1
|
Shen E, Chen X. Prediabetes and the risk of lung cancer incidence and mortality: A meta-analysis. J Diabetes Investig 2023; 14:1209-1220. [PMID: 37517054 PMCID: PMC10512911 DOI: 10.1111/jdi.14057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
AIMS/INTRODUCTION There has been conflicting evidence regarding the role of prediabetes as a risk factor of lung cancer. A systemic review and meta-analysis was conducted to determine the relationship between prediabetes and lung cancer incidence and mortality in general adult populations. MATERIALS AND METHODS Observational studies relevant to the objective were found in Medline, Embase, Cochrane Library, and Web of Science. By incorporating potential heterogeneity into the model, a randomized-effects model was selected. RESULTS Ten cohort studies were included. People with prediabetes were associated with a mildly increased risk of lung cancer incidence compared with controls with normoglycemia (risk ratio [RR]: 1.09, 95% confidence interval [CI]: 1.01-1.18, P = 0.03; I2 = 79%), which was mainly observed in men rather than in women (RR: 1.07 vs 0.99, P for subgroup difference < 0.001). Prediabetes was related to a higher risk of lung cancer mortality (RR: 1.19, 95% CI: 1.02-1.39, P = 0.03; I2 = 52%), and the results were consistent in both men and women (P for subgroup difference = 0.67). The association between prediabetes and lung cancer incidence or mortality did not appear to be significantly affected by different definitions of prediabetes (P for subgroup difference = 0.27 and 0.37). CONCLUSIONS Prediabetes might be associated with a mildly increased risk of lung cancer incidence in men, but not in women. In addition, prediabetes may be related to a higher risk of lung cancer mortality in the adult population.
Collapse
Affiliation(s)
- Enjian Shen
- Department of PathologyTaizhou Municipal HospitalTaizhouChina
| | - Xi Chen
- Department of PathologyTaizhou Municipal HospitalTaizhouChina
| |
Collapse
|
2
|
Adverse Effects of Tobacco Products (Cigarettes, E-Cigarettes, Hookah, Smokeless Tobacco) Use on Health. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
|
3
|
A comparison of lung cancer in HIV-positive and HIV-negative populations. Afr J Thorac Crit Care Med 2022; 28:10.7196/AJTCCM.2022.v28i2.162. [PMID: 35991342 PMCID: PMC9366453 DOI: 10.7196/ajtccm.2022.v28i2.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/08/2022] Open
Abstract
Background Lung cancer is the most common cancer worldwide and is the greatest contributor to malignancy-associated deaths. Human immunodeficiency virus (HIV) is an epidemic in many developing countries and South Africa carries the largest burden of this disease in the world. With the introduction of antiretroviral therapy (ART), acquired immune deficiency syndrome (AIDS)-defining malignancies (ADMs) are on the decline and non-AIDS-defining malignancies (NADMs) are becoming more common, with lung cancer being the most common among these. Objectives To describe and compare a cohort of HIV-positive lung cancer patients and a cohort of HIV-negative lung cancer patients. Methods A retrospective study of 188 patients with histologically confirmed bronchogenic carcinoma was conducted. Smoking history, cancer sub-type, cancer stage, HIV parameters and demographic data were collected. Results There were 31 (16.94%) HIV-positive patients. They presented at a younger age (53.94 years) than the HIV-negative group (61.64 years) (p=0.0001). Adenocarcinoma was the most common sub-type in the HIV-negative cohort while squamous cell carcinoma was slightly more common in the HIV-positive cohort. Both groups predominantly presented with locally advanced or metastatic disease. Conclusion HIV-positive patients present at a younger age than HIV-negative patients and both groups show a male-predominant pattern.
Collapse
|
4
|
Kang N, Qiu WJ, Wang B, Tang DF, Shen XY. Role of hemoglobin alpha and hemoglobin beta in non-small-cell lung cancer based on bioinformatics analysis. Mol Carcinog 2022; 61:587-602. [PMID: 35394695 DOI: 10.1002/mc.23404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/17/2021] [Accepted: 01/03/2022] [Indexed: 11/08/2022]
Abstract
The differentially expressed genes (DEGs) were identified and screened differentially in non-small-cell lung cancer (NSCLC) using information from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus databases, and the correlation of DEGs in protein interaction, function, and pathway enrichment were analyzed to search for new biomarkers and potential therapeutic targets for NSCLC. Protein-protein interaction network (PPI) analysis showed that CDK1 and GNGT1 were the most significantly upregulated hub nodes, while FPR2 was the most significantly downregulated. Gene Ontology enrichment analysis showed that upregulated DEGs were significantly enriched in protein heterodimerization activity and other functions, while downregulated DEGs were enriched in functions such as heparin-binding. Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that upregulation of DEGs were significantly associated with neuroactive ligand-receptor interaction pathways, while downregulation of DEGs were significantly associated with malaria pathways. According to the analysis results, we identified hemoglobin alpha (HBA) and hemoglobin beta (HBB) as the genes of interest for further study. Through tissue level and cell level experiments, we found that the expressions of HBA and HBB in NSCLC tissues were significantly lower than those in paracancerous tissues, and downregulation of HBA and HBB could significantly affect the proliferation ability of NSCLC cells. In addition, we also found that changes in HBA and HBB may affect NSCLC cells through the p38/MAPK pathway and JNK pathway, and ultimately affect the occurrence and development of NSCLC.
Collapse
Affiliation(s)
- Ning Kang
- Department of Thoracic Surgery, The Affiliated Huadong Hospital of Fudan University, Shanghai, China
| | - Wen-Jia Qiu
- Department of Respiration, The Affiliated Huadong Hospital of Fudan University, Shanghai, China
| | - Bin Wang
- Department of Thoracic Surgery, The Affiliated Huadong Hospital of Fudan University, Shanghai, China
| | - Dong-Fang Tang
- Department of Thoracic Surgery, The Affiliated Huadong Hospital of Fudan University, Shanghai, China
| | - Xiao-Yong Shen
- Department of Thoracic Surgery, The Affiliated Huadong Hospital of Fudan University, Shanghai, China
| |
Collapse
|
5
|
Tseng JS, Chiang CJ, Chen KC, Zheng ZR, Yang TY, Lee WC, Hsu KH, Huang YH, Liu TW, Hsia JY, Chang GC. Association of Smoking With Patient Characteristics and Outcomes in Small Cell Lung Carcinoma, 2011-2018. JAMA Netw Open 2022; 5:e224830. [PMID: 35353165 PMCID: PMC8968543 DOI: 10.1001/jamanetworkopen.2022.4830] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
IMPORTANCE Small cell lung carcinoma (SCLC) is uncommon in individuals who have never smoked (never-smokers). The related epidemiologic factors and prognosis remain unclear. OBJECTIVE To assess the epidemiologic factors, clinical characteristics, and outcomes of SCLC in never-smokers. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study was conducted using data from the national Taiwan Cancer Registry, which was inaugurated in 1979 and maintains standardized records of patients' characteristics and clinical information for all individuals with cancer. Patients with cytologically or pathologically proven lung cancer were included for analysis. The study obtained data on patients from January 1, 1996, to December 31, 2018; data analysis was conducted from January 1, 1996, to December 31, 2019. EXPOSURES Clinical characteristics and outcomes of smokers and never-smokers with SCLC. MAIN OUTCOMES AND MEASURES Clinical characteristics for comparison included age at diagnosis, sex, performance status, tumor stage, and treatment. The main outcome parameter was overall survival of patients with SCLC from 2011 to 2018. RESULTS From 1996 to 2018, a total of 225 788 patients had diagnosed lung cancer; 141 654 patients (62.7%) were men; mean (SD) age was 67.55 (12.58) years. The numbers of both patients with newly diagnosed lung cancer and those with SCLC increased until 2009 by 111.5% for lung cancer and 118.5% for SCLC. Thereafter, lung cancer cases grew in number, but SCLC cases did not; hence, the percentage of patients with SCLC decreased from 9.3% in 2009 to 6.3% in 2018. From 2011 to 2018, the percentage of never-smokers increased significantly among all patients with lung cancers (from 49.9% in 2011 to 60.2% in 2018) and among those with lung adenocarcinomas (from 64.1% in 2011 to 70.9% in 2018) (both P < .001). However, the percentage of never-smokers appeared to vary little in the SCLC population: 15.5% in 2011 and 16.1% in 2018 (P = .28). The median overall survival was significantly longer in patients with adenocarcinoma vs SCLC (adjusted hazard ratio, 0.32; 95% CI, 0.31-0.33; P < .001). Compared with smokers with SCLC, never-smokers with SCLC tended to include more older patients (age ≥70 years: 492 [57.3%] vs 2242 [44.8%]), more women (274 [31.9%] vs 322 [6.4%]), more individuals with a poor performance status (Eastern Cooperative Oncology Group performance status ≥2: 284 [33.1%] vs 1261 [25.2%]) and stage IV cancer (660 [76.9%] vs 3590 [71.8%]), and more patients without treatment (203 [23.7%] vs 626 [12.5%]). Furthermore, never-smokers, particularly men, experienced a shorter survival rate (adjusted hazard ratio, 1.10; 95% CI, 1.00-1.20; P = .04) compared with the other groups. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that the decrease in the percentage of patients with SCLC was associated with increased lung cancers of other histologic types, with no substantial decrease in the number of those with SCLC.
Collapse
Affiliation(s)
- Jeng-Sen Tseng
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Ju Chiang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Taiwan Cancer Registry, Taipei, Taiwan
| | - Kun-Chieh Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Zhe-Rong Zheng
- Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Tsung-Ying Yang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Wen-Chung Lee
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Taiwan Cancer Registry, Taipei, Taiwan
| | - Kuo-Hsuan Hsu
- Division of Critical Care and Respiratory Therapy, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yen-Hsiang Huang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tsang-Wu Liu
- National Institute of Cancer Research, National Health Research Institutes, Miaoli, Taiwan
| | - Jiun-Yi Hsia
- Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- Division of Thoracic Surgery, Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Gee-Chen Chang
- Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| |
Collapse
|
6
|
Siegfried JM. Sex and Gender Differences in Lung Cancer and Chronic Obstructive Lung Disease. Endocrinology 2022; 163:6470418. [PMID: 34927202 DOI: 10.1210/endocr/bqab254] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Indexed: 11/19/2022]
Abstract
Two highly prevalent pulmonary diseases, lung cancer and chronic obstructive lung disease (COPD), show both sex and gender differences in their presentations and outcomes. Sex differences are defined as biological differences associated with the male vs female genotype, and gender differences are defined as behavioral or social differences that primarily arise because of gender identity. The incidence of both lung cancer and COPD has increased dramatically in women over the past 50 years, and both are associated with chronic pulmonary inflammation. Development of COPD is also a risk factor for lung cancer. In this review, the main differences in lung cancer and COPD biology observed between men and women will be summarized. Potential causative factors will be discussed, including the role of estrogen in promoting pro-growth and inflammatory phenotypes which may contribute to development of both lung cancer and COPD. Response of the innate and adaptive immune system to estrogen is a likely factor in the biology of both lung cancer and COPD. Estrogen available from synthesis by reproductive organs as well as local pulmonary estrogen synthesis may be involved in activating estrogen receptors expressed by multiple cell types in the lung. Estrogenic actions, although more pronounced in women, may also have importance in the biology of lung cancer and COPD in men. Effects of estrogen are also timing and context dependent; the multiple cell types that mediate estrogen action in the lungs may confer both positive and negative effects on disease processes.
Collapse
Affiliation(s)
- Jill M Siegfried
- Department of Pharmacology, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Pharmacology & Chemical Biology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| |
Collapse
|
7
|
Ling J, Wang Y, Ma L, Zheng Y, Tang H, Meng L, Zhang L. KIF11, a plus end-directed kinesin, as a key gene in benzo(a)pyrene-induced non-small cell lung cancer. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2022; 89:103775. [PMID: 34800719 DOI: 10.1016/j.etap.2021.103775] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 06/13/2023]
Abstract
Evidence indicates that Benzo(a)pyrenediol-epoxide (BPDE) can damage lung cells, resulting in carcinogenesis with complex mechanisms. We aimed to explore the genes and pathway variations in this process. First, the key gene was screened out and identified through data mining, and then, it was in turn validated by bioinformatics analysis and experimental methods. Consequently, 106 up-regulated and 260 down-regulated differentially expressed genes were yielded, which were enriched in various pathways, such as Cell cycle, and p53 signaling pathway. Then, KIF11 was identified as the key gene. Overexpression of KIF11 in lung cancer had a correlation with advanced pathological grade, advanced T stage, and presence of lymph node metastasis, which predicted poor prognosis. In summary, the present study revealed that KIF11 might be a key gene in the tumorigenesis of BPDE-related lung cancer, raising the possibility of KIF11 as a target for BPDE-induced lung cancer prevention and therapy.
Collapse
Affiliation(s)
- Junjun Ling
- Department of Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China; Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Yuhong Wang
- Department of Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Lihai Ma
- Department of Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Yu Zheng
- Department of Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Hongqu Tang
- Department of Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Lingzhan Meng
- Department of Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.
| | - Liang Zhang
- Department of Oncology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.
| |
Collapse
|
8
|
Abstract
The world is witnessing a global epidemic of lung cancer in women. Cigarette smoking remains the dominant risk factor in both sexes, but multiple observations suggest that important sex-related distinctions in lung cancer exist. These include differences in histologic distribution, prevalence in never-smokers, frequency of activating EGFR mutations, likelihood of DNA adduct accumulation, and survival outcomes. Important questions such as whether women are more susceptible to carcinogenic effects of smoking or derive more benefit from lung cancer screening merit more study. A deeper understanding of sex-related differences in lung cancer may lead to improved outcomes for both women and men.
