Abstracts/Lung Cancer 13 (1995) 185-232 189

Is lung cancer associated with asbestos exposure when there An Rsa I polymorphism in the CYPZEl gene does not affect are no small opacities on the chest radiograph? lung cancer risk in a Japanese population Wilkinson P, Hansel1 DM, Janssens J, Rubens M, Rudd RM, Newman Taylor A et al. Royal Brompton Hospital, National Heart and Lung Institute, London SW3 6LY. Lancet 1995;345: 1074-8.

Watanabe J, Yang J-P, Eguchi H, Hayashi S-l, Imai K, Nakachi K et al. Department of Biochemistry Saitama Cancer Center Research Inst., Kitaadachi-gun, Kaitama 362. Jpn J Cancer Res 1995;86:245-8.

This study was designed to test the hypothesis that the risk of lung cancer from asbestos exposure is confined to persons with radiographic evidence of pulmonary fibrosis. OccupationaI and smoking histories were obtained from 27 1 patients with a confirmed diagnosis of primary lung cancer and 678 referents (279 with other respiratory disease and 399 with cardiac disease). Histories were reviewed blind to assess the timing, duration, and probability of exposure to asbestos. To allow for a lag between asbestos exposure and the development of lung cancer, subjects were classified by the time they had spent in an occupation entailing definite or probable exposure more than I5 years before diagnosis. The presence and extent oftlbrosis was assessed blindly from chest radiographs by three readers and scored for small opacities with the IL0 1989 International Classification of Radiographs of the Pneumoconioses. 93 (34.3%) cases had worked in an occupation with definite or probable asbestos exposure compared with 176 (25.8%) referents (crudeodds ratio for lung cancer I .49,95% CI 109-204). AfIer adjustment for age, sex, smoking history, and area of referral, the odds ratio (95% CI) was 2.03 (1.00-4.13) in the subgroup of 211 with a median IL0 score for small parenchymal opacities of l/O or more, and 1.56 (1.02-2.39) in the 738 with a score ofO/l or less tie, those without radiological evidence of pulmonary fbrosis). These results suggest that asbestos is associated with lung cancer even in the absence of radiologically apparent pulmonary fibrosis.

CYPZEI catalyzes the metabolic activation of tobacco-sp&Ic N- nitrosamines, including 4-(methylnitrosamino)-I-(3-pyridyl)-l- butanone. An Rsa I polymorphism, which is located in the 5’-flanking region of the CYP2El gene, has been found to affect the transcriptional regulation of the gene, resulting in different expression levels of the mRNA among individuals. In order to investigate an association between the Rsa I polymorphism and lung cancer susceptibility. the genotype distribution among 3 16 lung cancer patients was compared with that in 503 healthy controls. No statistically signilicant association was found between the Rsa I polymorphism and an increased risk of lung cancer, even though histological types of lung cancer, cigarette smoking and alcohol consumption were taken into account.

Mentholated cigarette use and lung cancer Sidney S, Tekawa IS, Friedman GD, Sadler MC, Tashkin DI? Kaiser Permanente Med. Care Pmgram. Division ofReseorch, 3505 Broaduq Oakland, CA 94611. Arch Intern Med 1995;155:727-32.

Background: Menthol combustion produces carcinogenic compounds such as benzo[a]pyrenes. Mentholated cigarettes are much more commonly smoked by black individuals than by white individuals. The incidence of lung cancer is much higher (60%) in black men than in white men, but it differs little by race in women. We examined the association of mentholated cigarette use with lung cancer in men and women because mentholated cigarette use could help to explain the higher incidence rate of lung cancer in black men than in white men. Methods: The study population consisted of 11 761 members of the Northern California Kaiser Permanente Medical Care Program, Oakland (5771 men and 3990 women), aged 30 to 89 years, who underwent a multiphasic health checkup in 1979 through 1985 and reported that they were current cigarette smokers who had smoked for at least 20 years. Data were collected about current cigarette brand, duration of mentholated cigarette use, and other smoking characteristics, Follow- up for incident lung cancer cases (n=3 18) was carried out through 199 1. Results: The relative risk of lung cancer associated with mentholation compared with nomnentholated cigarettes was 1.45 in men (95% confidence interval, 1.03 to 2.02) and it was 0.75 in women (95% confidence interval, 0.51 to 1.11). adjusted for age, race, education, number of cigar&es smoked per day, and duration of smoking. Further adjustment for tar content and self-reported smoking intensity characteristics did not substantially alter the estimate of relative risk. A graded increase in risk of lung cancer with increasing duration of mentholated cigarette use was present in men. Conclusion: This study suggests that there is an increased risk of lung cancer associated with mentholated cigarette use in male smokers but not in female smokers.

Mortality from lung cancer and other diseases related to smoking among fishermen in north east Italy Mastrangelo Cl, Malusa E, Veronese C, Zucchero A, Mania V, Bariga AB. Institute di Medicina del Lavoro. Universita di Padova, Ma Facciolati 71, 35127 Padova. Occup Environ Med 1995;52:150-3.

Objectives -To study the mortality offishermen. This was suggested by a cluster of cases of lung cancer in Chioggia, a large fishing harbour in the Veneto. The aim was to weight occupation against smoking with respect to risk of lung cancer. M&ho& - 7530 fishermen registered in the 1971-86 port authority registers of Chioggia and Venice were followed up for mortality from 1971 to 1989. Of475 causes of death, 460 were traced. Standardised mortality ratio (SMR) was calculated with the regional population as a reference. A nested case-control study was carried out in Chioggia decedents only by interviewing next of kin. Complete data were obtained in 172 (70% response). Cams (lung cancer deaths) and controls (other causes of death) were compared for smoking and occupation, as a group of nondshennen was available in the cohort. Logistic regression analysis was used to adjust for confounding factors. Results - SMRs were high for lung cancer but low for other diseases related to smoking: circulatory and respiratory disease, tumours of the mouth, pharynx, oesophagus, and bladder, Likewise, SMRs were high for liver cancer but low for other diseases related to alcohol: digestive and circulatory disease, buccal, pharyngeal, and OesophageaI tumours. In the case-control study, the risk of lung cancer was found to be related to smoking, and there was no interaction between occupation and smoking. When adjusted for age and smoking, the occupational indicators had no inIluence on the risk of mortality from lung cancer. Conclusions - Among fishermen in north east Italy the greatest health hazard is lung cancer, and the factor involved in this risk is smoking, not occupation, Smoking, however, was linked with long hours at sea in another study.

Adjuvant radiotherapy for breast cancer as a risk factor for the development of lung cancer Wiernik PH, Sklarin NT, Dutcher JP, Sparano JA, Greenwald ES. Department of Oncologv. III East 210th Stmet, Bronx, NY 10467. Med Oncol 1994;11:1215.

Women diagnosed with primary breast or lung cancer and recorded between 1972 and 1989 in our tumor registry were identitied. Of4,123 lung cancer patients and 3,537 breast cancer patients, 42 patients with both diagnoses were identified. The two malignancies were diagnosed simultaneously in five patients, lung cancer was diagnosed first in six patients and breast cancer was diagnosed first in 3 1 @ < 0.00 1). Nineteen