ets exposure, lung cancer - Legacy Tobacco Documents Library

. Vo 5 LIING CANCER IN NONSMOKERS - Kabat and k'yndtr 1215
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throughout the patient's lifetime . The histologic type of T .a.c ( . Hiuoloy,c Type of t-uns Cancer
.unQ cancer was obtatned from the pathology report or
an Nertt Smoken and srnokers
the discharge summary for each case Those cases in whom
Men women
the diagnosts was not pnmary lung cancer or in whom
there was an indtcation of smoking . even in the remote
(No 1 (41 (No / (4)
past . were excluded from the study . Those remaining in NeVcr emoken
the study are referred to as "validated" nonsmokers .
Kteybera type 1 13 (35 1) 20 (20 .6)
A control was matched to each case on the basis of
age (=5 years), sex, race (with 5 exceptions#), hospitat,
Epidermoid/squamous
(Jttc tt{l/ti .ant cell
Krsyberf type 11
13
0
20
(35 .(1
(Se .1)
16
4
72
(16 .3)
(4 .1)
(74 .2)
date of interview (±2 yean), and nonsmoking status .
Abenoarrinoma 16 (43 .2) 60 161 .9)
Controls were selected from a large pool of hospitalized
Alvealar 4 (10.E) 12 (12 .4)
patients who wera interviewed over the same period as
Miaed (Kreybers I /c 11)
and undiRcrenuated/
the cases and who had diseases which were not tobacco-
anapltutc • (10 i ) S (5 .2)
related . The distribution of diagnoses among the controls
was as follaws: men, 62 .1% other cancers . 24 .3% benign
Tou! 37 97
neoplastic disease, 13 .5% non-neoplastic discase, women, 5mokers'
$9 .9% other qncers, 14 .4% benign neoplastic disease,
25 .8% non-neoplastic disease .
Krrytxrg t,vpe l
KreyberT type 11
Mixed (Kreybers I & 11)
1111
600
(63 1)
(31 .9)
la 1
219
(52 .31
(42 .6)
All subjects were interviewed in the hospital with a
sxandardiied questionnaire including questions on de-
and undifferentuted/
anaplutic 93 (5 .0) 32 ( 4 .9)
moYraphic factors, occupation, occupational exposurea,
Total 111 : 652
tobacco smoking, alcohol use . Quetelet's index (ky,/cm'
X 10,000), and historti of tobacco-related diseases . Two
• A mort detatled bceakdown by htstolo ; c typa n not Presentcd for
smokers because this informsuon + .'u not codxd . For the nonsmokers
different versions of the questionnaire were used over the
10-year period, the first from 1971 to 1976 . and the second
thts information vas tetncved tnanually
from 1976 to 1980 . Differences between the two questionna
.irrs included a longer list of occupational exposures
msponses was smaller for the question "Does your spouse
amoke'.'", since this question appearesd in only one version
in the later version, and a longer list of previous diseases and since it was not answered by those subjecu who were
not married, widowed, separated, or divorced (see
Table 3) .
Differences between cases and controls were assessed
by the chi-squarc test for independence .' and by the Mantel-Haenszel
extension test for linear trend .' Point estimates
of the relative risk with test-based 95% confidence
intervais were calculated following Miettinen's method .'
in the earlier questionnaire (diabetes, Sout, bronchitis,
emphysema . hypenension, asthma, pleurisy, pneumonia,
bronchiectasis, and tuberculosis) than in the later version,
which included only four questions on previous diseases
(chronic bronchitis or emphysema, asthma, diabete•s, and
elevated blood pressure) .
Alcohol consumption was assessed in current drinkers
and exdrinkers (combined) relative to never-drinkers and
oxasional drinkers (combined) . Occasional drinkers were
those who consumed Iess than I ounce of whiskey equivalents
of alcohol per day ot beer, wine, and hard liquor
combined . Alcohol intake was categorized into three levels:
(1) never/occasional drinking . (2) 1 to 3 .9 oz/day,
and (3) 4+ oz/day .
In addition, a number of questions on exposure to
passive smoking were introduced in an addendum to the
main questionnairc in 1978, and the addendum was rcvised
in 1979 . Thus, information on passive smoking was
obtained on only a subset of the svbjecu, for men, 25 of
37 ases and their matched controi .s ; for women, 53 of
97 cases and their matched controls . This number of
responses was obtained for those questions included in
both versions of the addendum, whereas the numbcr of
$ otu onenuW male case was matched to a white cYmtrol : two hisa.nic
anrM t.vo oaunul femak nses wett matched to whitc controb .
http://legacy.library.ucsf.edu/tid/wyk81f00/pdf
Results
For the 10-year period, 1971 to t980, among 1919
cases of primary lung cancer in men . 37 (1 .9%) occurred
in validated nonsmokers . Among 749 lung cancer cases
in women, 97 (13 .0%) were vYlidated nonsmokers, This
difference in the proportion of nonsmokers in men and
women is hiittly statistically sipifiant. X2(1) - 137 .21,
P