Collapse
|
9
|
Liu B, Liu Y, Zou J, Zou M, Cheng Z. Smoking is Associated with Lung Adenocarcinoma and Lung Squamous Cell Carcinoma Progression through Inducing Distinguishing lncRNA Alterations in Different Genders. Anticancer Agents Med Chem 2021; 22:1541-1550. [PMID: 34315392 DOI: 10.2174/1871520621666210727115147] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/08/2021] [Accepted: 06/21/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Smoking participates in pathogenesis of lung cancer. Long non-coding RNAs (lncRNAs) play some specific roles during development of lung cancers. OBJECTIVE To investigate effects of smoking on lncRNA alterations in lung cancer. METHODS There are 522 lung adenocarcinoma (LUAD) and 504 lung squamous cell carcinoma (LUSC) participants. Clinical and lncRNA genetic data were downloaded from The Cancer Genome Atlas (TCGA) database. LncRNA alterations were analyzed in lung cancer patients. Smoking category and packs were evaluated. Correlations between smoking and LncRNA alterations were analyzed. Kaplan-Meier analysis was performed to determine overall survival and disease free survival. RESULTS There are more non-smokers in LUSC than in LUAD. In both LUAD and LUSC, smoking could increase total mutation counts and fraction of copy number alterations. Smoking index positively correlated with total mutations in LUAD, but not in LUSC. Smoking could trigger lncRNA alterations both in LUAD and LUSC. Smoking regulated different lncRNA between male and female. EXOC3-AS1 and LINC00603 alterations were positively correlated with smoking index in male LUAD smokers. In female LUAD smokers, smoking index was positively correlated with SNHG15, TP53TG1 and LINC01600 and negatively with LINC00609 and PTCSC3. In both male and female LUSC patients, smoking increased or decreased several lncRNA alterations. DGCR5 alteration increased in male LUSC than in female LUSC patients. In female LUSC patients, LOH12CR2 alteration was positively correlated with smoking index. CONCLUSIONS Smoking promoted LUAD and LUSC development by affecting different lncRNA alterations in different genders.
Collapse
Affiliation(s)
- Bing Liu
- Department of Respiratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Yuan Liu
- Department of Respiratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Jingfeng Zou
- Department of Respiratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Menglin Zou
- Department of Respiratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Zhenshun Cheng
- Department of Respiratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| |
Collapse
|
10
|
Rusmaully J, Tvardik N, Martin D, Billmann R, Cénée S, Antoine M, Blons H, Laurent-Puig P, Trédaniel J, Wislez M, Stücker I, Guénel P, Radoï L. Risk of lung cancer among women in relation to lifetime history of tobacco smoking: a population-based case-control study in France (the WELCA study). BMC Cancer 2021; 21:711. [PMID: 34134640 PMCID: PMC8207748 DOI: 10.1186/s12885-021-08433-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 06/03/2021] [Indexed: 01/12/2023] Open
Abstract
Background This study aims to provide new insights on the role of smoking patterns and cigarette dependence in female lung cancer, and to examine differences by histological subtype. Methods We conducted a population-based case-control study in the great Paris area among women including 716 incident cases diagnosed between 2014 and 2017 and 757 age-matched controls. Detailed data on smoking history was collected during in-person interviews to assess intensity and duration of tobacco smoking, time since cessation, smoking habits (depth of smoke inhalation, use of filter, type of tobacco, and type of cigarettes) and Fagerström test for cigarette dependence. The comprehensive smoking index (CSI), a score modelling the combined effects of intensity, duration and time since quitting smoking was determined for each subject. Multivariable logistic regression models were fitted to calculate odds ratios (ORs) and their confidence intervals (95%CI) of lung cancer associated with smoking variables. Results Lung cancer risk increased linearly with intensity and duration of tobacco smoking while it decreased with time since cessation, to reach the risk in never-smokers after 20 years of abstinence. The combined effect of intensity and duration of tobacco smoking was more than multiplicative (p-interaction 0.012). The OR in the highest vs the lowest quartile of CSI was 12.64 (95%CI 8.50; 18.80) (p-trend < 0.001). The risk of small cell or squamous cell carcinomas increased with the CSI more sharply than the risk of adenocarcinomas. Deep smoke inhalation, dark vs blond tobacco, conventional vs light cigarettes, and unfiltered vs filtered cigarettes, as well as having mixed smoking habits, were found to be independent risk factors. Having high cigarette addiction behaviours also increased the risk after adjusting for CSI. Conclusion This study provides additional insights on the effects of tobacco smoking patterns on lung cancer risk among women. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08433-z.
Collapse
Affiliation(s)
- Jennifer Rusmaully
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Nastassia Tvardik
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Diane Martin
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Régine Billmann
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Sylvie Cénée
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Martine Antoine
- AP-HP, Tenon Hospital, Pathology, 4 rue de la Chine, Paris, France.,UPMC Univ Paris 06, GRC No.04, Theranoscan, Paris, France
| | - Hélène Blons
- Assistance Publique Hôpitaux de Paris, Paris Cancer Institute CARPEM, AP-HP.Centre - Université de Paris, Department of Biology Physiology and Genetics, Hopital Européen Georges Pompidou, Paris, France.,Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France
| | - Pierre Laurent-Puig
- Assistance Publique Hôpitaux de Paris, Paris Cancer Institute CARPEM, AP-HP.Centre - Université de Paris, Department of Biology Physiology and Genetics, Hopital Européen Georges Pompidou, Paris, France.,Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France
| | - Jean Trédaniel
- Groupe Hospitalier Paris Saint Joseph, Université de Paris, Unité INSERM UMR-S 1124, Toxicologie, pharmacologie et signalisation cellulaire, Paris, France
| | - Marie Wislez
- AP-HP.Centre - Université de Paris, Hôpital Cochin, Unité d'Oncologie Thoracique, Service de Pneumologie, Paris, France.,Centre de Recherche des Cordeliers, Université de Paris, UMRS 1138 « Complement, Inflammation and Cancer », Paris, France
| | - Isabelle Stücker
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Pascal Guénel
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France.
| | - Loredana Radoï
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France.,AP-HP Nord - Université de Paris, Hôpital Louis Mourier, UFR d'odontologie, Paris, France
| |
Collapse
|
11
|
Succony L, Rassl DM, Barker AP, McCaughan FM, Rintoul RC. Adenocarcinoma spectrum lesions of the lung: Detection, pathology and treatment strategies. Cancer Treat Rev 2021; 99:102237. [PMID: 34182217 DOI: 10.1016/j.ctrv.2021.102237] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 02/07/2023]
Abstract
Adenocarcinoma has become the most prevalent lung cancer sub-type and its frequency is increasing. The earliest stages in the development of lung adenocarcinomas are visible using modern computed tomography (CT) as ground glass nodules. These pre-invasive nodules can progress over time to become invasive lung adenocarcinomas. Lesions in this developmental pathway are termed 'adenocarcinoma spectrum' lesions. With the introduction of lung cancer screening programs there has been an increase in the detection of these lesions raising questions about natural history, surveillance and treatment. Here we review how the radiological appearance of an adenocarcinoma spectrum lesion relates to its underlying pathology and explore the natural history and factors driving lesion progression. We examine the molecular changes that occur at each stage of adenocarcinoma spectrum lesion development, including the effects of the driver mutations, EGFR and KRAS, that are key to invasive adenocarcinoma pathology. A better understanding of the development of pre-invasive disease will create treatment targets. Our understanding of how tumours interact with the immune system has led to the development of new therapeutic strategies. We review the role of the immune system in the development of adenocarcinoma spectrum lesions. With a clear preinvasive phase there is an opportunity to treat early adenocarcinoma spectrum lesions before an invasive lung cancer develops. We review current management including surveillance, surgical resection and oncological therapy as well as exploring potential future treatment avenues.
Collapse
Affiliation(s)
- L Succony
- Department of Thoracic Oncology, Royal Papworth Hospital, Cambridge CB2 0AY, United Kingdom
| | - D M Rassl
- Department of Pathology, Royal Papworth Hospital NHS Foundation Trust, Cambridge CB2 0AY, United Kingdom
| | - A P Barker
- Department of Radiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge CB2 0AY, United Kingdom
| | - F M McCaughan
- Department of Medicine, University of Cambridge, Addenbrookes Hospital, Cambridge CB2 0QQ, United Kingdom
| | - R C Rintoul
- Department of Thoracic Oncology, Royal Papworth Hospital, Cambridge CB2 0AY, United Kingdom; Department of Oncology, University of Cambridge, Cambridge CB2 0QQ United Kingdom.
| |
Collapse
|
12
|
Sussman TA, Li H, Hobbs B, Funchain P, McCrae KR, Khorana AA. Incidence of thromboembolism in patients with melanoma on immune checkpoint inhibitor therapy and its adverse association with survival. J Immunother Cancer 2021; 9:jitc-2020-001719. [PMID: 33436486 PMCID: PMC7805375 DOI: 10.1136/jitc-2020-001719] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Thromboembolism (TE) in cancer significantly contributes to morbidity and mortality. Little is known about the incidence of arterial TE (ATE) and venous TE (VTE) in patients with melanoma on immune checkpoint inhibitor (ICI) therapy. METHODS We conducted a retrospective cohort study of patients with melanoma receiving ICI from July 2015 through December 2017 at the Cleveland Clinic. TE, including VTE events of deep venous thrombosis, pulmonary embolism, visceral vein thrombosis, and ATE events of myocardial infarction, stroke, peripheral arterial embolism, or transient ischemic attack after ICI initiation were identified. Overall survival (OS) from ICI initiation was estimated by Kaplan-Meier and Cox hazard models; associations between TE, ICI regimen, and clinical risk factors were evaluated using log-rank test. RESULTS The study population comprised 228 patients with median age of 65 years (23-91 years), 67% male, and median follow-up of 27.3 months. Pembrolizumab was most commonly used (38.7%), followed by combination of ipilimumab plus nivolumab (29.4%), ipilimumab (20%), and nivolumab (12.3%). Most had stage IV disease (81.1%) and 11% had brain metastases (BM) at treatment initiation. Fifty-one TE events occurred in 47 patients (20.6%), including 37 (16.2%) VTE and 14 (6.1%) ATE. Cumulative incidence of TE after ICI initiation was 9.3% (95% CI: 6.0% to 13.6%) at 6 months, and 16.0% (95% CI: 11.6% to 21.2%) at 12 months. The 6-month and 12-month VTE cumulative incidence rates were higher with combination ICI than single agent (16.7% vs 5.0% and 21.3% vs 9.5%, respectively; p=0.02). Risk factors significantly associated with VTE in multivariate analysis included combination ICI (HR 2.70; 95% CI: 1.28 to 5.70; p=0.009), Khorana Score ≥1 (HR 2.24; 95% CI: 1.06 to 4.74; p=0.03), history of coronary artery disease (HR 2.71; 95% CI: 1.16 to 6.29); p=0.02), and anticoagulation at treatment start (HR 4.14; 95% CI: 1.60 to 10.7; p=0.003). Of patients without BM, OS was worse in patients with TE compared with those without (2-year OS 50.8% vs 71.3%; HR 2.27; 95% CI: 1.36 to 3.79; p=0.002), when adjusted for age and stage. CONCLUSIONS ICI is associated with a high incidence of TE in patients with melanoma, with higher rates with combination therapy; TE is associated with substantial worsening of survival. Further studies are needed to identify pathophysiology, biomarkers, and preventive approaches.
Collapse
Affiliation(s)
- Tamara A Sussman
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Hong Li
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Brian Hobbs
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Pauline Funchain
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Keith R McCrae
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Alok A Khorana
- Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| |
Collapse
|
13
|
Cardona AF, Ruiz-Patiño A, Arrieta O, Ricaurte L, Zatarain-Barrón ZL, Rodriguez J, Avila J, Rojas L, Recondo G, Barron F, Archila P, Sotelo C, Bravo M, Zamudio N, Corrales L, Martín C, Rolfo C, Viola L, Carranza H, Vargas C, Otero J, Bermudez M, Gamez T, Pino LE, Rosell R. Genotyping Squamous Cell Lung Carcinoma in Colombia (Geno1.1-CLICaP). Front Oncol 2021; 10:588932. [PMID: 33384957 PMCID: PMC7771515 DOI: 10.3389/fonc.2020.588932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/10/2020] [Indexed: 11/29/2022] Open
Abstract
Background Lung cancer is a public health problem, and squamous cell carcinoma (SCC) is the second most prevalent subtype of this neoplasm. Compared to other subtypes, including adenocarcinoma, SCC is less well understood in terms of molecular pathogenesis, limiting therapeutic options among targeted agents approved for other disease subgroups. In this study, we sought to characterize the SCC genomic profile using a validated Next Generation Sequencing (NGS) platform. Methods The comprehensive NGS assay (TruSight Tumor 170) was used in order to target the full coding regions of 170 cancer-related genes on SCC samples. PD-L1 expression in tumor cells (TCs) was assessed using clone 22C3 (Dako). Clinical outcomes were correlated with molecular profile, including progression free survival (PFS), overall response rate (ORR), and overall survival (OS). Results A total of 26 samples were included, median age was 67 years (r, 33–83) and 53.8% were men. Tobacco consumption was identified in all subjects (mean 34-year package). For first-line treatment 80.8% of patients received cisplatin or carboplatin plus gemcitabine. In terms of molecular profile, we identified a high prevalence of inactivating mutations in TP53 (61.5%), PIK3CA (34.6%), MLL2 (34.6%), KEAP1 (38.4%), and NOTCH1 (26.9%). PD-L1 expression ranged from negative, 1, 2–49, and ≥50% in 23.1, 38.5, 26.9, and 11.5%, respectively. Interestingly, the genetic alterations did not have an effect in PFS, OS or ORR in this study. However, PDL1 expression was higher among those who had mutations in TP53 (p = 0.037) and greater expression of PDL1 was related to PIK3CA alterations (p = 0.05). Conclusions The genomic profile of SCC encompasses important genes including TP53, PIK3CA and KEAP1. TP53 mutations could be associated with PDL1 expression, generating hypothesis regarding specific treatment options.
