Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
POSTER SESSION 1 - MONDAY, DECEMBER 5, 2016
POSTER SESSION 1 - P1.01: EPIDEMIOLOGY, TOBACCO
CONTROL AND CESSATION/PREVENTION
Tobacco, Radon, Air Pollution, Other Risk Factors –
MONDAY, DECEMBER 5, 2016
P1.01-001 REDUCTION OF CIGARETTE CONSUMPTION THROUGH A
NATIONAL POLICY FOR TOBACCO CONTROL IN BRAZIL
Ana Paula Teixeira, Tânia Cavalcante
Executive Secretariat of the National Commission for Implementation the
Framework Convention on Tobacco Control, National Cancer Institute-Ministry of
Health, Rio de Janeiro/Brazil
Background: According to WHO, “approximately one person dies every six
seconds due to tobacco, accounting for one in 10 adult deaths. Up to half of
current users will eventually die of a tobacco-related disease”, which can be
lung cancer (87%), pulmonary disease (61%) and coronary heart disease (32%),
considering secondhand smoke exposure too as says the Surgeon General´s
Report. To protect the health of the Brazilian population, the government
has been applying measures, since the 90 years, to reduce the harm caused by
tobacco use. Brazil is also committed to reduce the premature mortality from
tobacco use in 30% from 2013 to 2025, to achieve one of the nine voluntary
WHO Global NCD´s Targets. Methods: Quantitative secondary data analysis
confronting the cigarette prevalence rates found in Risk and Protective
Factors Surveillance for Chronic Diseases Telephone Survey (VIGITEL) and the
National Policy for Tobacco Control measures. Results: Before ratifying the
WHO Framework Convention on Tobacco Control, in 1996 the government
started promoting smoke-free places, banning the advertising, promotion
and sponsorship, that were finally regulated in 2014. In 2011, the Secretariat of
Federal Revenue developed a new system for cigarette taxation to establish
a minimum price for a pack of twenty cigarettes and raise the cigarette´s
excise tax gradually. In May,2016 the total taxation represents 76% of the
cigarette price and will bring to 81% afther December 2016. This is one of the
measures of the Framework Convention for Tobacco Control/WHO more costeffective
in the country: Article 6, which deals with the rising prices and taxes
on tobacco products to reduce demand. Several surveys and studies point
to a reduction in smoking prevalence. Every year, since 2006, the VIGITEL
report has shown prevalence rates collected in the entire adult population of
the 27 state capitals. In 2015 the frequency of smokers decreased to 10.4%,
compared to 2006 which were 15.7% for both sexes. The report also reiterated
the effectiveness of the prices and taxes measure, when you compare the
frequency of former smokers with lower education, those representing people
with lower income. In 2006 they were 25.6%, and in 2015 they increased to
29.1%. Conclusion: The present study shows a prevalence decline as a positive
result coming from the National Policy for Tobacco Control implementation
between the years of 2006 and 2015. To achieve the WHO Global NCD´s Target
we still have too much work to do, specilally protect the National Policy from
the tobacco industry interference.
Keywords: WHO FCTC, Tax and Price, Consumption, Tobacco Control
POSTER SESSION 1 - P1.01: EPIDEMIOLOGY, TOBACCO CONTROL AND CESSATION/
PREVENTION
TOBACCO, RADON, AIR POLLUTION, OTHER RISK FACTORS –
MONDAY, DECEMBER 5, 2016
P1.01-002 ENVIRONMENTAL TOBACCO SMOKE EXPOSURE AND
EGFR MUTATIONS/ALK TRANSLOCATION IN NEVER SMOKERS. A
MULTICENTRE STUDY IN SPANISH NEVER-SMOKERS
Mónica Pérez-Ríos 1 , Alberto Ruano-Ravina 2 , Maruxa Zapata 1 , María Torres-
Durán 3 , Virginia Leiro-Fernández 3 , Isaura Parente-Lamelas 4 , Iria Vidal-García 5 ,
Olalla Castro-Añón 6 , Margarita Amenedo 7 , Mariano Provencio-Pulla 8 , Antonio
Golpe Gómez 9 , Rosirys Guzmán-Taveras 10 , María José Mejuto-Martí 11 , Ángeles
Rodríguez 12 , Juan Barros-Dios 1
1 University of Santiago de Compostela, Santiago de Compostela/Spain, 2 Preventive
Medicine & Public Health, University of Santiago de Compostela, Santiago
de Compostela/Spain, 3 Neumology, Alvaro Cunqueiro Hospital, Vigo/Spain,
4 Pulmonary Medicine, Ourense Hospital Complex, Ourense/Spain, 5 University
Hospital Complex of A Coruna, A Coruña/Spain, 6 Lucus Augusti Hospital, Lugo/
Spain, 7 Oncologic Center of Galicia, A Coruña/Spain, 8 Puerta de Hierro University
Hospital, Madrid/Spain, 9 Santiago de Compostela University Hospital Complex,
Santiago de Compostela/Spain, 10 Central University Hospital of Asturias, Oviedo/
Spain, 11 Arquitecto Marcide Hospital, Ferrol/Spain, 12 Pontevedra Hospital Complex,
Pontevedra/Spain
tobacco smoke (ETS) might provide some explanation to the presence of
such genetic traits. Furthermore, ETS exposure might have a different effect
should occur at home in adult life, during childhood, or at work. We aim to
know if ETS exposure is associated with EGFR mutations or ALK alterations
in a huge sample of never smoking lung cancer cases. Methods: We recruited
never smoking lung cancer cases diagnosed consecutively in 9 Spanish
Hospitals since 2011. We collected extensive information on different lifestyle
activities and also measured residential radon exposure. Cases had to be
older than 30 years with no upper age limit and with no previous history of
cancer. A never smoker was defined as: 1) an individual who smoked less than
1 daily cigarette for no more than 6 months or, 2) no more than 100 cigarettes
smoked in lifetime. EGFR mutations and ALK alterations were determined
using standard procedures. Logistic regressions were performed to analyze
the influence of exposure to ETS in different settings (adult life at home, at
work or during childhood). The dependent variables were EGFR mutation
(of any type) or not, or ALK translocation (present/absent). Results were
adjusted by age, gender and residential radon exposure. Results: We included
389 never smoking lung cancer cases. 80.5% were females and the median
age was 71 and the interquartilic range 61-78 years. 246 patients had EGFR
determined (63.2% of the total) and of them, EGFR was mutated in 43%.
