ets exposure, lung cancer - Legacy Tobacco Documents Library

Lung Cancer in Nonsmokers
OECtFFREY C . KABAT, PwD, AND ERNST L WYNDER, MD
NOTICE
This material may be
ptote :ied by
isw (TiUe 17 U .S . Gode) .
Among 2663 prtieats with aewly diagnosed lung cancer laterriewcd between 1971 aa.d 19a0, 134 cases
«ecvrred in ".alid.ated" .oascsokerx . The proportioa of .oascwkers among all tases was 1 .99k (37 of
1919) for tsuo and 13,0% (97 of 749) for women, ririag a sex ratio of 1 :2-6 . KreybetY Type 11 (mainly
asdetwcarrirsoeu) was more common among nonsmoking cases, espaialty women, tttan asnoa= all lung
rocer tssu . Comparisoa of tases with equal numbers olaqe-, sex-, tace-, and Isospitil-tstatcised oaumoking
eonerols showed no diRerersces by nligion, Fropottioo of forcigrt-born, saariai sntus, raideoce (nrban/
mrai), ako6ol coostrmption or Quttelet's Isdex . Mate eases teaded to hare Yi=her Froponioos of profes•
sionals and to be wore eduated than controls . No differences ln occvpatioa or tsocnpatioaat exposure
were seen in roen . Among women, cases were more likely than corttrots to La•t worked in a textiltrxlLted
job (retati .e risk - 3 .10 . 93% confidence iater .al 1 .11-8b4}, but the signifiusKe of this finding
8t not clear . Preiimitnry data oa exposure to ptissive itth+lation of tobacco smokt, a*ailable for a subset
of tYses and controls, showed no diA'erences except for more frequent exposure among male cases than
eontrots to sidestream tobacco smoke at work . The seed for more complete informatioa on exposure to
s+ecoadhand tobacco smoke is discussed .
Gtwter 53 :1214-1221, 1984 .
NfA,e.cr,' l
A LTHOUGH LUNG CANCER risk is strongly associated
with cigarette smoking, lung cancer dtxs infrequently
occur in nonsmokers .'-2 Several features distinauish
lung cancer in nonsmokers from that occurring in
smokers. First, most eases of lung cancer in nonsmokers
are found in women .2-y Second, the d'tstribution of histalogic
types of lung cancer differs between smokers and
nonsmokers . In smokers the epidermoid type predomi-
From the Divrsion of Epidemiology, Mahoney Institute for Health
Muntnuna, Amenun Health Foundation, 320 Eau 43rd Stseet, New
Yort, New York .
Supponcd by National Cancer Institute contract N01-CP-056t4 and
grant CA-32617 .
Addras for reprints: Geoffrey C. KabaL rtsD . Divis+on of Epdemiolo{y
. Mahoney Institute for Health Marntenancs. Amenan Health
Foundauon, 320 East 43rd Stroet . New York, NY 10017,
The authors thank the fdlowtnj txoqerauni ; institutions and individuals
(or their a)uabk contnbuuons : Memonal Hoapital . Dr . Devid
Schotankld; Manhatun Vetensn's Hotpttal . Dr . Norton Spritz; Long
ktand-Jewish Hillside Medical Center, Dr . Arthur Sawitsky; Uaiversity
of Alabama Hawttal, Dr . William bndrm; birmirraham Vetsran's Hospital,
Ds . Herman F. Le?tman : Layota Uoisrsity Hoexul (Chica=o) .
Dr . Walter S. Wood: Hina Veteran's Hospital (Chia=o), Dr. John
fhup ; Hoeplta) of the U .iversity of Tennsylvania, Dr . RoEen M . txrin ;
Jefferson Medical Collese and Thomas lofferson Univatity Hospital .
C?r .1 . E. CotbtM Allegheny t'xneral HoepiW (FitttburYh), Dr. Sunley
A. Eriller, Universiry otHttstwrfh Eye atxi Ear HoepW, Dr . Lewis H .
Kulkr, rittsburflt Veurran's Hoapital . Dr . Eusenc N . Mym; MoRrtt
Hospital (San Francisco). Univtrsity of Ca)iforni+ u San Francisco and
County Hospital (San Francisco), Dr . Niehotts htnicir and St. Luke's
Hospital (San Francisco). Dr . Richard A . t3ohannan . The authors also
thank Ms. Marpret Mushinski for her collaboration in the exrly staaes
of this study . Ms. Nancy Vrouoc for programming assiuanct, and Mr .
Monte He+son and Ms . Mana Nanfiro for manuscript preparation .
Acrcpted for publipuon August 31, 1983 .
http://legacy.library.ucsf.edu/tid/wyk81f00/pdf
1214
nates, whereas in nonsmokers adenocarcinoma is more
common, especially in women .2-s
This article presents data from a case-control study of
nonsmoking patients with histologically confirmed diagnoses
of primary lung cancer with rtspect to histology,
dernoQraphic factors, residence, Quetelet's index, alcohol
consumption, previous diseases, occupation and txcupational
exposures, and, to a limited extent, exposure to
the tobacco smoke of others . Due to the small number
of cases and controls on whom we have infotTrtation on
passive inhalation, the data presente :d here; on that question
are in the nature of prtliminary results . A discussion
of previous studies concerning this issue emphasizes the
netd for obtaining more detailed information on sidesveam
smoke exposure and related variables .
Metbods
All txsa of primary cancer of the lung occurring in
cases who reported never having smoked on a regular
basis' were extracted from an ongoing case-control study
of tobacco-related ancers conducted in a number ofcities
between 1971 and 1980t and described previously .' For
each txse, the hospital ehart was rc-examined in order
to confirm the diagntuis and the absence of smoking ~
~_. ~s*+
• our definition of a nonsmoker was someone who had never smokedN
as much as one tajarttte. pipe, or erfar ptr day for a ytar .
t T1x ma'oAt otthe ases (+nd matctKd controls) were rnte,viewed X
J Y
at Memorial Hospital in New York City, . 30 of the 37 male asea andQ
70 of the 97 femalc easa .