Collapse
Affiliation(s)
- Andrés F Cardona
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Alejandro Ruiz-Patiño
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - Luisa Ricaurte
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | | | - July Rodriguez
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jenny Avila
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia.,Oncology Department, Clínica Colsanitas, Bogotá, Colombia
| | - Gonzalo Recondo
- Thoracic Oncology Section, Centro de Educación Médica e Investigaciones Clínicas - CEMIC, Buenos Aires, Argentina
| | - Feliciano Barron
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - Pilar Archila
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Carolina Sotelo
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Melissa Bravo
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Nataly Zamudio
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
| | - Luis Corrales
- Oncology Department, Hospital San Juan de Dios, San José Costa Rica, Costa Rica
| | - Claudio Martín
- Medical Oncology Group, Fleming Institute, Buenos Aires, Argentina
| | - Christian Rolfo
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Lucia Viola
- Thoracic Oncology Unit, Fundación Neumológica Colombiana, Bogotá, Colombia
| | - Hernán Carranza
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Carlos Vargas
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Jorge Otero
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia.,Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Maritza Bermudez
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Tatiana Gamez
- Department of Medical Oncology, Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia.,Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - Luis Eduardo Pino
- Department of Medical Oncology, Fundación Santa Fé de Bogotá, Bogotá, Colombia
| | - Rafael Rosell
- Department of Medical Oncology, Catalan Institute of Oncology, Barcelona, Spain
| |
Collapse
|
14
|
Deligkaris C, Millam E, Wade EO, Grayer ML, Wahl DM. Physico-chemical properties of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) diazonium ion: a theoretical investigation. RSC Adv 2021; 11:26750-26762. [PMID: 35480014 PMCID: PMC9037334 DOI: 10.1039/d1ra04343a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/17/2021] [Indexed: 11/26/2022] Open
Abstract
We have explored the physico-chemical properties of NNK diazonium ion to gain insight into its shape, bonding, charge distribution, and ro-vibrational features. This information is essential if the chemical reactivity and physical properties of this important intermediate are to be understood. NNK diazonium ion is a well-known alkylating agent. Its enzymatic production, its reaction with DNA, and its role in mutagenesis/carcinogenesis have all received significant experimental study. Computational work on the ion, however, is lacking. The species is sufficiently small such that its properties may be probed using sophisticated model chemistries. We present the first in silico investigation of NNK diazonium ion. Kohn–Sham density functional theory (B3LYP/6-311G**) and coupled cluster theory (CCSD/6-31G*) were deployed to obtain energies, geometries, electrostatic potential surfaces, molecular orbitals, and vibrational analyses for several energy-minimized structures. To provide insight into the motion of NNK diazonium ion (NNKDI) in solution, molecular dynamics simulations on the solvated intermediate were undertaken. To explore the initial reactivity of this important electrophile, local Fukui indices and natural population analysis charges were predicted. Analogous ab initio work on propane diazonium ion was also performed. Our vibrational analyses suggest a relatively weak carbon–nitrogen bond and a robust nitrogen–nitrogen interaction. Our condensed Fukui indices show that the terminal nitrogen is a site of significant electrophilicity while our electrostatic predictions yield high values near the formally charged nitrogen and its α carbon. NNKDI TCTT molecular orbital energies (a), molecular orbitals 46 (HOMO), 47 (LUMO) and 48 (LUMO+1) as calculated at the B3LYP/6-311G** level of theory.![]()
Collapse
Affiliation(s)
- Christos Deligkaris
- Department of Geology and Physics
- University of Southern Indiana
- Evansville
- USA
| | - Evan Millam
- Department of Chemistry
- University of Southern Indiana
- Evansville
- USA
| | - Edmir O. Wade
- Department of Chemistry
- University of Southern Indiana
- Evansville
- USA
| | - Maverick L. Grayer
- Department of Geology and Physics
- University of Southern Indiana
- Evansville
- USA
| | - David M. Wahl
- Department of Geology and Physics
- University of Southern Indiana
- Evansville
- USA
| |
Collapse
|
15
|
Lei L, Huang A, Cai W, Liang L, Wang Y, Liu F, Peng J. Spatial and Temporal Analysis of Lung Cancer in Shenzhen, 2008-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010026. [PMID: 33375213 PMCID: PMC7793115 DOI: 10.3390/ijerph18010026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/19/2020] [Accepted: 12/20/2020] [Indexed: 02/05/2023]
Abstract
Lung cancer is the most commonly diagnosed cancer in China. The incidence trend and geographical distribution of lung cancer in southern China have not been reported. The present study explored the temporal trend and spatial distribution of lung cancer incidence in Shenzhen from 2008 to 2018. The lung cancer incidence data were obtained from the registered population in the Shenzhen Cancer Registry System between 2008 and 2018. The standardized incidence rates of lung cancer were analyzed by using the joinpoint regression model. The Moran's I method was used for spatial autocorrelation analysis and to further draw a spatial cluster map in Shenzhen. From 2008 to 2018, the average crude incidence rate of lung cancer was 27.1 (1/100,000), with an annual percentage change of 2.7% (p < 0.05). The largest average proportion of histological type of lung cancer was determined as adenocarcinoma (69.1%), and an increasing trend was observed in females, with an average annual percentage change of 14.7%. The spatial autocorrelation analysis indicated some sites in Shenzhen as a high incidence rate spatial clustering area. Understanding the incidence patterns of lung cancer is useful for monitoring and prevention.
Collapse
Affiliation(s)
- Lin Lei
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
| | - Anyan Huang
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou 515065, China
| | - Weicong Cai
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
| | - Ling Liang
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
| | - Yirong Wang
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
| | - Fangjiang Liu
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
| | - Ji Peng
- Department of Cancer Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (L.L.); (A.H.); (W.C.); (L.L.); (Y.W.); (F.L.)
- Correspondence: ; Tel.: +86-13602658282
| |
Collapse
|
16
|
Qiu B, Li G, Luo F, Cai X, Wu L, Chen J, Hu Y, Tang Z, Yang S, He J. Treatment patterns, clinical outcomes, and healthcare resource use associated with advanced/metastatic lung cancer in China: protocol for a retrospective observational study. Transl Lung Cancer Res 2020; 9:2460-2468. [PMID: 33489806 PMCID: PMC7815359 DOI: 10.21037/tlcr-20-1269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Lung cancer (LC) is the most common cancer worldwide. The prevalence of LC and rate of associated mortality are high and increasing faster in China than in Western countries. Non-small cell lung cancer (NSCLC) accounts for most LCs. This study aims to be the first large, multi-center, non-interventional retrospective study of treatment patterns (type/duration, number of lines, completion rate), real-world outcomes, and medical costs among Chinese patients with advanced/metastatic NSCLC (IIIb/IV) or extensive-stage small cell LC (ES-SCLC). Methods This study will enroll 8,800 patients (≥18 years, with a diagnosis of advanced/metastatic NSCLC made between 1 December 2013 to 30 November 2014) from 35 to 50 Chinese sites. Hospital information systems (HIS) and electronic medical records will be retrospectively reviewed, in adherence with regulatory and ethical requirements. Early-stage treatment (starting from 1 December 2010) of patients with recurrent disease or early disease progression will be examined. Data will be collected at baseline (diagnosis) and 6 and 12 months after this. Observation will end after 3 years or death. Data will be stratified by histology, staging, age, region, health insurance, and epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK) mutation status. Treatment duration and overall survival will be estimated using Kaplan-Meier curves. Descriptive statistics will be used for disease characteristics and patient demographics. Cox-proportional hazards models will be used to examine the impact of demographics/treatment on survival. Treatment patterns and outcome predictors will be explored using multivariate logistic regression. Discussion This protocol describes the methodology for collecting real-world data to guide evidence-based clinical practice and inform unmet needs in NSCLC treatment, with potential to identify gaps between guidelines and current practice. Trial registration NCT03505515; data registered on ClinicalTrials.gov: 12h Apr., 2018.
Collapse
Affiliation(s)
- Bin Qiu
- Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | | | - Feng Luo
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaohong Cai
- Sichuan Cancer Hospital & Institute, Chengdu, China
| | - Lin Wu
- Hunan Cancer Hospital, Changsha, China
| | | | | | - Zhiliu Tang
- Bristol-Myers Squibb, Shanghai, China (was with BMS at the time when the research and the manuscript were conducted)
| | - Shuo Yang
- Bristol-Myers Squibb, Shanghai, China
| | - Jie He
- Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
17
|
Jemal A, Miller KD, Sauer AG, Bandi P, Fidler-Benaoudia MM, Culp M, Islami F, Fedewa SA, Ma J. Changes in Black-White Difference in Lung Cancer Incidence among Young Adults. JNCI Cancer Spectr 2020; 4:pkaa055. [PMID: 32851203 PMCID: PMC7440250 DOI: 10.1093/jncics/pkaa055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/20/2020] [Accepted: 05/30/2020] [Indexed: 01/02/2023] Open
Abstract
Background We previously reported that lung cancer incidence between Blacks and Whites younger than 40 years of age converged in women and approached convergence in men. Whether this pattern has continued in contemporary young birth cohorts is unclear. Methods We examined 5-year age-specific lung cancer incidence in Blacks and Whites younger than 55 years of age by sex and calculated the Black-to-White incidence rate ratios (IRRs) and smoking prevalence ratios by birth cohort using nationwide incidence data from 1997 to 2016 and smoking data from 1970 to 2016 from the National Health Interview Survey. Results Five-year age-specific incidence decreased in successive Black and White men born since circa 1947 and women born since circa 1957, with the declines steeper in Blacks than Whites. Consequently, the Black-to-White IRRs became unity in men born 1967-1972 and reversed in women born since circa 1967. For example, the Black-to-White IRRs in ages 40-44 years born between 1957 and 1972 declined from 1.92 (95% confidence interval [CI] = 1.82 to 2.03) to 1.03 (95% CI = 0.93 to 1.13) in men and from 1.32 (95% CI = 1.24 to 1.40) to 0.71 (95% CI = 0.64 to 0.78) in women. Similarly, the historically higher sex-specific smoking prevalence in Blacks than Whites disappeared in men and reversed in women born since circa 1965. The exception to these patterns is that the incidence became higher in Black men than White men born circa 1977-1982. Conclusions The historically higher lung cancer incidence in young Blacks than young Whites in the United States has disappeared in men and reversed in women, coinciding with smoking patterns, though incidence again became higher in Black men than White men born circa 1977-1982.
Collapse
Affiliation(s)
- Ahmedin Jemal
- Data Science, Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, GA, USA
| | - Kimberly D Miller
- Data Science, Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, GA, USA
| | - Ann Goding Sauer
- Data Science, Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, GA, USA
| | - Priti Bandi
- Data Science, Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, GA, USA
| | - Miranda M Fidler-Benaoudia
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Alberta, Canada.,Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - MaryBeth Culp
- Data Science, Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, GA, USA
| | - Farhad Islami
- Data Science, Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, GA, USA
| | - Stacey A Fedewa
- Data Science, Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, GA, USA
| | - Jiemin Ma
- Data Science, Office of the Chief Medical and Scientific Officer, American Cancer Society, Atlanta, GA, USA
| |
Collapse
|
18
|
Smida T, Bruno TC, Stabile LP. Influence of Estrogen on the NSCLC Microenvironment: A Comprehensive Picture and Clinical Implications. Front Oncol 2020; 10:137. [PMID: 32133288 PMCID: PMC7039860 DOI: 10.3389/fonc.2020.00137] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/27/2020] [Indexed: 12/15/2022] Open
Abstract
Lung cancer mortality represents the leading cause of cancer related deaths in the United States and worldwide. Almost half of these deaths occur in female patients, making lung cancer the most common cause of cancer mortality in women with a higher annual mortality rate than breast, uterine, and ovarian cancers combined. The distinct epidemiological, histological and biological presentation of non-small cell lung cancer (NSCLC) in women combined with extensive preclinical data have demonstrated that the female sex hormone β-estradiol (E2) plays an important role in NSCLC tumorigenesis, prognosis, and treatment response. Estrogen receptors are widely expressed on stromal and immune cells, and estrogen-linked signaling pathways are known to be involved in regulating the response of both the innate and adaptive immune system. Immune evasion has been recognized as a “hallmark” of cancer and immunotherapy has re-defined standard of care treatment for NSCLC. Despite these advancements, the low response rates observed in patients treated with immune checkpoint inhibitors has led to a search for mediators of immunosuppression and ways to augment the action of these agents. We focus on emerging data describing sex differences that modulate immunotherapy efficacy in NSCLC, immunosuppressive properties of E2 that lead to a pro-tumor microenvironment (TME), and the translational potential of altering the immune microenvironment by targeting the estrogen signaling pathway. E2-induced modulation affects multiple cell types within the TME, including cancer-associated fibroblasts, tumor infiltrating myeloid cells, and tumor infiltrating lymphocytes, all of which interplay with lung tumor cells via E2 and estrogen receptor engagement, ultimately shaping the TME that may, in part, be responsible for the sex-based disparities observed in NSCLC. An improved understanding of the role of the estrogen pathway in NSCLC anti-cancer immunity may lead to novel therapeutic approaches for altering the TME to improve the efficacy of immunotherapy agents.
