PURPOSE: To identify predictors for major lung cancer cell types.
METHODS: Cohort study of 126,293 persons, who supplied baseline data from 1978 - 1985 and were followed until 2008. We studied incident lung cancer using tumor registry diagnoses of 1852 persons and performed Cox proportional hazards models with 8 covariates, yielding hazard ratios (HR) and 95% confidence intervals (CI). Data presented here pertain to the 3 main types (adenocarcinoma, squamous cell, and small cell), with adjusted HRs shown for the weakest and strongest associations.
RESULTS: As expected, heavy cigarette smoking (≥1 pack per day versus never smoked) was a powerful predictor (p<0.0001) of all types, with a HR range from 13.9 for adenocarcinoma to 62.7 for squamous cell cancers. Other HR ranges included: Male/female from 1.1 (adenocarcinoma, p>0.05) to 2.0 (squamous, p<0.001); Black/White from 0.8 (small, p<0.05) to 1.7 (squamous, p<0.001); Asian/White from 0.8 (small, p>0.05) to 1.4 (adenocarcinoma, p>0.05; Hispanic/White from 0.4 (squamous, p<0.05) to 1.0 (adenocarcinoma); heavy alcohol intake (≥ 3 drinks per day versus never) from 1.0 (squamous) to 1.5 (adenocarcinoma, p<0.01). College graduation (versus no college) and BMI > 30 kg/m2 (versus < 25) had similar inverse relationships (p<0.001) to all cell types. There were 2 noteworthy sex disparities: 1) Asian women had HR of 1.8 versus Whites for adenocarcinoma (p<0.01) and 2.2 for squamous cell lesions (p<0.05), 2) heavy alcohol intake in women had a HR of 2.2 for adenocarcinoma (p<0.001).
CONCLUSIONS: We conclude that there are important disparities in risk factors for the major specific lung cancer cell types.
CLINICAL IMPLICATIONS: Lung cell cancer disparities reflect biological differences in subject susceptibility and in the nature of the tumors, which may ultimately lead to changes in prognosis and therapy.
DISCLOSURE: The following authors have nothing to disclose: H. Nicole Tran, Stanton Siu, Yan Li, David Baer, Natalia Udaltsova, Arthur Klatsky
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