title: Lung cancer risk in white and black Americans.
abstract: OBJECTIVE
  To test whether differences in smoking-related lung cancer risks in blacks and whites can explain why lung cancer incidence is greater in black males than in white males but about equal in black and white females, given that a greater proportion of blacks are smokers, but smoke far fewer cigarettes per day than do whites.
  
  
  METHODS
  A hospital-based case-control study was conducted between 1984 and 1998 that included interviews with 1,710 white male and 1,321 white female cases of histologically confirmed lung cancer, 254 black male and 163 black female cases, and 8,151 controls. Relative risks were estimated via odds ratios using logistic regression, adjusted for age, education, and body mass index.
  
  
  RESULTS
  We confirmed prior reports that smoking prevalence is higher but overall dosage is lower among blacks. Overall ORs were similar for blacks and whites, except among the heaviest smoking males (21+ cigarettes per day or 37.5 pack-years), in whom ORs for blacks were considerably greater than for whites. Long-term benefits of cessation were similar for white and black ex-smokers. Smokers of menthol flavored cigarettes were at no greater risk for lung cancer than were smokers of unflavored brands.
  
  
  CONCLUSIONS
  Lung cancer risks were similar for whites and blacks with similar smoking habits, except possibly for blacks who were very heavy smokers; this sub-group is unusual in the general population of African American smokers. Explanations of racial disparities in lung cancer risk may need to account for modifying factors including type of cigarette (yield, mentholation), diet, occupation, and host factors such as ability to metabolize mainstream smoke carcinogens.
authors.affiliation: American Health Foundation, One Dana Road, Valhalla, NY 10595, USA. sds91@columbia.edu
authors.forename: Steven D
authors.initials: SD
authors.lastname: Stellman
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Muscat
authors.forename: Mirjana V
authors.initials: MV
authors.lastname: Djordjevic
authors.forename: John P
authors.initials: JP
authors.lastname: Richie
authors.forename: Philip
authors.initials: P
authors.lastname: Lazarus
authors.forename: Seth
authors.initials: S
authors.lastname: Thompson
authors.forename: Nasser
authors.initials: N
authors.lastname: Altorki
authors.forename: Marianne
authors.initials: M
authors.lastname: Berwick
authors.forename: Marc L
authors.initials: ML
authors.lastname: Citron
authors.forename: Susan
authors.initials: S
authors.lastname: Harlap
authors.forename: Tajinder B
authors.initials: TB
authors.lastname: Kaur
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.forename: Sara
authors.initials: S
authors.lastname: Olson
authors.forename: John M
authors.initials: JM
authors.lastname: Travaline
authors.forename: Philip
authors.initials: P
authors.lastname: Witorsch
authors.forename: Zuo-Feng
authors.initials: ZF
authors.lastname: Zhang
mesh_terms: D001741:Black or African American; D015992:Body Mass Index; D004522:Educational Status; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking; D012923:Social Class; D014481:United States / Q000453:epidemiology; D044465:White People