Collapse
Affiliation(s)
- Tanner Smida
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tullia C Bruno
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA, United States.,UPMC Hillman Cancer Center, Pittsburgh, PA, United States
| | - Laura P Stabile
- UPMC Hillman Cancer Center, Pittsburgh, PA, United States.,Department of Pharmacology & Chemical Biology, University of Pittsburgh, Pittsburgh, PA, United States
| |
Collapse
|
19
|
Hernandez-Castillo C, Termini J, Shuck S. DNA Adducts as Biomarkers To Predict, Prevent, and Diagnose Disease-Application of Analytical Chemistry to Clinical Investigations. Chem Res Toxicol 2020; 33:286-307. [PMID: 31638384 DOI: 10.1021/acs.chemrestox.9b00295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Characterization of the chemistry, structure, formation, and metabolism of DNA adducts has been one of the most significant contributions to the field of chemical toxicology. This work provides the foundation to develop analytical methods to measure DNA adducts, define their relationship to disease, and establish clinical tests. Monitoring exposure to environmental and endogenous toxicants can predict, diagnose, and track disease as well as guide therapeutic treatment. DNA adducts are one of the most promising biomarkers of toxicant exposure owing to their stability, appearance in numerous biological matrices, and characteristic analytical properties. In addition, DNA adducts can induce mutations to drive disease onset and progression and can serve as surrogate markers of chemical exposure. In this perspective, we highlight significant advances made within the past decade regarding DNA adduct quantitation using mass spectrometry. We hope to expose a broader audience to this field and encourage analytical chemistry laboratories to explore how specific adducts may be related to various pathologies. One of the limiting factors in developing clinical tests to measure DNA adducts is cohort size; ideally, the cohort would allow for model development and then testing of the model to the remaining cohort. The goals of this perspective article are to (1) provide a summary of analyte levels measured using state-of-the-art analytical methods, (2) foster collaboration, and (3) highlight areas in need of further investigation.
Collapse
Affiliation(s)
- Carlos Hernandez-Castillo
- Department of Molecular Medicine , Beckman Research Institute at City of Hope Duarte , California 91010 , United States
| | - John Termini
- Department of Molecular Medicine , Beckman Research Institute at City of Hope Duarte , California 91010 , United States
| | - Sarah Shuck
- Department of Molecular Medicine , Beckman Research Institute at City of Hope Duarte , California 91010 , United States
| |
Collapse
|
20
|
Abstract
Lung cancer in women is a modern epidemic and a major health crisis. Cigarette smoking remains the most important risk factor for lung cancer, and unfortunately smoking rates are either stabilized or continue to increase among women. Women may not be more susceptible to the carcinogenic effects of tobacco, but the biology of lung cancer differs between the sexes. This paper summarizes the biological sex differences in lung cancer, including molecular abnormalities, growth factor receptors, hormonal influences, DNA repair capacity, as well as differences in the histology and treatment outcomes of lung cancer in women.
Collapse
Affiliation(s)
- Christina R MacRosty
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Interventional Pulmonary Program, University of North Carolina at Chapel Hill, 130 Mason Farm Road, Chapel Hill, NC 27599-7020, USA
| | - M Patricia Rivera
- Division on Pulmonary and Critical Medicine, University of North Carolina at Chapel Hill, 130 Mason Farm Road, Suite 4125, Chapel Hill, NC 27599-7020, USA.
| |
Collapse
|
21
|
Zang R, Wang X, Jin R, Lei Y, Huang J, Liu C, Zheng S, Zhou F, Wu Q, Sun N, Gao S, He J. Translational value of IDH1 and DNA methylation biomarkers in diagnosing lung cancers: a novel diagnostic panel of stage and histology-specificity. J Transl Med 2019; 17:430. [PMID: 31888670 PMCID: PMC6936123 DOI: 10.1186/s12967-019-2117-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/26/2019] [Indexed: 12/24/2022] Open
Abstract
Background Lung cancer is the leading cause of cancer-related death worldwide, and the timely and serial assessment of low-dose computed tomography (LDCT) in high-risk populations remains a challenge. Furthermore, testing a single biomarker for the diagnosis of lung cancers is of relatively low effectiveness. Thus, a stronger diagnostic combination of blood biomarkers is needed to improve the diagnosis of non-small cell lung cancer (NSCLC). Methods The blood levels of individual biomarkers [IDH1, DNA methylation of short stature homeobox 2 gene (SHOX2), and prostaglandin E receptor 4 gene (PTGER4)] were measured and statistically analyzed in samples from healthy controls and patients with lung cancer. In total, 221 candidates were enrolled and randomly assigned into two groups for the training and validation of a diagnostic panel. Additionally, a subgroup analysis was performed in the whole cohort. Results A newly combined 3-marker diagnostic model for lung cancers was established and validated with area under the receiver operating characteristic (ROC) curve (AUC) values ranging from 0.835 to 0.905 in independent groups showing significantly stronger diagnostic value compared with a single tested biomarker. The sensitivity of the diagnostic model was as high as 86.1% and 80.0% in the training and validation sets, respectively. Although no apparent differences were found between the 3-marker and 2-marker models, the high clinical T-stage and histological type specificity of IDH1 and two other methylated DNA biomarkers were demonstrated in the subgroup analysis. Conclusions The combination of single biomarkers with high stage-specificity and histological type specificity (SHOX2 and PTGER4 DNA methylation and IDH1) showed better diagnostic performance in the detection of lung cancers compared with single marker assessment. A greater clinical utility of the panel may be developed by adding demographic/epidemiologic characteristics.
Collapse
Affiliation(s)
- Ruochuan Zang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xinfeng Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Runsen Jin
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yuanyuan Lei
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jianbing Huang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Chengming Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Sufei Zheng
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Fang Zhou
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Qian Wu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Nan Sun
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| |
Collapse
|
22
|
Sakhri L, Bertocchi M. [Bronchial carcinoma and tobacco: An update]. Rev Mal Respir 2019; 36:1129-1138. [PMID: 31767264 DOI: 10.1016/j.rmr.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 06/18/2018] [Indexed: 11/29/2022]
Abstract
Lung cancer remains the most lethal cancer. The most common cause is smoking, which is also preventable, unlike the causes of other types of cancer. A genetic characteristic has emerged over several years, which explains particular profiles of smokers, or highly dependent smokers. The emergence of new therapies for the treatment of lung cancer, and the impact of tobacco on reducing the effectiveness of these therapies must challenge practitioners to obtain a complete cessation of smoking regardless of the stage of the disease.
Collapse
Affiliation(s)
- L Sakhri
- Institut de cancérologie Daniel-Hollard, groupe hospitalier mutualiste de Grenoble, 8, rue Docteur-Calmette, 38028 Grenoble cedex 1, France.
| | - M Bertocchi
- Service de pneumologie, centre hospitalier Annecy Genevois, 1, avenue de l'Hôpital, 74374 Pringy, France
| |
Collapse
|
23
|
Christian WJ, Vanderford NL, McDowell J, Huang B, Durbin EB, Absher KJ, Walker CJ, Arnold SM. Spatiotemporal Analysis of Lung Cancer Histological Types in Kentucky, 1995-2014. Cancer Control 2019; 26:1073274819845873. [PMID: 31014079 PMCID: PMC6482657 DOI: 10.1177/1073274819845873] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Recent metabolic and genetic research has demonstrated that risk for specific histological types of lung cancer varies in relation to cigarette smoking and obesity. This study investigated the spatial and temporal distribution of lung cancer histological types in Kentucky, a largely rural state with high rates of smoking and obesity, to discern population-level trends that might reflect variation in these and other risk factors. The Kentucky Cancer Registry provided residential geographic coordinates for lung cancer cases diagnosed from 1995 through 2014. We used multinomial and discrete Poisson spatiotemporal scan statistics, adjusted for age, gender, and race, to characterize risk for specific histological types—small cell, adenocarcinoma, squamous cell, and other types—throughout Kentucky and compared to maps of risk factors. Toward the end of the study period, adenocarcinoma was more common among all population subgroups in north-central Kentucky, where smoking and obesity are less prevalent. During the same time frame, squamous cell, small cell, and other types were more common in rural Appalachia, where smoking and obesity are more prevalent, and in some high poverty urban areas. Spatial and temporal patterns in the distribution of histological types of lung cancer are likely related to regional variation in multiple risk factors. High smoking and obesity rates in the Appalachian region, and likely in high poverty urban areas, appeared to coincide with high rates of squamous cell and small cell lung cancer. In north-central Kentucky, environmental exposures might have resulted in higher risk for adenocarcinoma specifically.
Collapse
Affiliation(s)
- W Jay Christian
- 1 Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Nathan L Vanderford
- 2 Department of Toxicology and Cancer Biology, Markey Cancer Center, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Jaclyn McDowell
- 3 Kentucky Cancer Registry, University of Kentucky, Lexington, KY, USA
| | - Bin Huang
- 4 Department of Biostatistics, Markey Cancer Control Program, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Eric B Durbin
- 5 Division of Biomedical Informatics, Department of Internal Medicine, Kentucky Cancer Registry, Markey Cancer Center, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Kimberly J Absher
- 6 Department of Pathology, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Courtney J Walker
- 7 Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Susanne M Arnold
- 8 Department of Internal Medicine, Markey Cancer Center, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
24
|
Daneshvar C, Falconer WE, Ahmed M, Sibly A, Hindle M, Nicholson TW, Aldik G, Telisinghe LA, Riordan RD, Marchbank A, Breen D. Prevalence and outcome of central airway obstruction in patients with lung cancer. BMJ Open Respir Res 2019; 6:e000429. [PMID: 31673363 PMCID: PMC6797367 DOI: 10.1136/bmjresp-2019-000429] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/03/2019] [Accepted: 08/31/2019] [Indexed: 12/17/2022] Open
Abstract
Introduction Central airway obstruction (CAO) is a life-threatening complication of lung cancer. The prevalence of CAO in lung cancer patients is unknown. We audited CAO burden to inform our local cancer service. Methods This is a cohort review of all new lung cancer diagnoses between 1 November 2014 and 30 November 2015. CAO was defined by CT appearance. CT scans and routine patient records were followed up to 30 November 2018 to determine the prevalence of CAO at diagnosis; the characteristics of patients with prevalent CAO; mortality (using survival analysis); and incident CAO over follow-up. Results Of 342 new lung cancer diagnoses, CAO prevalence was 13% (95% CI 10% to 17%; n=45/342). Dedicated CT scan review identified missed CAO in 14/45 (31%) cases. In patients with prevalent CAO, 27/44 (61%) had a performance status of ≤2, 23/45 (51%) were diagnosed during an acute admission and 36/44 (82%) reported symptoms. Treatments were offered to 32/45 (71%); therapeutic bronchoscopy was performed in only 8/31 (26%) eligible patients. Median survival of patients with prevalent CAO was 94 (IQR 33–274) days. Multivariate analysis, adjusting for age, gender and disease stage, found CAO on index CT scan was independently associated with an increased hazard of death (adjusted HR 1.78 (95% CI 1.27 to 2.48); p=0.001). In total, 15/297 (5%) developed CAO during follow-up (median onset 340 (IQR 114–551) days). Over the audit period, 60/342 (18%; 95% CI 14% to 22%) had or developed CAO. Discussions This is the first description of CAO prevalence in 40 years. Patients with prevalent CAO had a higher mortality. Our data provide a benchmark for service planning.
Collapse
Affiliation(s)
- Cyrus Daneshvar
- Respiratory Medicine, Plymouth Hospitals NHS Trust, Plymouth, UK
| | | | - Mohammed Ahmed
- Interventional Respiratory Unit, Galway University Hospitals, Galway, Ireland
| | - Abdul Sibly
- Respiratory Medicine, Plymouth Hospitals NHS Trust, Plymouth, UK
| | - Madeleine Hindle
- Respiratory Medicine, Plymouth Hospitals NHS Trust, Plymouth, UK
| | | | - Ghanem Aldik
- Respiratory Medicine, Plymouth Hospitals NHS Trust, Plymouth, UK
| | - Lilanganee A Telisinghe
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Adrian Marchbank
- Cardiothoracic Surgery, Plymouth Hospitals NHS Trust, Plymouth, UK
| | - David Breen
- Respiratory, Galway University Hospital, Galway, Ireland
| |
Collapse
|
25
|
Velez MA, Burns TF, Stabile LP. The estrogen pathway as a modulator of response to immunotherapy. Immunotherapy 2019; 11:1161-1176. [PMID: 31361169 DOI: 10.2217/imt-2019-0024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Lung cancer is the leading cause of cancer deaths worldwide, with a 5-year survival rate of about 18%. Thus, there is a great need for novel therapeutic approaches to treat non-small-cell lung cancer (NSCLC). Immune checkpoint inhibitors (ICIs) have improved outcomes for a subset of patients, especially those with high programmed death-ligand 1 expression and/or high tumor mutational burden, but have failed in the majority of patients. Increasing evidence suggests that the estrogen signaling pathway may be a therapeutic target in metastatic NSCLC and that the estrogen pathway may play a role in sex-based responses to ICIs. This report will review the epidemiologic, preclinical and clinical data on the estrogen pathway in NSCLC, its implications in sex-based responses to ICIs and the potential use of antiestrogen therapy in combination with ICIs.
