126 Abstracts/Lung Cancer II (1994) 123-150

Department of Occupational Medicine, Sahlgrenska Hospital, St. Si&idsS 195, S-412 66 Goteborg. Eur Respir 1 1993;6:

cancers of the hilar type, but is considered to be effective in detecting 1271-5. hmg cancers of the peripheral type. Positive and careful effort should be

We wanted to assess the quantitative importance of asbestos as a continued for the detection of early lung cancers in workers. cause of lung cancer. In a case-referent study, the exposure to asbestos, tobacco smoke and some other occupational exposure were compared between 147 cases of lung cancer (100 men, 47 women), 111 hospital referents, and 109 population referents, all below the age of 75 yrs and living in mn industrial city. The attributable risk of lung cancer due to asbestos exposure was 16 46 in men (95 56 confidence interval l-3 1%). No woman had occupational exposure to asbestos. We conclude that in the mid 1980’s tobacco smoking was the major attributable risk, being 95 % for men and 78 96 for women, but that in men asbestos was an appreciable contributing factor in the general population of a Swedish industrial city.

Main drug- and carcinogen-metabolizing enzyme systems in human non-small cell lung cancer and peritumoral tissues Toussaint C, Albin N, Massand L, Gruaenwald D, Parise 0 Jr, Morixet Jet al. Institut Gustave-Roursy, Pavilion derecherche 2.94SOS Villejuif Cedex. Cancer Res 1993;53:4608-12.

A survey of primary lung cancer among N’IT workers in the Tokyo area. The incidence and mortality during the past 30 years and significance of radiologic screening Miyagawa H, Yamada R, Tamura S. Department of Respiratory Medicine, NIT Tokyo Health Administration Ctr., 3-S-S Toranomon. Minato-ku, Tokyo 105. Jpn J Industr Health 1993;35: 395-402.

An epidemiological study of primaty lung cancer was conducted on NTT workers in the Tokyo area (about 40,000 persons). During the past 3Oyears(1960-1989), 77cases(71 malesand6females)ofprimaryhmg cancerweredetected by routinemedicalexamination(radiologicscreening by radiophotography at their workplaces) or by clinical symptoms, of whom 59 (54 males and 5 females) were dead as of the end of December 199 1. Standardized incidence rate and standardized death rate of the males by the direct method (5-yr age groups from 20 to 59 yr of age, per 100,000 population) were 4.5 in the 1960’s, 9.9 in the 1970’s and 9.8 in the 1980’s, and 3.3 in the 1960’s. 7.9 in the 1970’s and 8.2 in the 1980’s, respectively, with increase being observed from the 1970’s. Standardized incidence ratio and standardized death ratio of the males by the indirect method (5-yr age groups from 30 to 59 yr of age) were 107 in the 1970’s, 86.8 in the 1980’s, and 53.8 in the 1960’s, 99.4 in the 1970’sand98.5inthe 1980’s, respectively. Nosignificantdifference couldbeobservedwhencompsredtothenationalaverage. Byhistological type, 44 cases of adenocarcinoma, 12 cases of squamous cell carcinoma, 8 cases of small cell carcinoma, 7 cases of large cell carcinoma and 6 cases of other or unclear types were detected. Excluding the 3 unclear cases, of the 77 cases, 54 cases were peripheral type and the remaining 20caseswerehiIartypeonmdiophotography. Periphemladeoocarcioma was the most common type. Clinical stage by TNM classification was contirmed in 50 cases, of whom 12 cases were stage I, 5 cases were stage II, 9 cases were stage IIIA, 8 cases were stage IIIB and 16 cases were stage IV. As for the means of detection, 41 cases were detected by routine medical examination (radiologic screening by radiophotography) and 36 cases were detected by clinical symptoms. The lung cancers of thehilar typecould be detected by clinical symptoms at ahigher rate than by radiologic screening, but those of the peripheral type were detected at a significantly higher rate by radiologic screening than by clinical symptoms. The 41 screened cases were detected at an earlier stage and showed abetter prognosis than the 36 clinical cases. The rate of operable cases (75.6% in screened cases vs. 30.6 % in clinical cases) and 1, 2, 3 and4-yrsurvival. rates(lyr88.61 vs.41.4%,2yr48.6%vs. 17.3%, 3 yr 37.1% vs. 13.81, and 4 yr 34.3% vs. 10.3%) were significantly higher in the screened cases than in the clinical cases. Though the 5-yr survival rate was not significantly different between the two groups, the survivalcurvecalcul&dbyKaplan-Meiermethodand testbygeneraiixed Wilcoxon method showed that the prognosis of the screened cases were better than that of the clinical cases. Routine medical examination by radiological screening at workplaces is not sufficient to detect lung

