title: Risk factors differ for non-small-cell lung cancers with and without EGFR mutation: assessment of smoking and sex by a case-control study in Japanese.
abstract: The present study aimed to assess the impact of smoking and sex for the risk of non-small-cell lung cancer (NSCLC) with or without epidermal growth factor receptor (EGFR) mutation. We conducted a case-control study using 152 patients with EGFR-mutated (EGFRmut) NSCLC, 283 with EGFR-wild-type (EGFRwt) NSCLC and 2175 age- and sex-frequency-matched controls. Smoking was a significant risk factor for EGFRwt NSCLC (odds ratio [OR] for ever-smokers, 4.05; 95% confidence interval [CI], 2.79-5.88) but not for EGFRmut NSCLC (OR, 0.73; CI, 0.46-1.14). Sex did not affect this association. The association was observed consistently with other smoking-related parameters including pack-years. Sex was the sole risk factor for EGFRmut NSCLC (OR for women relative to men, 2.19; CI, 1.41-3.39) and there was no significant interaction between women and smoking. In contrast, sex, smoking and their interaction were significant in EGFRwt NSCLC. The impact of sex on EGFR mutation status was assessed by several indicators of reproductive history among women. Total fertile years showed a significant positive association with EGFRmut NSCLC but not with EGFRwt NSCLC. Other indicators showed similar trends and this result may partly explain the sexual difference in the acquisition of EGFR mutation. In conclusion, our case-control study clearly demonstrated that the impacts of smoking and sex on the risk of EGFRmut NSCLC are different from those for EGFRwt NSCLC. Further epidemiological evaluation is warranted.
authors.affiliation: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan. kmatsuo@aichi-cc.jp
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.forename: Hidemi
authors.initials: H
authors.lastname: Ito
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yatabe
authors.forename: Akio
authors.initials: A
authors.lastname: Hiraki
authors.forename: Kaoru
authors.initials: K
authors.lastname: Hirose
authors.forename: Kenji
authors.initials: K
authors.lastname: Wakai
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kosaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tajima
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mitsudomi
mesh_terms: D000368:Aged; D044466:Asian People; D002289:Carcinoma, Non-Small-Cell Lung / Q000209:etiology / Q000235:genetics* / Q000473:pathology*; D016022:Case-Control Studies; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000235:genetics* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*
chemical_list: D066246:ErbB Receptors