Collapse
Affiliation(s)
- Maria A Velez
- Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Timothy F Burns
- Department of Pharmacology & Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Medicine, Division of Hematology-Oncology, University of Pittsburgh, Pittsburgh, PA, USA.,UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Laura P Stabile
- Department of Pharmacology & Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA.,UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| |
Collapse
|
26
|
Zeng Q, Vogtmann E, Jia MM, Parascandola M, Li JB, Wu YL, Feng QF, Zou XN. Tobacco smoking and trends in histological subtypes of female lung cancer at the Cancer Hospital of the Chinese Academy of Medical Sciences over 13 years. Thorac Cancer 2019; 10:1717-1724. [PMID: 31293059 PMCID: PMC6669800 DOI: 10.1111/1759-7714.13141] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/20/2019] [Indexed: 01/06/2023] Open
Abstract
Background Lung cancer is the leading cause of cancer mortality among women in China, and incidence and mortality continue to rise despite the fact that smoking prevalence is very low among Chinese women. Aim This study investigated tobacco smoking and trends in histological subtypes of female lung cancer in a central cancer hospital in China. Methods Demographic, smoking history and histological information on female lung cancer patients diagnosed or treated from 2000 to 2012 was collected from the Cancer Hospital, Chinese Academy of Medical Science (CHCAMS). The classification of histological subtypes and clinical stages were conducted using the ICD‐O‐3 and Eighth AJCC Cancer Staging Manuals. Time‐trends of histological subtypes were analyzed based on annual percentage change (APC). Results Overall, 5870 female cases of lung cancer were included in the analysis. The number of female lung cancer patients increased from 509 (2000–2002) to 1744 (2011–2012). The most common histological type of lung cancer was adenocarcinoma (ADC) (72.93%), followed by small cell lung cancer (SCLC) (11.06%), squamous cell carcinoma (SCC) (8.38%) and other (7.63%). Among smokers, the proportion of SCC decreased from 40.5% to 23.7% (P = 0.005), while ADC increased from 35.7% to 50.7% (P = 0.009). In non‐smokers, ADC increased from 63.1% to 80.6% (P = 0.006) and SCC decreased from 13.6% to 4.5% (P = 0.016). Among SCC cases, smokers made up a larger proportion of early stage (I/II: 47.1%) compared with late stages (III, 34.3%; IV, 18.6%). Conclusion The number of female lung cancer patients has increased in CHCAMS. In both smoking and non‐smoking cases, the proportion of adenocarcinoma increased. Squamous cell carcinomas were more likely to be diagnosed in early stages among smokers.
Collapse
Affiliation(s)
- Qiang Zeng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Emily Vogtmann
- Metabolic Epidemiology Branch, National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA
| | - Man-Man Jia
- Department of Gynecological Oncology, Henan Cancer Hospital, Zhengzhou, China
| | - Mark Parascandola
- Tobacco Control Research Branch, National Cancer Institute Division of Cancer Control and Population Sciences, Bethesda, Maryland, USA
| | - Ji-Bin Li
- Office of Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan-Ling Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qin-Fu Feng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiao-Nong Zou
- Office of Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
27
|
Elmetwaly MMF, Emarah ZA, Abd Elhamied AEM, Hegazy MA, Kamel EA, Al-Wehedy AI. Morbidity Profile of Cases Attended Oncology Center of Mansoura University (OCMU), Egypt: A Cross-Sectional Study. Osong Public Health Res Perspect 2019; 10:177-186. [PMID: 31263667 PMCID: PMC6590881 DOI: 10.24171/j.phrp.2019.10.3.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives In Egypt, the National Cancer Registry Program integrates hospital-based data from multiple Egyptian governorates to obtain representative rates. Unfortunately, Dakahlia (one of the largest Egyptian governorates) was not integrated in the National Cancer Registry Program. This research aimed to acquire malignancy rates from the Oncology Center of Mansoura University, which is one of the two oncology centers present in Dakalia Governorate in Egypt. Methods Electronic records of patients who attended the Oncology Center of Mansoura University during 2016 were accessed with permission. Analysis was performed to extract diagnostic categories (age, gender, and geographic distribution of cases). Results Most commonly diagnosed malignancies were breast cancer which represented about 10% of cases in the Oncology Center of Mansoura University during 2016. This was followed by leukemia (3.80%), lymphoma (3.59%), and liver cancer (3.44%). Diagnoses encountered included benign and malignant tumors as well as non-tumor diagnoses. The Mansoura district had the highest proportionate rate of breast cancer cases. Females in the age group ≥ 35 < 60 years had the highest incidence of malignancy cases across all diagnoses. Conclusion The burden of breast cancer in Mansoura district is high. Risk factors need further evaluation with a recommendation to perform an environmental risk assessment.
Collapse
Affiliation(s)
- Miada M F Elmetwaly
- Department of Community Medicine and Public Health, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ziad A Emarah
- Department of Medical Oncology, Oncology Center of Mansoura University, Mansoura, Egypt
| | - Abd Elhamied M Abd Elhamied
- Department of Community Medicine and Public Health, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed A Hegazy
- Department of Surgical Oncology, Oncology Center of Mansoura University, Mansoura, Egypt
| | - Emily A Kamel
- Department of Community Medicine and Public Health, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Adel I Al-Wehedy
- Department of Community Medicine and Public Health, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| |
Collapse
|
28
|
Abstract
China is in the midst of a lung cancer epidemic on an unprecedented scale. In 2015, there were an estimated 733,000 new lung cancer cases (17% of total cancer incidence) and 610,000 deaths (21.7% of total cancer mortality) in China. Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer mortality in China. Tobacco smoke exposure is the primary factor driving current lung cancer trends. In 2015, smoking prevalence was 27.7% (52.1% among men and 2.7% among women). China has taken substantial steps to control tobacco use in recent years, including 19 cities implementing comprehensive smoke free laws and expansion of cessation services. However, significant challenges remain in order to meet the 2030 Healthy China goal of reducing smoking prevalence to 20%. In particular, ongoing attention is needed to continuing to control secondhand smoke exposure, to further enhance smoking cessation services, and to address novel alternative nicotine delivery devices (ANDS).
Collapse
Affiliation(s)
- Mark Parascandola
- Tobacco Control Research Branch, National Cancer Institute, Bethesda, MD, USA
| | - Lin Xiao
- Center for Disease Control and Prevention, Beijing 102206, China
| |
Collapse
|
29
|
Willén L, Berglund A, Bergström S, Bergqvist M, Öjdahl-Bodén A, Wagenius G, Lambe M. Educational level and management and outcomes in non-small cell lung cancer. A nationwide population-based study. Lung Cancer 2019; 131:40-46. [PMID: 31027696 DOI: 10.1016/j.lungcan.2019.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/25/2019] [Accepted: 03/06/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES We examined associations between educational level and clinical presentation, patterns of management and mortality in patients with non-small cell lung cancer (NSCLC) in Sweden, a country with a National Health Care System. MATERIALS AND METHODS We identified 39,671 patients with a NSCLC diagnosis 2002-2016 in Lung Cancer Data Base Sweden (LCBaSe), a population-based research database. In analyses adjusted for comorbidity and other prognostic factors, odds Ratios (OR) and hazard Ratios (HR) were estimated to examine associations between patients' educational level and aspects of management and mortality. RESULTS Stage at diagnosis and waiting times did not differ between educational groups. In multivariable analysis, the likelihood to undergo PET/CT and assessment in a multidisciplinary team setting were higher in patients with high compared to low education (aOR 1.14; CI 1.05-1.23 and aOR 1.22; CI 1.14-1.32, respectively). In patients with early stage IA-IIB disease, the likelihood to undergo stereotactic radiotherapy was elevated in patients with high education (aOR 1.40; CI 1.03-1.91). Both all-cause (aHR 0.86; CI 0.77-0.92) and cause-specific mortality (aHR 0.83; CI 0.74-0.92) was lower in patients with high compared to low education in early stage disease (IA-IIB). In higher stage NSCLC no differences were observed. Patterns were similar in separate assessments stratified by sex and histopathology. CONCLUSIONS While stage at diagnosis and waiting times did not differ between educational groups, we found socioeconomic differences in diagnostic intensity, multidisciplinary team assessment, stereotactic radiotherapy and mortality in patients with NSCLC. These findings may in part reflect social gradients in implementation and use of novel diagnostic and treatment modalities. Our findings underscore the need for improved adherence to national guidelines.
Collapse
Affiliation(s)
- Linda Willén
- Center for Research and Development, Uppsala University/Region Gävleborg, Sweden; Department of Radiation Sciences and Oncology, Umeå University Hospital, Umeå, Sweden; Department of Oncology, Gävle Hospital, Gävle, Sweden.
| | | | - Stefan Bergström
- Center for Research and Development, Uppsala University/Region Gävleborg, Sweden; Department of Oncology, Gävle Hospital, Gävle, Sweden
| | - Michael Bergqvist
- Center for Research and Development, Uppsala University/Region Gävleborg, Sweden; Department of Radiation Sciences and Oncology, Umeå University Hospital, Umeå, Sweden; Department of Oncology, Gävle Hospital, Gävle, Sweden
| | - Anna Öjdahl-Bodén
- Division of Respiratory Diseases, Department of Medical Sciences, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Gunnar Wagenius
- Division of Oncology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lambe
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Regional Cancer Center Uppsala Örebro, Uppsala, Sweden
| |
Collapse
|
30
|
Gao H, Niu Z, Zhang Z, Wu H, Xie Y, Yang Z, Li A, Jia Z, Zhang X. TNFSF15 promoter polymorphisms increase the susceptibility to small cell lung cancer: a case-control study. BMC MEDICAL GENETICS 2019; 20:29. [PMID: 30736740 PMCID: PMC6368786 DOI: 10.1186/s12881-019-0762-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 01/31/2019] [Indexed: 12/30/2022]
Abstract
Background Tumor necrosis factor superfamily member 15 (TNFSF15) is closely related to tumorigenesis and development. This study aimed to investigate the correlations between TNFSF15 polymorphisms and genetic susceptibility to lung cancer. Methods This case-control study included 209 small cell lung cancer patients (SCLC), 340 non- small cell lung cancer patients (NSCLC) and 460 health controls. TNFSF15–638 A > G and − 358 T > C polymorphisms were genotyped by polymerase chain reaction-restrictive fragment length polymorphism (PCR-RFLP) analysis. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated by unconditional logistic regression. Results Our results showed that subjects carrying the TNFSF15–638GG genotype or -358CC genotype were more likely to develop SCLC (−638GG, OR = 1.84, 95%CI = 1.13–2.99; -358CC, OR = 2.44, 95%CI = 1.46–4.06), but not NSCLC (P > 0.05). In stratified analysis, −638GG genotype was related to SCLC among males (OR = 1.95, 95%CI = 1.09–3.45, P = 0.023) and older patients (OR = 2.93, 95%CI = 1.44–8.68, P = 0.006). However, -358CC genotype was associated with SCLC among females (OR = 8.42, 95%CI = 2.22–31.89, P = 0.002) and older subjects with OR (95%CI) of 11.04 (3.57–34.15) (P < 0.001). Moreover, TNFSF15 -358CC was linked with a higher risk of SCLC among non-smokers (OR = 2.54, 95%CI = 1.20–5.35, P = 0.015) but not among smokers (OR = 1.88, 95%CI = 0.92–3.84, P = 0.086). Conclusion These findings highlight the importance of TNFSF15 polymorphisms in the development of SCLC.
