meat seems to reduce the risk of lung cancer, whereas consumption of fish could exert an influence by increasing the risk of this disease.
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Affiliation(s)
- O Dosil-Díaz
- Galician Public Foundation for Health Emergencies-061, Spain
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Raimondi S, Paracchini V, Autrup H, Barros-Dios JM, Benhamou S, Boffetta P, Cote ML, Dialyna IA, Dolzan V, Filiberti R, Garte S, Hirvonen A, Husgafvel-Pursiainen K, Imyanitov EN, Kalina I, Kang D, Kiyohara C, Kohno T, Kremers P, Lan Q, London S, Povey AC, Rannug A, Reszka E, Risch A, Romkes M, Schneider J, Seow A, Shields PG, Sobti RC, Sørensen M, Spinola M, Spitz MR, Strange RC, Stücker I, Sugimura H, To-Figueras J, Tokudome S, Yang P, Yuan JM, Warholm M, Taioli E. Meta- and pooled analysis of GSTT1 and lung cancer: a HuGE-GSEC review. Am J Epidemiol 2006; 164:1027-42. [PMID: 17000715 DOI: 10.1093/aje/kwj321] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Lung cancer is the most common malignancy in the Western world, and the main risk factor is tobacco smoking. Polymorphisms in metabolic genes may modulate the risk associated with environmental factors. The glutathione S-transferase theta 1 gene (GSTT1) is a particularly attractive candidate for lung cancer susceptibility because of its involvement in the metabolism of polycyclic aromatic hydrocarbons found in tobacco smoke and of other chemicals, pesticides, and industrial solvents. The frequency of the GSTT1 null genotype is lower among Caucasians (10-20%) than among Asians (50-60%). The authors present a meta- and a pooled analysis of case-control, genotype-based studies that examined the association between GSTT1 and lung cancer (34 studies, 7,629 cases and 10,087 controls for the meta-analysis; 34 studies, 7,044 cases and 10,000 controls for the pooled analysis). No association was observed between GSTT1 deletion and lung cancer for Caucasians (odds ratio (OR) = 0.99, 95% confidence interval (CI): 0.87, 1.12); for Asians, a positive association was found (OR = 1.28, 95% CI: 1.10, 1.49). In the pooled analysis, the odds ratios were not significant for either Asians (OR = 0.97, 95% CI: 0.83, 1.13) or Caucasians (OR = 1.09, 95% CI: 0.99, 1.21). No significant interaction was observed between GSTT1 and smoking on lung cancer, whereas GSTT1 appeared to modulate occupational-related lung cancer.
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Abstract
Tobacco use is the leading risk factor for lung cancer, yet in addition to smoking habit, diet may also play a role in the disease's appearance. While there are reports to indicate that antioxidant vitamins and carotenoids may decrease the risk of lung cancer, results to date have been somewhat ambiguous. This review aimed to describe the results yielded by different studies, which have addressed antioxidant vitamin intake and lung cancer, and to indicate the mechanisms whereby these nutrients might be exercising their activity. Antioxidant vitamins were observed to have no clear protective effect, though there was some evidence pointing to a protective role for vitamins C and E. Vitamin A, in contrast, evinced no clear effect. Insofar as provitamin A carotenoids were concerned, lutein/zeaxanthin, lycopene and alpha-carotene displayed a certain protective trend, yet beta-carotene exhibited no protective effect whatsoever; and indeed, there was speculation as to whether it might even be pernicious in smokers. Beta-criptoxanthin, on the other hand, showed a more consistent protective effect. The study highlighted the need to conduct further research on smokers and non-smokers alike, and in particular, to investigate the effect, if any, on lung cancer of carotenoids or vitamins when ingested in differing dosages.