ALK status was determined in 97 patients (24.9% of the total), and was
positive in 16 patients (16.5%). Living at home with a smoker for more than 20
years was not associated with EGFR mutation or ALK translocation, and the
same occurred for being exposed to ETS at work. When exposure to ETS in
childhood (before 16) was considered, we observed that those exposed to ETS
had an OR of EGFR mutation of 0.57 (95%CI 0.31-1.05; p= 0.07). No association
was observed for ALK translocation. Conclusion: These results suggest that
exposure to environmental tobacco smoke in childhood might reduce the
chance of EGFR mutation in never smokers with lung cancer. This observation
would add more evidence to avoid exposure to ETS in any time of life. Funding:
ISCIII/PI13/01765/Cofinanciado FEDER
Keywords: EGFR, ALK, Environmental tobacco smoke
POSTER SESSION 1 - P1.01: EPIDEMIOLOGY, TOBACCO CONTROL AND CESSATION/
PREVENTION
TOBACCO, RADON, AIR POLLUTION, OTHER RISK FACTORS –
MONDAY, DECEMBER 5, 2016
P1.01-003 NOVEL ASSOCIATIONS BETWEEN LUNG CANCER-
RELATED GENES AND INDOOR RADON EXPOSURE
Jung Ran Choi 1 , Seong Yong Park 2 , Hye Run Kim 3 , Dae Ryong Kang 4
1 Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju/
Korea, Republic of, 2 Thoracic and Cardiovascular Surgery, Ajou University School
of Medicine, Suwon/Korea, Republic of, 3 Internal Medicine, Division of Medical
Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul/
Korea, Republic of, 4 Ajou University School of Medicine, Suwon/Korea, Republic of
Background: Although the most important risk factor for lung cancer is
smoking, lung cancer in never smokers (LCINS) is being increasingly reported.
Thus, studies of other risk factors for lung cancer are needed. Recently, radon
(Rn), a natural, noble gas, was recognized as the second most common risk
factor for lung cancer. OBJECTIVES
To identify variations in genes associated with lung cancer in never smokers
exposed to radon gas. Methods: We conducted an optimized next generation
sequencing analysis of lung cancer-related genes in normal and tumor tissues
from Korean LCINS patients who had been exposed to radon gas indoors.
A total of 926 SNPs showing genome-wide statistical significance were
analyzed. Results: Several genes commonly associated with lung cancer,
EGFR and TP53 in chromosomes 7 and 17, respectively, showed significant
correlations with LCINS. Others included ERG in chromosome 21, RIT1 in
chromosome 1, and BIRC6 in chromosome 2. Meanwhile, several additional
loci showed novel associations with LCINS as a result of exposure to radon
gas, including PDK1, VHL, WHSC1L1, CHD4, MBD2, ATRX, CCND1, and PTPRD.
Conclusion: Using next generation sequencing, we found several lung
cancer-related genes to be associated with tumors in never smokers exposed
to radon. Most of the noted loci have not been shown to be associated with
lung cancer, and provide new insights into the development of LCINS. Our
findings may serve as a reference for replication and validation studies on
the prevention and treatment of LCINS as a result of exposure to radon gas.
ACKNOWLEDGMENTS: This study was supported by the Korean Ministry of
Environment as part of the “Environmental Health Action Program” (grant
number 2015001350002).
Keywords: Radon, next generation sequencing, lung cancer in never smoker,
genetic variation
Background: Mutations or translocations in driver genes of lung cancer such as
EGFR or ALK are important treatment targets for advanced lung cancer. These
alterations are present mainly in never-smokers. Exposure to environmental
Copyright © 2016 by the International Association for the Study of Lung Cancer
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