To better understand the importance of drug-metabolizing enzymes in carcinogenesis and anticancer drug sensitivity of human non-small cell lung cancer, we studied the main drug-metabolizing enzyme systems in both lung tumors and their corresponding nontumoral lung tissues in 12 patients. The following enzymes were assayed by Western blot analysis: cytochromes P-450 (lAllA2, 2Bl/B2, 2C8-10, 2E1, 3A4); epoxide hydrolase; and glutathione S-transferase isoenzymes (GSTa, -, and a). The activity of the following enzymes or cofactor were determined by spectrophotometric or fluorometric assays: glutathione S-transferase (GST); total glut&&one; UDP- glucurono- syltransferase; 8-glucuronidase; sulfotransferase; and sulfatase. Results showedthepresenceofcytochromeP-450 lAl/lA2 inbothtumoral and oootumoral tissues. P-450 lAlllA2 levels were 3-fold lower in tumors compared to corresponding nootumoral tissues (P < 0.05). None of the other probed cytochromes P-450 were detected in either tumoral or oontumoral lung tissues. For the glutathiooe system, no significant difference between tumoral and oontumoral tissues was observed (GST activity, glutathione content, GSTa, - , and a). A positive linear correlation was observed between GST activity and GST-a or GSTa. No significant difference was observed for the glucuronide and the sulfate pathways and their corresponding hydrolytic enzymes. Epoxide hydrolase was significantly decreased in tumors compared to oootumoral lung tissues (P < 0.05). In conclusion, these results showed differences between non-small cell lung tumors and nontumoral tissues for cytochrome P-450 lAl/lA2 and epoxide hydrolase. These differences between tumors and peritumoral tissues with regard to these drug- metabolizing enzymes could reflect differences occurring after malignant transformation and may play a role in drug sensitivity to anticancer drugs.

Occupational risk factors for lung cancer among nonsmoking women: A casecontrol study in Missouri (United States) Brownsoo RC, Alavanja MCR, Chang JC. Div. Chronic Disease Prevention, Health Promotion, Missouri Department of Health, 201 Business Loop 70 West, Columbia, MO 65203. Cancer Causes Control 1993;4:499-504.

Occupationally related risk of lung cancer among women and among nonsmokershasnot been widely studied. Amcendyconductedpopulation- based, case-control study in Missouri (United States) provided the opportunity to evaluate risk of lung cancer associated with several occupational factors. Incident cases (o = 429) were identified through the Missouri Cancer Registry for the period 1986 through 1991, and included 294 lifetime nonsmokers and 135 ex-smokers who had stopped at least 15 years prior to diagnosis or had smoked for less than one pack- year. Controls (o = 1,021) were selected through driver’s license and Medicare files. Risk was elevated among women exposed to asbestos (ever: odds ratio [OR] = 3.5,95 percent confidence interval [CI] = 1.2- 10.0; > 9 yrs: OR = 4.6, CI = 1.1-19.2) and pesticides (ever: OR = 2.4, CI = 1.1-5.6; > 17.5 yrs: OR = 2.4, CI = 0.8-7.0). Risk also was elevated among dry cleaning workers (ever: OR = 1.8, CI = 1. l- 3.0; > 1.125~~~ OR = 2.9, CI = 1.5-5.4). Occupational risksforlung cancer among women merit further study.