LUNG CANCER

-%e- IMIE ELSEVIER Lung Cancer 12 (1995) 265-329

Abstracts

Prevention

Radiographicabnormalitieaand tbcriskoflungcanceramongworkers exposed to silica dust in Ontario Finkelstcin MM. Health and Safe@ Sludies UniI, Ontario Minisby of Lobour, 400 UniversityAvenue, Tonmfo, 0~. M7A lT7. Can Med Assoc J 1995;152:31- 43.

Objecriw: To determine whether workers in Ontario who had been exposed to silica dust and who have radiographic abnormalities are at increased risk of lung cancer. Design: Cohort and case-control studies of rates of death from lung cancer and cancer incidence rates; data were obtained from the Ontario Silicosis Surveillance Registry. Follow-up was through linkage to the Ontario mortality and cancer registries. Setting: Ontario. Parficiponfx A total of 523 workers with radiographic abnormalities and 1568 control subjects with normal radiographic findings who had been exposed to silica dust. Matching criteria were year of birth end the requirement that the control subject have a normal radiographic finding either later than or in the same year that the radiographic abnormality was identified in the silicosis subject. Outcome measures: Standardized mortality

ratios (SMRs), standardized incidence ratios (SIRS) and odds ratios for lung cancer. Rem&: In the cohort analysis, with the Ontario population rates as reference, the all-cause SMR was 0.96 among the workers with radiographic abnormalities and 0.51 among the control subjects. The corresponding SIRS for lung cancer were 2.49 and 0.87 (p < 0.001). In the case-control analysis the workers with silicasis were more likely than the control subjects to have been smokers, but this difference likely accounted for only a small part of the difference in the incidence of lung cancer. The relative risk of lung cancer was elevated among the workers with silicosis from the foundry, mining and nonmetallic- minerals industries; however, the number ofsubjects was too small for a significant difference to be detected Among the miners exposure to radon daughters did not affect the risk of lung cancer attributable to radiographic abnormalities. Conclusions: Radiographic abnormalities suggestive ofexposure to silica dust are markers for increased risk of lung cancer. Physicians might thus wish to warn their patients with silica-associated radiographic abnormalities about the increased risk and to counsel those who smoke to stop.

Evolution ofaerodigestivetract lkis-retinoid acidcbemoprevcotion: The M.D. Anderson experience Hong WK, Benncr SE, Lippman SM. The Universi~ of Texas, MD Anderson Comer Cmle,: Dept. Thorocic/Head Neck Med. Oncol., IS15 Holconbe Boulewrd, Houston. TX 77030. Leukemia 1994,8:Suppl3:S33-7.

The ultimate goal of our chemoprevention research is to prevent or inhibit the development of nerodigestive cancer in humans. We have made substantial progress from our trials IO years ago. The chemopreventive strategies utilized in our clinical trials involve the use of retinoids and carotenoids as chemo-preventive agents. The choice ofthcse agents was based upon their important anticarcinogenic and differentiation properties. It is important to understand how retinoids interact with cells to carry out their modulating activities, and we hope to increase our understanding through molecular analysis of retinoid receptors. In the case of acrodigestivc epithelial tissues at risk, normal, non-kcratinizing epithelial cells oRen express inappropriate squamous differentiation. Rctinoids are thought to

suppress prcmalignant lesions by suppressing these inappropriate squamous differentiation pathways. The role of rctinoids in suppressing squamous differentiation markers and reversing prcmalignsnt lesions will be elucidated from retinoid project. The development of a fundamental understanding of tomorigencsis in the nerodigestive tract can lead to novel preventive approaches. A relative degra of risk for cancer development in individuals depends on several components, including the extent of carcinogenic exposure, inherent sensitivity of the individual to carcinogens, the individual’s nutritional states, etc. individuals with a genetic component of increased carcinogen sensitivity appear to be at increased risk for developing primary and secondary tumors. Our chemoprevention research program is designed, to develop innovative strategies for aemdigestivc tract epithelial cancer prevention. The strength of our program is to bridge the gap behveen fundamental and cellular molecular stodies in clinical chemoprevcntion trials. The outcome of our research efforts may have an enormous impact on public health in controlling nerodigestive epithclial cancers and other cpithclial cancers as well.

Smoking habits and attitudes of medical students towards smoking and anti-smoking campaigns in tbe Faculty of Medicine, University of -m, srkey Cuhadaroglu C, Erkan F, Erhrgrol E. Deparmten~ ofchesf Medicine, FacuNy of Medicine. Univmify of Ismrbul, Islanbul. J Smok Rclat Disord 1994;5:183-7.

A study designed to assess smoking behaviour and attitudes towards smoking was undertaken in medical students of the Faculty of Medicine, University of Istanbul. A World Health Organization (WHO)-based multiple choice questionnaire prepared by the Tobacco and Health Committee ofthe International Union Against Tuberculosis and Lung Disease (IUATLD) was completed by 1267 first- to final-year medical students in the Faculty of Medicine. Their

mean age was 19.8(4.0) years. Non-smokers accounted for 74% of the students, 11.4% were smokers and 0.9% were heavy smokers. Daily smoking rate was 4.9% in the tint year and 30.4% in the final year. In the first year, 75.5% of students and 91.5% of final-year students were aware of the fact that smoking is a cause of lung cancer, whereas 21.4% of first-year and 61.4% of final-ycsr students gave correct 8nswers to a question about the reletionship bchvecn low birthweight and smoking. Attitudes were influenced by smoking with 78.6% of non-smokers and 64% of smokers saying that they would advise their patients against smoking. It appears that the study of medicine does not influence the bchaviour of medical students against smoking, although it improves their knowledge of smoking-related diseases.

Bronchopulmonary prccaacerous and tumor diseases-Risk groups frum the point of view of occupational medicine Baur X, Marczynski B, Rozynek F’, ‘km B. BGFA. Burkle-de-LComp-Plalr 1. D-44789 Bmhum. Pneumologie 1994;48:825-34.

Risk groups with regard to bronchopulmonary precancerous and tumor diseases of occupational origin can be deduced from current occupational disease