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Lung cancer death rates in lifelong nonsmokers.
J Natl Cancer Inst 2006; 98(10):691-9JNCI

Abstract

BACKGROUND

Few studies have directly measured the age-, sex-, and race-specific risks of lung cancer incidence and mortality among never tobacco smokers. Such data are needed to quantify the risks associated with smoking and to understand racial and sex disparities and temporal trends that are due to factors other than active smoking.

METHODS

We measured age-, sex-, and race-specific rates (per 100,000 person-years at risk) of death from lung cancer among more than 940,000 adults who reported no history of smoking at enrollment in either of two large American Cancer Society Cancer Prevention Study cohorts during 1959-1972 (CPS-I) and 1982-2000 (CPS-II). We compared lung cancer death rates between men and women and between African Americans and whites and analyzed temporal trends in lung cancer death rates among never smokers across the two studies by using directly age-standardized rates as well as Poisson and Cox proportional hazards regression analyses. All statistical tests were two-sided.

RESULTS

The age-standardized lung cancer death rates among never-smoking men and women in CPS-II were 17.1 and 14.7 per 100,000 person-years, respectively. Men who had never smoked had higher age-standardized lung cancer death rates than women in both studies (CPS-I: hazard ratio [HR] = 1.52, 95% confidence interval [CI] = 1.28 to 1.79; CPS-II: HR = 1.21, 95% CI = 1.09 to 1.36). The rate was higher among African American women than white women in CPS-II (HR = 1.43, CI = 1.11 to 1.85). A small temporal increase (CPS-II versus CPS-I) in lung cancer mortality was seen for white women (HR = 1.25, CI = 1.12 to 1.41) and African American women (HR = 1.22, CI = 0.64 to 2.33), but not for white men (HR = 0.89, CI = 0.74 to 1.08). Among white and African American women combined, the temporal increase was statistically significant only among those aged 70-84 years (P < .001).

CONCLUSIONS

Contrary to clinical perception, the lung cancer death rate is not higher in female than in male never smokers and shows little evidence of having increased over time in the absence of smoking. Factors that affect the interpretation of lung cancer trends are discussed. Our novel finding that lung cancer mortality is higher among African American than white women never smokers should be confirmed in other studies.

Authors+Show Affiliations

Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA 30229-4251, USA. mthun@cancer.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16705123

Citation

Thun, Michael J., et al. "Lung Cancer Death Rates in Lifelong Nonsmokers." Journal of the National Cancer Institute, vol. 98, no. 10, 2006, pp. 691-9.
Thun MJ, Henley SJ, Burns D, et al. Lung cancer death rates in lifelong nonsmokers. J Natl Cancer Inst. 2006;98(10):691-9.
Thun, M. J., Henley, S. J., Burns, D., Jemal, A., Shanks, T. G., & Calle, E. E. (2006). Lung cancer death rates in lifelong nonsmokers. Journal of the National Cancer Institute, 98(10), pp. 691-9.
Thun MJ, et al. Lung Cancer Death Rates in Lifelong Nonsmokers. J Natl Cancer Inst. 2006 May 17;98(10):691-9. PubMed PMID: 16705123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lung cancer death rates in lifelong nonsmokers. AU - Thun,Michael J, AU - Henley,S Jane, AU - Burns,David, AU - Jemal,Ahmedin, AU - Shanks,Thomas G, AU - Calle,Eugenia E, PY - 2006/5/18/pubmed PY - 2006/5/31/medline PY - 2006/5/18/entrez SP - 691 EP - 9 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 98 IS - 10 N2 - BACKGROUND: Few studies have directly measured the age-, sex-, and race-specific risks of lung cancer incidence and mortality among never tobacco smokers. Such data are needed to quantify the risks associated with smoking and to understand racial and sex disparities and temporal trends that are due to factors other than active smoking. METHODS: We measured age-, sex-, and race-specific rates (per 100,000 person-years at risk) of death from lung cancer among more than 940,000 adults who reported no history of smoking at enrollment in either of two large American Cancer Society Cancer Prevention Study cohorts during 1959-1972 (CPS-I) and 1982-2000 (CPS-II). We compared lung cancer death rates between men and women and between African Americans and whites and analyzed temporal trends in lung cancer death rates among never smokers across the two studies by using directly age-standardized rates as well as Poisson and Cox proportional hazards regression analyses. All statistical tests were two-sided. RESULTS: The age-standardized lung cancer death rates among never-smoking men and women in CPS-II were 17.1 and 14.7 per 100,000 person-years, respectively. Men who had never smoked had higher age-standardized lung cancer death rates than women in both studies (CPS-I: hazard ratio [HR] = 1.52, 95% confidence interval [CI] = 1.28 to 1.79; CPS-II: HR = 1.21, 95% CI = 1.09 to 1.36). The rate was higher among African American women than white women in CPS-II (HR = 1.43, CI = 1.11 to 1.85). A small temporal increase (CPS-II versus CPS-I) in lung cancer mortality was seen for white women (HR = 1.25, CI = 1.12 to 1.41) and African American women (HR = 1.22, CI = 0.64 to 2.33), but not for white men (HR = 0.89, CI = 0.74 to 1.08). Among white and African American women combined, the temporal increase was statistically significant only among those aged 70-84 years (P < .001). CONCLUSIONS: Contrary to clinical perception, the lung cancer death rate is not higher in female than in male never smokers and shows little evidence of having increased over time in the absence of smoking. Factors that affect the interpretation of lung cancer trends are discussed. Our novel finding that lung cancer mortality is higher among African American than white women never smokers should be confirmed in other studies. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/16705123/Lung_cancer_death_rates_in_lifelong_nonsmokers_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djj187 DB - PRIME DP - Unbound Medicine ER -