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Affiliation(s)
- A Ruano-Ravina
- Department of Preventive Medicine and Public Health, School of Medicine, c/ San Francisco s/n, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
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Darby S, Hill D, Deo H, Auvinen A, Barros-Dios JM, Baysson H, Bochicchio F, Falk R, Farchi S, Figueiras A, Hakama M, Heid I, Hunter N, Kreienbrock L, Kreuzer M, Lagarde F, Mäkeläinen I, Muirhead C, Oberaigner W, Pershagen G, Ruosteenoja E, Rosario AS, Tirmarche M, Tomásek L, Whitley E, Wichmann HE, Doll R. Residential radon and lung cancer--detailed results of a collaborative analysis of individual data on 7148 persons with lung cancer and 14,208 persons without lung cancer from 13 epidemiologic studies in Europe. Scand J Work Environ Health 2006; 32 Suppl 1:1-83. [PMID: 16538937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVES Studies seeking direct estimates of the lung cancer risk associated with residential radon exposure lasting several decades have been conducted in many European countries. Individually these studies have not been large enough to assess moderate risks reliably. Therefore data from all 13 European studies of residential radon and lung cancer satisfying certain prespecified criteria have been brought together and analyzed. METHODS Data were available for 7148 persons with lung cancer and 14,208 controls, all with individual smoking histories and residential radon histories determined by long-term radon gas measurements. RESULTS The excess relative risk of lung cancer per 100 Bq/m3 increase in the observed radon concentration was 0.08 [95% confidence interval (95% CI) 0.03-0.16; P=0.0007] after control for confounding. The dose-response relationship was linear with no evidence of a threshold, and it remained significant when only persons with observed radon concentrations of <200 Bq/m3 were included. There was no evidence that the excess relative risk varied with age, sex, or smoking history. Removing the bias induced by random uncertainties related to radon exposure assessment increased the excess relative risk of lung cancer to 0.16 (95% CI 0.05-0.31) per 100 Bq/m3. With this correction, estimated risks at 0, 100, and 400 Bq/m3, relative to lifelong nonsmokers with no radon exposure, were 1.0, 1.2, and 1.6 for lifelong nonsmokers and 25.8, 29.9, and 42.3 for continuing smokers of 15-24 cigarettes/day. CONCLUSIONS These data provide firm evidence that residential radon acts as a cause of lung cancer in the general population. They provide a solid basis for the formulation of policies with which to manage risk from radon and reduce deaths from the most common fatal cancer in Europe.
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Affiliation(s)
- Sarah Darby
- Clinical Trial Service Unit, Richard DOll Building, University of Oxford, Oxford, United Kingdom.
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Darby S, Hill D, Auvinen A, Barros-Dios JM, Baysson H, Bochicchio F, Deo H, Falk R, Forastiere F, Hakama M, Heid I, Kreienbrock L, Kreuzer M, Lagarde F, Mäkeläinen I, Muirhead C, Oberaigner W, Pershagen G, Ruano-Ravina A, Ruosteenoja E, Rosario AS, Tirmarche M, Tomásek L, Whitley E, Wichmann HE, Doll R. Radon in homes and risk of lung cancer: collaborative analysis of individual data from 13 European case-control studies. BMJ 2005; 330:223. [PMID: 15613366 PMCID: PMC546066 DOI: 10.1136/bmj.38308.477650.63] [Citation(s) in RCA: 860] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the risk of lung cancer associated with exposure at home to the radioactive disintegration products of naturally occurring radon gas. DESIGN Collaborative analysis of individual data from 13 case-control studies of residential radon and lung cancer. SETTING Nine European countries. SUBJECTS 7148 cases of lung cancer and 14,208 controls. MAIN OUTCOME MEASURES Relative risks of lung cancer and radon gas concentrations in homes inhabited during the previous 5-34 years measured in becquerels (radon disintegrations per second) per cubic metre (Bq/m3) of household air. RESULTS The mean measured radon concentration in homes of people in the control group was 97 Bq/m3, with 11% measuring > 200 and 4% measuring > 400 Bq/m3. For cases of lung cancer the mean concentration was 104 Bq/m3. The risk of lung cancer increased by 8.4% (95% confidence interval 3.0% to 15.8%) per 100 Bq/m3 increase in measured radon (P = 0.0007). This corresponds to an increase of 16% (5% to 31%) per 100 Bq/m3 increase in usual radon--that is, after correction for the dilution caused by random uncertainties in measuring radon concentrations. The dose-response relation seemed to be linear with no threshold and remained significant (P = 0.04) in analyses limited to individuals from homes with measured radon < 200 Bq/m3. The proportionate excess risk did not differ significantly with study, age, sex, or smoking. In the absence of other causes of death, the absolute risks of lung cancer by age 75 years at usual radon concentrations of 0, 100, and 400 Bq/m3 would be about 0.4%, 0.5%, and 0.7%, respectively, for lifelong non-smokers, and about 25 times greater (10%, 12%, and 16%) for cigarette smokers. CONCLUSIONS Collectively, though not separately, these studies show appreciable hazards from residential radon, particularly for smokers and recent ex-smokers, and indicate that it is responsible for about 2% of all deaths from cancer in Europe.
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Affiliation(s)
- S Darby
- Clinical Trials Service Unit and Epidemiological Studies Unit, Radcliffe Infirmary, Oxford OX2 6HE.
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Abstract
BACKGROUND Few epidemiological studies have examined the effect of wine on the risk of lung cancer. A study was therefore undertaken to estimate the effect of wine consumption, both overall and by type of wine, on the risk of developing lung cancer. METHODS A hospital based case-control study was conducted on 319 subjects (132 cases, 187 controls) in 1999-2000. All subjects were interviewed about their lifestyles with particular reference to alcohol consumption and tobacco use. The results were analysed using non-parametric logistic regression. The main outcome measure was the risk of lung cancer associated with consumption of wine and its individual types. RESULTS A very slight but significant association was observed between the risk of lung cancer and white wine consumption (odds ratio (OR) 1.20 for each daily glass). Red wine consumption, on the other hand, had an OR of 0.43 (95% CI 0.19 to 0.96), with each daily glass of red wine having an inverse association with the development of lung cancer (OR 0.87 (95% CI 0.77 to 0.99)). There was no apparent association between lung cancer and consumption of beer or spirits. CONCLUSIONS These results suggest that the consumption of red wine is negatively associated with the development of lung cancer. Further studies are needed to test this finding in cancer induced laboratory animals.