Collapse
Affiliation(s)
- Hui Gao
- College of Life Science, North China University of Science and Technology, Tangshan, 063210, China.,School of Public Health, North China University of Science and Technology, Tangshan, 063210, China
| | - Zeren Niu
- College of Life Science, North China University of Science and Technology, Tangshan, 063210, China.,School of Public Health, North China University of Science and Technology, Tangshan, 063210, China
| | - Zhi Zhang
- Affliated Tangshan Gongren Hospital, North China University of Science and Technology, Tangshan, 063000, China
| | - Hongjiao Wu
- College of Life Science, North China University of Science and Technology, Tangshan, 063210, China
| | - Yuning Xie
- College of Life Science, North China University of Science and Technology, Tangshan, 063210, China.,School of Public Health, North China University of Science and Technology, Tangshan, 063210, China
| | - Zhenbang Yang
- School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, 063210, China
| | - Ang Li
- College of Life Science, North China University of Science and Technology, Tangshan, 063210, China.,School of Public Health, North China University of Science and Technology, Tangshan, 063210, China
| | - Zhenxian Jia
- College of Life Science, North China University of Science and Technology, Tangshan, 063210, China.,School of Public Health, North China University of Science and Technology, Tangshan, 063210, China
| | - Xuemei Zhang
- College of Life Science, North China University of Science and Technology, Tangshan, 063210, China.
| |
Collapse
|
31
|
Adjuvant Chemotherapy Improves Survival in Surgically Resected Stage IB Squamous Lung Cancer. Ann Thorac Surg 2018; 107:1683-1689. [PMID: 30468727 DOI: 10.1016/j.athoracsur.2018.10.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 09/25/2018] [Accepted: 10/01/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND At present there is a significant lack of clinical data for patients with surgically resected stage I squamous lung cancer. The purpose of this study was to investigate the impact of postoperative chemotherapy in this specific population. METHODS We retrospectively identified patients who had undergone complete squamous lung cancer resection at the Shanghai Chest Hospital between January 2008 and January 2014. RESULTS A total of 596 patients (236 stage IA, 360 stage IB) were included in this study. Results demonstrated that adjuvant chemotherapy (ACT) could provide longer overall survival for patients with p-stage IB disease (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.34-0.90; p = 0.017). Among p-stage IB patients the ACT-treated cohort trended toward a benefit (HR, 0.69; 95% CI, 0.45-1.04) in recurrence-free survival but failed to reach statistical significance (p = 0.076). After propensity score matching the HRs of recurrence-free survival and overall survival were 0.58 (95% CI, 0.35-0.96; p = 0.033) and 0.49 (95% CI, 0.27-0.88; p = 0.017), respectively. With regards to patients with p-stage IA disease, neither overall survival (HR, 0.87; 95% CI, 0.34-2.27; p = 0.783) nor recurrence-free survival (HR, 0.79; 95% CI, 0.38-1.65; p = 0.534) was significantly different when compared between patients receiving ACT and those who did not. Similar results were also achieved after propensity score matching. CONCLUSIONS The data presented herein demonstrated that ACT might provide survival benefits for squamous lung cancer patients with p-stage IB disease.
Collapse
|
32
|
Henley SJ, Gallaway S, Singh SD, O'Neil ME, Buchanan Lunsford N, Momin B, Richards TB. Lung Cancer Among Women in the United States. J Womens Health (Larchmt) 2018; 27:1307-1316. [PMID: 30312110 PMCID: PMC6546283 DOI: 10.1089/jwh.2018.7397] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
November marks Lung Cancer Awareness Month, and reminds us that lung cancer is the leading cause of cancer death among women in the United States. In this brief report, we highlight CDC resources that can be used to examine the most recent data on lung cancer incidence, survival, prevalence, and mortality among women. Using the U.S. Cancer Statistics Data Visualizations tool, we report that in 2015, 104,992 new cases of lung cancer and 70,073 lung cancer deaths were reported among women in the United States. The 5-year relative survival among females diagnosed with lung cancer was 22%, and as of 2015, ∼185,759 women were living with a lung cancer diagnosis. We also describe ways CDC works to collect and disseminate quality cancer surveillance data, prevent initiation of tobacco use, promote cessation, eliminate exposure to secondhand smoke, identify and eliminate disparities, promote lung cancer screening, and help cancer survivors live longer by improving health outcomes.
Collapse
Affiliation(s)
- S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Shayne Gallaway
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Simple D Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Mary Elizabeth O'Neil
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Behnoosh Momin
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Thomas B Richards
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| |
Collapse
|
33
|
Soeroso NN, Zain-Hamid R, Sinaga BYM, Sadewa AH, Syafiuddin T, Syahruddin E, Tann G, Mutiara E. Genetic Polymorphism of CYP2A6 and Its Relationship with Nicotine Metabolism in Male Bataknese Smokers Suffered from Lung Cancer in Indonesia. Open Access Maced J Med Sci 2018; 6:1199-1205. [PMID: 30087722 PMCID: PMC6062282 DOI: 10.3889/oamjms.2018.259] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/22/2018] [Accepted: 05/25/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cytochrome P450 2A6 (CYP2A6) is known as an enzyme which is responsible for the metabolism of chemical compounds. AIM This study aimed to analyse the relationship between CYP2A6 gene polymorphism with nicotine metabolism rates and lung cancer incidence among smokers of Batak ethnic group in Indonesia. METHODS This study was a case-control study involving 140 research subjects through a purposive sampling technique from three hospitals in Medan, Indonesia. An examination of nicotine metabolism rates was conducted for all subjects using the 3HC/cotinine ratio parameter with LC-MS/MS technique. The examination of the CYP2A6 gene was performed with PCR-RFLP. Data were analysed with Conditional Logistic Regression test using Epi Info 7.0 software. RESULTS The allele frequencies of CYP2A6*1A, CYP2A6*1B, and CYP2A6*4A found were 44.3%, 48.9%, and 6.8%, respectively. The *1B allele showed the highest metabolism rate. It is found that slow metabolizer individuals were 5.49 times more likely to develop lung cancer (P = 0.01, 95%CI 1.2-24.8). CONCLUSION Among the Bataknese smokers studied, the CYP2A6*1B allele was found to be the most common allele and showed the highest rate of nicotine metabolism. However, the results show the insignificant relationship among CYP2A6 genetic polymorphism, nicotine metabolism, and lung cancer incidence.
Collapse
Affiliation(s)
- Noni Novisari Soeroso
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| | - Rozaimah Zain-Hamid
- Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| | - Bintang Y M Sinaga
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| | - Ahmad Hamim Sadewa
- Department of Biochemistry, Faculty of Medicine, Gadjah Mada University, Jl. Farmako Sekip Utara, Yogyakarta 55281, Indonesia
| | - Tamsil Syafiuddin
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| | - Elisna Syahruddin
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jl. Persahabatan Raya No.1, Jakarta 13230, Indonesia
| | - Gino Tann
- Department of Clinical Pathology, Faculty of Medicine, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| | - Erna Mutiara
- Department of Biostatistics, Faculty of Public Health, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| |
Collapse
|
34
|
Pardos MC, Alvarez-Sala R, Terreros Caro FJ, Gómez L, Gómez de Terreros FJ, Villamor J. The Concentrations of Five Tumor Markers in Both Bal Fractions in Lung Cancer Patients in Relation to Cigarette Smoking. TUMORI JOURNAL 2018; 85:454-7. [PMID: 10774565 DOI: 10.1177/030089169908500606] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Lung cancer is the leading cause of death from cancer. Tobacco is related to the development of this type of tumor due to genetic alterations and to the secretion of certain biological markers. Bronchogenic carcinomas secrete a series of biological substances known as tumor markers. Some of these markers, such as carcinoembryonic antigen, neuron-specific enolase, tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and CYFRA 21.1, possess clear clinical value when analyzed in bronchoalveolar lavage (BAL) of patients with lung malignancies, particularly when they are analyzed in the two BAL fractions, bronchial (BF) and alveolar (AF), being more increased in the BF. For this reason, we intend to demonstrate that smokers with cancer secrete more biological substances in the BF and that the concentrations of these markers are higher in the BAL of smokers than in that of non-smokers. Methods The five aforementioned tumor markers were studied in the two BAL fractions of 52 lung cancer patients (46 smokers and 6 non-smokers). We performed BAL using 150 ml of 0.9% saline solution divided in three aliquots of 50 ml. The fluid obtained from the first 50 ml was the BF. The liquid from the other two aliquots was the AF. The five tumor marker concentrations were calculated in accord with the indications of the laboratory. Results The TPA and TPS levels in the BAL of lung cancer patients were more increased in the BF than in the AF, even when the patients were divided into smokers and non-smokers. When we compared smokers with non-smokers, the smokers had higher levels of TPS in the BF and of TPA in the AF. Conclusions Thus, we believe that the cellular alterations produced by tobacco are responsible for the secretion of these tumor markers.
Collapse
Affiliation(s)
- M C Pardos
- Pneumology services, La Paz Hospital, Complutense University, Madrid, Spain
| | | | | | | | | | | |
Collapse
|
35
|
Houston KA, Mitchell KA, King J, White A, Ryan BM. Histologic Lung Cancer Incidence Rates and Trends Vary by Race/Ethnicity and Residential County. J Thorac Oncol 2018; 13:497-509. [PMID: 29360512 PMCID: PMC5884169 DOI: 10.1016/j.jtho.2017.12.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/30/2017] [Accepted: 12/21/2017] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Lung cancer incidence is higher among non-Hispanic (NH) blacks than among the NH white and Hispanic populations in the United States. However, national cancer estimates may not always reflect the cancer burden in terms of disparities and incidence in small geographic areas, especially urban-rural disparities. Moreover, there is a gap in the literature regarding rural-urban disparities in terms of cancer histologic type. METHODS Using population-based cancer registry data-Surveillance, Epidemiology and End Results and National Program of Cancer Registries data-we present age-adjusted histologic rates and trends by race/ethnicity and residential county location at the time of first cancer diagnosis. Rate ratios were calculated to examine racial/ethnic differences in rates. Annual percent change was calculated to measure changes in rates over time. RESULTS We found that declines in squamous cell carcinoma are occurring fastest in metropolitan counties, whereas rates of adenocarcinoma increased fastest in counties nonadjacent to metropolitan areas. Further, although NH black men have increased lung cancer incidence compared with NH white and Hispanic men in all geographic locations, we found that the degree of the disparity increases with increasing rurality of residence. Finally, we discovered that among women whose lung cancer was diagnosed when they were younger than 55 years, the incidence of squamous cell carcinoma and adenocarcinoma was higher for NH blacks than for NH whites. CONCLUSIONS Our results highlight disparities among NH blacks in nonadjacent rural areas. These findings may have significant impact for the implementation of smoking cessation and lung cancer screening programs.
Collapse
Affiliation(s)
- Keisha A. Houston
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control
| | - Khadijah A. Mitchell
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD, 20892
| | - Jessica King
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control
| | - Arica White
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control
| | - Bríd M. Ryan
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD, 20892
| |
Collapse
|
36
|
Cheah YK, Teh CH, Lim HK. Factors associated with second-hand smoke awareness in Malaysia. PROCEEDINGS OF SINGAPORE HEALTHCARE 2017. [DOI: 10.1177/2010105817747627] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The proportion of people exposed to second-hand smoke increases dramatically with a sharp increase in the prevalence of smoking. It is expected that awareness of the effect of second-hand smoke plays an important role in curbing smoking. Objectives: The objective of this study is to examine factors affecting awareness of second-hand smoke in Malaysia. Methods: Nationally representative data, covering a large sample size (4153 respondents) and collected based on multistage sampling, are used. Multiple logistic regression is employed to analyse the effects of demographic and lifestyle variables on the likelihood of being aware of second-hand smoke. Results: Results show that older people are less likely to be aware of second-hand smoke than youngsters and that less-educated individuals are less likely to be aware of second-hand smoke than well-educated individuals. Significant relationships are found between second-hand smoke awareness and wealth index, ethnicity and smoking behaviour. Conclusion: Demographic profiles should be considered when drawing up policies aimed at improving awareness of second-hand smoke among adults. The government needs to focus more on older people, wealthy individuals, less-educated individuals, Chinese individuals and smokers if a successful policy is to be implemented.
Collapse
Affiliation(s)
- Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Malaysia
| | | | | |
Collapse
|
37
|
Sengupta D, Guha U, Bhattacharjee S, Sengupta M. Association of 12 polymorphic variants conferring genetic risk to lung cancer in Indian population: An extensive meta-analysis. ENVIRONMENTAL AND MOLECULAR MUTAGENESIS 2017; 58:688-700. [PMID: 29076184 DOI: 10.1002/em.22149] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 06/10/2017] [Accepted: 09/27/2017] [Indexed: 06/07/2023]
Abstract
Candidate gene as well as genome-wide association studies identified several polymorphic variants to be associated with lung cancer worldwide including in India. However, contradictory results have failed to estimate the overall effect of the polymorphic variants on the disease. Textmining was conducted on PubMed following specific search strings to gather all the publications related to genetic association with lung cancer in India. Out of 211 PubMed hits only 30 studies were selected for meta-analysis following specific inclusion criteria. Heterogeneity between studies was calculated by Cochran's Q-test (P < 0.05) and heterogeneity index (I2 ). Publication bias was visualized by funnel plots and Egger's regression test. For each variant, following a fixed-effect model, summary odds ratio (OR) along with 95% confidence interval (CI) was estimated. The meta-analysis revealed three polymorphic variants viz. 'deletion polymorphism (del1) (OR = 1.39, 95% CI = 1.03-1.87, P = 0.027) in GSTT1', 'deletion polymorphism (del2) (OR = 1.30, 95% CI = 1.01-1.67, P = 0.038) in GSTM1' and 'rs1048943 (OR = 1.98, 95% CI = 1.27-3.10, P = 0.002) in CYP1A1' to be associated with lung cancer. However, after multiple testing correction, only rs1048943 was found to be significantly associated (P value = 0.0321) with lung cancer. None of the polymorphic variants showed any evidence of heterogeneity between studies or of publication bias. Our meta-analysis revealed strong association of rs1048943 in CYP1A1, but a suggestive association of deletion polymorphisms in GSTT1 and GSTM1 with lung cancer, which provides a comprehensive insight on the overall effect of the polymorphic variants, reported in various case-control studies on Indian population, on the risk of lung cancer development. Environ. Mol. Mutagen. 58:688-700, 2017. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
| | - Udayan Guha
- Dept. of Genetics, University of Calcutta, Kolkata, India
| | | | | |
Collapse
|
38
|
Mehta N, Elo I, Stenholm S, Aromaa A, Heliövaara M, Koskinen S. International Differences in the Risk of Death from Smoking and Obesity: The Case of the United States and Finland. SSM Popul Health 2017; 3:141-152. [PMID: 28798949 PMCID: PMC5546741 DOI: 10.1016/j.ssmph.2016.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 10/31/2016] [Accepted: 12/06/2016] [Indexed: 11/17/2022] Open
Abstract
Despite much interest in the health risks associated with behavioral factors, little is known about whether individuals residing in different countries experience a different set of risks. International comparisons of the death risks from major behavioral factors can shed light on whether features of health systems and epidemiological histories modify the health effects of risky behaviors. We used nationally representative samples and mortality linkages spanning the 1971-2014 period from the United States and Finland to examine cross-national differences in the risks of death from cigarette smoking and obesity. We evaluated both current and former smoking and current and prior obesity. In 1990, the approximate midpoint of our study, the death risks from current smoking were about 55% higher in U.S. women compared to Finnish women, but similar for men in the two countries. Death risks from smoking significantly increased over the period for women in both countries and there was no parallel increase in risks among men. Death risks from obesity did not significantly differ in the two countries and no significant trend in the risks were detected in either country. Reasons for the relatively high and increasing risks from smoking among American women warrant further evaluation.
