ets exposure, lung cancer - Legacy Tobacco Documents Library

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3fl0 H . 6himisu et .l .
The causes of lung cancer in Japanese women have not been clearly
identified . It is widely accepted that cigarette smoking is eaueally associated
with lung cancer, but the increasing trend in the incidence of lung cancer in
Japanese women cannot be explained by amoking alone . The proportion of
smokers among Japanese women tamained around 15% during the last thirty
years (TominAga 1982) and the most predominant histologic type of lung cancer
among them n•as adenocarcinoma, which was considered to be more n-eakly
associated with smoking as compared to lung aancer of other celJ types (Shimizu
1983 : Takamurs et al . 1986 ; Shimizu et a] . 1986) .
Several studies have been oonductcd with emphasis laid on paaaive smoking
and lung cancer since the first positive results were presented by Hirayama (1981)
and Trichopouloc et al . (1981) . Some of these studies showed a clear association
of passive smoking with lung cancer (Correa et al . 1983 ;(3arfinkel et al . 1985 :
Akiba et a) . 1986 . Inoue et al . 1986) . However, the resulte of other studies were
,
equivocal or negative (Garfinkel 1981 ; Kabat and Wynder 1984 ; Koo et al, 1984
Wu et al, 1935 : Lee et al 1986) .
This paper reports a casrcontrol study of lung cancer in Japanese nonsmok-
ing a•omen, in which passive smoking and other factors such as occupational
histon• . domestic heating system and dietary habits were investigated .
MATIRIALS AYD MITHODS
Our n~k> tronsistcd of female patienu with primary lung cancer who were treated in 4
hospitals in Xato .ya from Au6ust 1962 to July 19&S . One of the bospitals (Aiehi Cancer
Center Huspitall Fas a cancer boapiul and the eetaainins tbree were seneral boepttak
V,tgoya is th, fourtC largest city in Japan .'itb a populauora of 2 .1 milleon and located in
the nliddl~ of the mntn itland . Honshu
During the rbot•e period 118 female lung cancer pati•enu ecere patbologically identifxd
The ph .yiicun ; or nurscs uled all of them to fill in a qu .stionnaire for taia study on tbe first
or second dat' of admt>sion to the hoapttals . Out of 118 lung cancer patients 4 refused to
fill in the que>tionn .tire and 24 reported tdat they were current or enmol•ers . The nmatntng
90 nonsmoktng pattenu were selected u the eaan for the following aael .ats . The
questionnaire tnainl}• consisted of tbe questions about rmoking, oceupation .l history,
dietan• hrbic :' personal disease hiatory and about the kinds of fuel for ooolcing. M rsEards
passtt•e saaking we asl• .d them about the smoking habiu or the number of eiiarettes
smoked per dar by p.renu, eiblirtgs, children or husband's parenu in the home . We also
asked them about the length of time which the wonun spent with her husband in the same
room, the period of married life and the number of eisareues smoked by her husband . The
passive stuoke exposure at working placea .cu awseaasd only in terms of the prossnoe or
absence of smokers . As regards dietary history, we asked the frequency in noent 6te years
of intake of food items and dirid.d into four esss#ories (no intal-e, l or 2 days ; w .ek, 3 or
4 days week and almost even• day) . We aaled directly the number of giaus of milk and
the number of onutftec tal•en pet week .
The 90 lung cancers included 69 .deaocarcinomaa (77y,), 13 spuamous eell c.reinomas
(14°,.al . 4 large cell earcinomu (1a/,), 3 tma11 cell eareinoma (3°a) and I adenoid cystic
ea.rcinoma (11,1 The number of e.w in the age poup of JO-39 . 4049, 50-59 . i4-69 . 70i9
and t10-rears were 3(3° .), 16 (l7%) . 28 (31° .), 27 (30%) . li (16°,41) and 2(2° .a)
tespertivelc The minimum and maximum " of the wes were 35 and 81 ysan and those