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Affiliation(s)
- A Ruano-Ravina
- Department of Preventive Medicine and Public Health, School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
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Ruano-Ravina A, Barros-Dios JM, Figueiras A, Brañas-Tato P. Correspondence re Yuan JM et al., Prediagnostic levels of serum beta-cryptoxanthin and retinol predict smoking-related lung cancer risk in Shanghai, China. 2001;10:767-73. Neuhoser ML et al., Fruits and vegetables are associated with lower lung cancer risk only in the placebo arm of the beta-carotene and retinol efficacy trial (CARET). 2002;12:350-8. Satia-Abouta J et al., Associations of micronutrients with colon cancer risk in African Americans and whites: results from the North Carolina Colon Cancer Study. 2003;12:747-54. Cancer Epidemiol Biomarkers Prev 2004; 13:679-80; author reply 680. [PMID: 15066939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
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Ruano-Ravina A, Figueiras A, Loidi L, Barros-Dios JM. GSTM1 and GSTT1 polymorphisms, tobacco and risk of lung cancer: a case-control study from Galicia, Spain. Anticancer Res 2003; 23:4333-7. [PMID: 14666648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND Only 15% of heavy smokers go on to develop lung cancer, indicating the existence of individual predisposition. PATIENTS AND METHODS Using a case-control study, we ascertained whether there were differences between cases and controls in the frequency of GSTM1 and GSTT1 gene polymorphisms, and whether their effect might be linked to smoking habit. RESULTS While a risk of lung cancer of 1.7 (1.0-3.0) was observed for GSTM1 gene deficiency, there appeared to be no such association for absence of the GSTT1 gene. The interaction observed with tobacco use indicated an excess risk of 24.5% (IC 95%-59.8-109.0) for the GSTM1 gene, with no such interaction in evidence for the GSTT1 gene. The highest risk for a combination of the different haplotypes was for subjects with the GSTT1 gene present and the GSTM1 gene deleted, with an Odds Ratio of 2.19 (1.18-4.07). CONCLUSION The absence of the GSTM1 gene is, while that of the GSTT1 gene is seemingly not, implicated in susceptibility to lung cancer.
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Affiliation(s)
- A Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
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Abstract
The purpose of this work is to model the relationship between smoking-related variables and the risk of lung cancer by using parametric and non-parametric models. A hospital-based case-control study was conducted to ascertain the influence of smoking on risk of lung cancer. We used parametric logistic regression with a series of categorized independent variables and non-parametric logistic regression models. Such models allow for variables to be treated as continuous, since they avoid arbitrariness in the selection of cut-offs and furnish information on the dose-risk relationship. The results point to the possible existence of a saturation effect for a lifetime tobacco consumption of around 25 000-30 000 packets. Duration of habit and years of abstinence show a linear relationship marked by opposite, though similar, slopes, which would seem to indicate that for every year of smoking, risk rises by an amount (8.00%, 95% confidence interval (CI) 5.94-10.06) equal to the decline in risk for every year of abstinence (6.98%, 95% CI 2.53-11.84). Lastly, a lower age of smoking initiation appears to have an influence, although non-significant, on the appearance of the disease. The risk of lung cancer due to duration of the habit would seem to be proportional to years of abstinence, and there could be a saturation effect with respect to lifetime tobacco consumption.
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Affiliation(s)
- A Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
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Ruano-Ravina A, Figueiras A, Dosil-Diaz O, Barreiro-Carracedo A, Barros-Dios JM. A population-based case-control study on fruit and vegetable intake and lung cancer: a paradox effect? Nutr Cancer 2003; 43:47-51. [PMID: 12467134 DOI: 10.1207/s15327914nc431_5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
A population-based case-control study was carried out in Northwest Spain to analyze the effect of fruit and vegetable intake on the appearance of lung cancer. A non-significant protective association was found for overall consumption of leafy green and other vegetables, with consumption once a day or more vs. less than once a week yielding odds ratios of 0.63 [95% confidence interval (CI) = 0.24-1.63] for leafy green vegetables and 0.64 (95% CI = 0.30-1.36) for other vegetables. A significant protective association was found for potato consumption. No protective associations were recorded for fruit, whether overall or singly; instead, fruit consumption once a day or more vs. less than once a week registered a risk of 2.16 (95% CI = 1.02-4.58). Although the possibility that this effect may be due to a phenomenon of reverse causation cannot be ruled out, these results could support other reports and hypotheses which indicate that the protective effect of fruit might not be as pronounced as generally thought.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
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