Collapse
Affiliation(s)
- Neil Mehta
- University of Michigan, Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
| | - Irma Elo
- University of Pennsylvania, Population Studies Center, Philadelphia, PA, USA
| | - Sari Stenholm
- University of Turku, Department of Public Health, Turku, Finland
- National Institute for Health and Welfare (THL), Department of Health, Functional Capacity and Welfare, Turku/Helsinki, Finland
| | - Arpo Aromaa
- National Institute for Health and Welfare (THL), Department of Health, Functional Capacity and Welfare, Turku/Helsinki, Finland
| | - Markku Heliövaara
- National Institute for Health and Welfare (THL), Department of Health, Functional Capacity and Welfare, Turku/Helsinki, Finland
| | - Seppo Koskinen
- National Institute for Health and Welfare (THL), Department of Health, Functional Capacity and Welfare, Turku/Helsinki, Finland
| |
Collapse
|
39
|
Twardella D, Geiss K, Radespiel-Tröger M, Benner A, Ficker JH, Meyer M. [Trends in incidence of lung cancer according to histological subtype among men and women in Germany : Analysis of cancer registry data with the application of multiple imputation techniques]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 61:20-31. [PMID: 29181809 DOI: 10.1007/s00103-017-2659-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Lung cancer can be described by histological subtype, of which small cell, squamous cell and adenocarcinoma are the most common. International data show that adenocarcinoma is becoming the dominant histological subtype of lung cancer although the relative risk due to smoking has been found to be smaller than that for other histological subtypes. OBJECTIVE The aim of the analysis was to describe the time trends in incidence of lung cancer among women and men in Germany according to histological subtype. MATERIALS AND METHODS All lung cancer cases (ICD-10 C33-C34) newly diagnosed between 2003 and 2012 and collected by the epidemiologic cancer registries of the German federal states with average completeness of registration of at least 90% were considered and grouped into histologic subtypes. If data on tumor histology were not microscopically verified or unspecific, multiple imputation techniques were applied to estimate the histologic subtype. RESULTS Among women age-standardized lung cancer rates increased considerably between 2003 and 2012 (annual percent change APC = 2.7%), mostly driven by a rising adenocarcinoma incidence (APC = 4.7%). Among men overall lung cancer rates decreased during the same time (APC = -1.7%). Still, a slight increase in adenocarcinoma incidence was also observed in men (APC = 1.0%). CONCLUSION The rising incidence of adenocarcinoma of the lung is alarming. The cancer registry data do not allow risk factor analysis. In the international discussion, the introduction of filter cigarettes as well as the changing composition of cigarettes has been hypothesized as being responsible. Further epidemiologic studies are strongly needed.
Collapse
Affiliation(s)
- Dorothee Twardella
- Zentrum für Krebsfrüherkennung und Krebsregistrierung, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Schweinauer Hauptstraße 80, 90441, Nürnberg, Deutschland.
| | - Karla Geiss
- Zentrum für Krebsfrüherkennung und Krebsregistrierung, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Schweinauer Hauptstraße 80, 90441, Nürnberg, Deutschland
| | - Martin Radespiel-Tröger
- Zentrum für Krebsfrüherkennung und Krebsregistrierung, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Schweinauer Hauptstraße 80, 90441, Nürnberg, Deutschland
| | - Axel Benner
- Abteilung Biostatistik, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - Joachim H Ficker
- Universitätsklinik für Innere Medizin 3, Schwerpunkt Pneumologie, Allergologie, Schlafmedizin, Klinikum Nürnberg/Paracelsus Medizinische Privatuniversität Nürnberg, Nürnberg, Deutschland
| | - Martin Meyer
- Zentrum für Krebsfrüherkennung und Krebsregistrierung, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Schweinauer Hauptstraße 80, 90441, Nürnberg, Deutschland
| |
Collapse
|
40
|
Qu LW, Zhou B, Wang GZ, Chen Y, Zhou GB. Genomic variations in paired normal controls for lung adenocarcinomas. Oncotarget 2017; 8:104113-104122. [PMID: 29262625 PMCID: PMC5732791 DOI: 10.18632/oncotarget.22020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 09/23/2017] [Indexed: 02/06/2023] Open
Abstract
Somatic genomic mutations in lung adenocarcinomas (LUADs) have been extensively dissected, but whether the counterpart normal lung tissues that are exposed to ambient air or tobacco smoke as the tumor tissues do, harbor genomic variations, remains unclear. Here, the genome of normal lung tissues and paired tumors of 11 patients with LUAD were sequenced, the genome sequences of counterpart normal controls (CNCs) and tumor tissues of 513 patients were downloaded from TCGA database and analyzed. In the initial screening, genomic alterations were identified in the "normal" lung tissues and verified by Sanger capillary sequencing. In CNCs of TCGA datasets, a mean of 0.2721 exonic variations/Mb and 5.2885 altered genes per sample were uncovered. The C:G→T:A transitions, a signature of tobacco carcinogen N-methyl-N-nitro-N-nitrosoguanidine, were the predominant nucleotide changes in CNCs. 16 genes had a variant rate of more than 2%, and CNC variations in MUC5B, ZXDB, PLIN4, CCDC144NL, CNTNAP3B, and CCDC180 were associated with poor prognosis whereas alterations in CHD3 and KRTAP5-5 were associated with favorable clinical outcome of the patients. This study identified the genomic alterations in CNC samples of LUADs, and further highlighted the DNA damage effect of tobacco on lung epithelial cells.
Collapse
Affiliation(s)
- Li-Wei Qu
- Division of Molecular Carcinogenesis and Targeted Therapy for Cancer, State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| | - Bo Zhou
- Division of Molecular Carcinogenesis and Targeted Therapy for Cancer, State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- University of the Chinese Academy of Sciences, Beijing 100049, China
| | - Gui-Zhen Wang
- Division of Molecular Carcinogenesis and Targeted Therapy for Cancer, State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| | - Ying Chen
- Division of Molecular Carcinogenesis and Targeted Therapy for Cancer, State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| | - Guang-Biao Zhou
- Division of Molecular Carcinogenesis and Targeted Therapy for Cancer, State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| |
Collapse
|
41
|
Lung Cancer in Patients With Tuberculous Fibrothorax and Empyema: Computed Tomography and 18F-Fluorodeoxyglucose Positron Emission Tomography Findings. J Comput Assist Tomogr 2017; 41:772-778. [PMID: 28448410 DOI: 10.1097/rct.0000000000000608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to describe the characteristics of lung cancers in patients with tuberculous fibrothorax or empyema. METHODS We retrospectively evaluated 138 consecutive patients with a diagnosis of lung cancer combined with fibrothorax (n = 127) or empyema (n = 11) from January 2005 to May 2015. All patients underwent computed tomography, and 105 underwent F-fluorodeoxyglucose positron emission tomography. Clinical, pathologic, and computed tomography characteristics and maximum standardized uptake values on positron emission tomography of 76 cancers ipsilateral to the fibrothorax or empyema (group 1) were compared with those of 62 contralateral cancers (group 2). RESULTS The median age at diagnosis of patients was 70 years, with a male-to-female ratio of 8.9:1. The most common type was squamous cell carcinoma (41.3%) followed by adenocarcinoma (39.1%). Most were in the peripheral lung (70.3%), and half abutted the pleura. The median maximum standardized uptake value was 8.9. Tumors in group 1 were larger (median, 48.5 vs 42.8 mm, P = 0.036) and more advanced (T3 or T4) (P = 0.014) than those in group 2. CONCLUSIONS Lung cancers ipsilateral to tuberculous fibrothorax or empyema presented larger and advanced T stages, and the diagnosis could be delayed. The most common type cancer was squamous cell carcinoma.
Collapse
|
42
|
Upregulation of CISD2 augments ROS homeostasis and contributes to tumorigenesis and poor prognosis of lung adenocarcinoma. Sci Rep 2017; 7:11893. [PMID: 28928421 PMCID: PMC5605537 DOI: 10.1038/s41598-017-12131-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 09/05/2017] [Indexed: 12/12/2022] Open
Abstract
CISD2 is a redox-sensitive gene critical for normal development and mitochondrial integrity. CISD2 was known to have aberrant expression in several types of human cancers. However, its relation with lung cancer is still not clear. In this study we found CISD2 mRNA was significantly upregulated in lung adenocarcinoma (ADC) samples, compared with their adjacent normal counterparts, and was correlated with tumor stage, grade, and prognosis based on analysis of clinical specimens-derived expression data in public domain and our validation assay. Cell based assay indicated that CISD2 expression regulated accumulation of reactive oxygen species (ROS), polarization of mitochondrial membrane potential, as well as cell viability, apoptosis, invasiveness, and tumorigenicity. In addition, CISD2 expression was found significantly correlated with stress response/redox signaling genes such as EGR1 and GPX3, while such correlations were also found valid in many public domain data. Taken together, upregulation of CISD2 is involved in an increased antioxidant capacity in response to elevated ROS levels during the formation and progression of lung ADC. The molecular mechanism underlying how CISD2 regulates ROS homeostasis and augments malignancy of lung cancer warrants further investigations.
Collapse
|
43
|
Song MA, Benowitz NL, Berman M, Brasky TM, Cummings KM, Hatsukami DK, Marian C, O'Connor R, Rees VW, Woroszylo C, Shields PG. Cigarette Filter Ventilation and its Relationship to Increasing Rates of Lung Adenocarcinoma. J Natl Cancer Inst 2017; 109:3836090. [PMID: 28525914 DOI: 10.1093/jnci/djx075] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 03/23/2017] [Indexed: 01/09/2023] Open
Abstract
The 2014 Surgeon General's Report on smoking and health concluded that changing cigarette designs have caused an increase in lung adenocarcinomas, implicating cigarette filter ventilation that lowers smoking machine tar yields. The Food and Drug Administration (FDA) now has the authority to regulate cigarette design if doing so would improve public health. To support a potential regulatory action, two weight-of-evidence reviews were applied for causally relating filter ventilation to lung adenocarcinoma. Published scientific literature (3284 citations) and internal tobacco company documents contributed to causation analysis evidence blocks and the identification of research gaps. Filter ventilation was adopted in the mid-1960s and was initially equated with making a cigarette safer. Since then, lung adenocarcinoma rates paradoxically increased relative to other lung cancer subtypes. Filter ventilation 1) alters tobacco combustion, increasing smoke toxicants; 2) allows for elasticity of use so that smokers inhale more smoke to maintain their nicotine intake; and 3) causes a false perception of lower health risk from "lighter" smoke. Seemingly not supportive of a causal relationship is that human exposure biomarker studies indicate no reduction in exposure, but these do not measure exposure in the lung or utilize known biomarkers of harm. Altered puffing and inhalation may make smoke available to lung cells prone to adenocarcinomas. The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers. Thus, the FDA should consider regulating its use, up to and including a ban. Herein, we propose a research agenda to support such an effort.
Collapse
Affiliation(s)
- Min-Ae Song
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Neal L Benowitz
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Micah Berman
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Theodore M Brasky
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - K Michael Cummings
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Dorothy K Hatsukami
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Catalin Marian
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Richard O'Connor
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Vaughan W Rees
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Casper Woroszylo
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| | - Peter G Shields
- Affiliations of authors: Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH (MAS, MB, TMB, CM, PGS); Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH (MAS, CW); Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics and Center for Tobacco Control Research and Education, University of California, San Francisco, CA (NLB); College of Public Health and Moritz College of Law, The Ohio State University, Columbus, OH (MB); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC (KMC); Tobacco Research Programs and Department of Psychiatry, University of Minnesota, Minneapolis, MN (DH); Biochemistry and Pharmacology Department, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania, (CM); Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY (RO); Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA (VWR)
| |
Collapse
|
44
|
Meyers TJ, Chang SC, Chang PY, Morgenstern H, Tashkin DP, Rao JY, Cozen W, Mack TM, Zhang ZF. Case-control study of cumulative cigarette tar exposure and lung and upper aerodigestive tract cancers. Int J Cancer 2017; 140:2040-2050. [PMID: 28164274 PMCID: PMC5552057 DOI: 10.1002/ijc.30632] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 01/04/2017] [Accepted: 01/13/2017] [Indexed: 11/11/2022]
Abstract
The development of comprehensive measures for tobacco exposure is crucial to specify effects on disease and inform public health policy. In this population-based case-control study, we evaluated the associations between cumulative lifetime cigarette tar exposure and cancers of the lung and upper aerodigestive tract (UADT). The study included 611 incident cases of lung cancer; 601 cases of UADT cancers (oropharyngeal, laryngeal and esophageal cancers); and 1,040 cancer-free controls. We estimated lifetime exposure to cigarette tar based on tar concentrations abstracted from government cigarette records and self-reported smoking histories derived from a standardized questionnaire. We analyzed the associations for cumulative tar exposure with lung and UADT cancer, overall and according to histological subtype. Cumulative tar exposure was highly correlated with pack-years among ever smoking controls (Pearson coefficient = 0.90). The adjusted odds ratio (95% confidence limits) for the estimated effect of about 1 kg increase in tar exposure (approximately the interquartile range in all controls) was 1.61 (1.50, 1.73) for lung cancer and 1.21 (1.13, 1.29) for UADT cancers. In general, tar exposure was more highly associated with small, squamous and large cell lung cancer than adenocarcinoma. With additional adjustment for pack-years, positive associations between tar and lung cancer were evident, particularly for small cell and large cell subtypes. Therefore, incorporating the composition of tobacco carcinogens in lifetime smoking exposure may improve lung cancer risk estimation. This study does not support the claim of a null or inverse association between "low exposure" to tobacco smoke and risk of these cancer types.
Collapse
Affiliation(s)
- Travis J. Meyers
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Shen-Chih Chang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Po-Yin Chang
- Division of Epidemiology, Department of Public Health Sciences, University of California, Davis School of Medicine, Davis, CA
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI
| | - Donald P. Tashkin
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Jian-Yu Rao
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA
- Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Wendy Cozen
- Departments of Preventive Medicine and Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Thomas M. Mack
- Departments of Preventive Medicine and Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA
- Healthy and At-Risk Populations Program, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA
| |
Collapse
|
45
|
Das A, Krishnamurthy A, Ramshankar V, Sagar TG, Swaminathan R. The increasing challenge of never smokers with adenocarcinoma lung: Need to look beyond tobacco exposure. Indian J Cancer 2017; 54:172-177. [PMID: 29199684 DOI: 10.4103/ijc.ijc_33_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Lung cancer continues to remain as one of the leading causes of morbidity and mortality worldwide, despite the decreasing trends in smoking prevalence worldwide. An earlier study from the authors' institute reported the increasing trends of "Nonsmoking associated lung cancers." MATERIALS AND METHODS All consecutive histologically confirmed patients with lung cancer who presented to the outpatient department over a year (November 2014-October 2015) were included in this current prospective study. RESULTS Seven hundred and thirteen patients presented with clinicoradiologically suspicious findings of lung cancer in the said period. A pathological confirmation of lung cancer could be ascertained in 495 patients, and this cohort was further analyzed. The mean age of presentation was 57.76 years; the male to female ratio was approximately 2.5:1. Interestingly, 55.35% of the patients were nonsmokers. Adenocarcinoma (63%) was the predominant histology. Never smokers, both among men (P = 0.02) and women (P = 0.001), presented more frequently with adenocarcinoma histology. Further, 84.9% (45/53) of rural and 76.1% (19/25) of urban women who were never smokers reported exposure to indoor air pollution (secondhand smoke/fuel used for cooking purposes) which was significantly associated with adenocarcinoma histology. CONCLUSION Our study confirmed our initial observation of the changing epidemiology of lung cancer in the Indian subcontinent, paralleling the global trends of rise in adenocarcinoma. Lung cancer in never smokers outnumbering that among smokers was another interesting observation. The take-home message for both the clinicians as well as the policymakers is to study factors beyond tobacco exposure to understand the direction of the current lung cancer epidemic.
Collapse
Affiliation(s)
- A Das
- Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - A Krishnamurthy
- Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - V Ramshankar
- Department of Preventive Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - T G Sagar
- Department of Medical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | - R Swaminathan
- Division of Epidemiology and Biostatistics, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| |
Collapse
|
46
|
Noone AM, Cronin KA, Altekruse SF, Howlader N, Lewis DR, Petkov VI, Penberthy L. Cancer Incidence and Survival Trends by Subtype Using Data from the Surveillance Epidemiology and End Results Program, 1992-2013. Cancer Epidemiol Biomarkers Prev 2016; 26:632-641. [PMID: 27956436 DOI: 10.1158/1055-9965.epi-16-0520] [Citation(s) in RCA: 261] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/18/2016] [Accepted: 11/22/2016] [Indexed: 12/12/2022] Open
Abstract
Background: Cancers are heterogeneous, comprising distinct tumor subtypes. Therefore, presenting the burden of cancer in the population and trends over time by these tumor subtypes is important to identify patterns and differences in the occurrence of these subtypes, especially to generalize findings to the U.S. general population.Methods: Using SEER Cancer Registry Data, we present incidence rates according to subtypes for diagnosis years (1992-2013) among men and women for five major cancer sites: breast (female only), esophagus, kidney and renal pelvis, lung and bronchus, and thyroid. We also describe estimates of 5-year relative survival according to subtypes and diagnosis year (1992-2008). We used Joinpoint models to identify years when incidence rate trends changed slope. Finally, recent 5-year age-adjusted incidence rates (2009-2013) are presented for each subtype by race and age.Results: Hormone receptor-positive and HER2-negative was the most common subtype (about 74%) of breast cancers. Adenocarcinoma made up about 69% of esophagus cases among men. Adenocarcinoma also is the most common lung subtype (43% in men and 52% in women). Ninety percent of thyroid subtypes were papillary. Distinct incidence and survival patterns emerged by these subtypes over time among men and women.Conclusions: Histologic or molecular subtype revealed different incidence and/or survival trends that are masked when cancer is considered as a single disease on the basis of anatomic site.Impact: Presenting incidence and survival trends by subtype, whenever possible, is critical to provide more detailed and meaningful data to patients, providers, and the public. Cancer Epidemiol Biomarkers Prev; 26(4); 632-41. ©2016 AACR.
Collapse
Affiliation(s)
- Anne-Michelle Noone
- Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, Bethesda, Maryland.
| | - Kathleen A Cronin
- Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, Bethesda, Maryland
| | - Sean F Altekruse
- Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, Bethesda, Maryland
| | - Nadia Howlader
- Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, Bethesda, Maryland
| | - Denise R Lewis
- Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, Bethesda, Maryland
| | - Valentina I Petkov
- Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, Bethesda, Maryland
| | - Lynne Penberthy
- Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute, Bethesda, Maryland
| |
Collapse
|
47
|
Wang A, Qin F, Hedlin H, Desai M, Chlebowski R, Gomez S, Eaton CB, Johnson KC, Qi L, Wactawski-Wende J, Womack C, Wakelee HA, Stefanick ML. Physical activity and sedentary behavior in relation to lung cancer incidence and mortality in older women: The Women's Health Initiative. Int J Cancer 2016; 139:2178-92. [PMID: 27439221 PMCID: PMC5501309 DOI: 10.1002/ijc.30281] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 06/10/2016] [Accepted: 06/20/2016] [Indexed: 01/02/2023]
Abstract
Physical activity has been associated with lower lung cancer incidence and mortality in several populations. We investigated these relationships in the Women's Health Initiative Observational Study (WHI-OS) and Clinical Trial (WHI-CT) prospective cohort of postmenopausal women. The WHI study enrolled 161,808 women aged 50-79 years between 1993 and 1998 at 40 U.S. clinical centers; 129,401 were eligible for these analyses. Cox proportional hazards models were used to assess the association of baseline physical activity levels [metabolic equivalent (MET)-min/week: none <100 (reference), low 100 to <500, medium 500 to <1,200, high 1,200+] and sedentary behavior with total lung cancer incidence and mortality. Over 11.8 mean follow-up years, 2,148 incident lung cancer cases and 1,365 lung cancer deaths were identified. Compared with no activity, higher physical activity levels at study entry were associated with lower lung cancer incidence [p = 0.009; hazard ratios (95% confidence intervals) for each physical activity category: low, HR: 0.86 (0.76-0.96); medium, HR: 0.82 (0.73-0.93); and high, HR: 0.90 (0.79-1.03)], and mortality [p < 0.0001; low, HR: 0.80 (0.69-0.92); medium, HR: 0.68 (0.59-0.80); and high, HR: 0.78 (0.66-0.93)]. Body mass index (BMI) modified the association with lung cancer incidence (p = 0.01), with a stronger association in women with BMI < 30 kg/m(2) . Significant associations with sedentary behavior were not observed. In analyses by lung cancer subtype, higher total physical activity levels were associated with lower lung cancer mortality for both overall NSCLC and adenocarcinoma. In conclusion, physical activity may be protective for lung cancer incidence and mortality in postmenopausal women, particularly in non-obese women.
Collapse
Affiliation(s)
- Ange Wang
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - FeiFei Qin
- Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA
| | - Haley Hedlin
- Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA
| | - Manisha Desai
- Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA
| | - Rowan Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
| | | | - Charles B Eaton
- Department of Family Medicine, Memorial Hospital of Rhode Island, and Department of Epidemiology, School of Public Health at Brown University, Providence, RI
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis, Davis, CA
| | - Jean Wactawski-Wende
- Department of Social and Preventive Medicine, University at Buffalo, Buffalo, NY
| | - Catherine Womack
- Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Heather A Wakelee
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Marcia L Stefanick
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA.
| |
Collapse
|
48
|
Cheng TYD, Cramb SM, Baade PD, Youlden DR, Nwogu C, Reid ME. The International Epidemiology of Lung Cancer: Latest Trends, Disparities, and Tumor Characteristics. J Thorac Oncol 2016; 11:1653-71. [PMID: 27364315 PMCID: PMC5512876 DOI: 10.1016/j.jtho.2016.05.021] [Citation(s) in RCA: 384] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 05/13/2016] [Accepted: 05/26/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Our aim was to update global lung cancer epidemiology and describe changing trends and disparities. METHODS We presented country-specific incidence and mortality from GLOBOCAN 2012 by region and socioeconomic factors via the Human Development Index (HDI). Between- and within-country incidence by histological type was analyzed by using International Agency for Research on Cancer data on cancer incidence on five continents. Trend analyses including data from the International Agency for Research on Cancer, cancer registries, and the WHO mortality database were conducted using joinpoint regression. Survival was compared between and within countries and by histological type. RESULTS In 2012, there were 1.82 and 1.59 million new lung cancer cases and deaths worldwide, respectively. Incidence was highest in countries with a very high HDI and lowest in countries with a low HDI (42.2 versus 7.9 in 100,000 for males and 21.8 versus 3.1 in 100,000 for females, respectively). In most countries with a very high HDI, as incidence in males decreased gradually (ranging from -0.3% in Spain to -2.5% in the United States each year), incidence in females continued to increase (with the increase ranging from 1.4% each year in Australia to 6.1% in recent years in Spain). Although histological type varied between countries, adenocarcinoma was more common than squamous cell carcinoma, particularly among females (e.g., in Chinese females, the adenocarcinoma-to-squamous cell carcinoma ratio was 6.6). Five-year relative survival varied from 2% (Libya) to 30% (Japan), with substantial within-country differences. CONCLUSIONS Lung cancer will continue to be a major health problem well through the first half of this century. Preventive strategies, particularly tobacco control, tailored to populations at highest risk are key to reducing the global burden of lung cancer.
Collapse
Affiliation(s)
- Ting-Yuan David Cheng
- Department of Cancer Prevention and Control, Roswell Park Cancer Institutes, Buffalo, New York
| | - Susanna M Cramb
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Peter D Baade
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Danny R Youlden
- Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
| | - Chukwumere Nwogu
- Department of Thoracic Surgery, Roswell Park Cancer Institutes, Buffalo, New York
| | - Mary E Reid
- Department of Medicine, Roswell Park Cancer Institutes, Buffalo, New York.
| |
Collapse
|
49
|
Denton EJ, Hart D, Wainer Z, Wright G, Russell PA, Conron M. Changing trends in diagnosis, staging, treatment and survival in lung cancer: comparison of three consecutive cohorts in an Australian lung cancer centre. Intern Med J 2016; 46:946-54. [DOI: 10.1111/imj.13132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 04/19/2016] [Accepted: 05/06/2016] [Indexed: 11/30/2022]
Affiliation(s)
- E. J. Denton
- Department of Respiratory and Sleep Medicine; St Vincent's Hospital Melbourne; Melbourne Victoria Australia
| | - D. Hart
- Department of Respiratory and Sleep Medicine; St Vincent's Hospital Melbourne; Melbourne Victoria Australia
| | - Z. Wainer
- Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | - G. Wright
- Department of Surgery; The University of Melbourne, St Vincent's Hospital Melbourne; Melbourne Victoria Australia
| | - P. A. Russell
- Department of Anatomical Pathology; The University of Melbourne, St Vincent's Hospital Melbourne; Melbourne Victoria Australia
| | - M. Conron
- Department of Respiratory and Sleep Medicine; St Vincent's Hospital Melbourne; Melbourne Victoria Australia
| |
Collapse
|
50
|
Lee PN, Forey BA, Coombs KJ, Lipowicz PJ, Appleton S. Time trends in never smokers in the relative frequency of the different histological types of lung cancer, in particular adenocarcinoma. Regul Toxicol Pharmacol 2016; 74:12-22. [DOI: 10.1016/j.yrtph.2015.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 11/12/2015] [Accepted: 11/23/2015] [Indexed: 02/07/2023]
|