Relationships between lung adenocarcinoma and gender, age, smoking and occupational risk factors: A case-case study.
BACKGROUND
The hypothesis that some risk factors for lung cancer may have more specific associations with particular histologic types remains controversial. The aim of this study was to investigate possible associations between adenocarcinoma and gender, age, smoking characteristics and selected occupational carcinogens in relation to other histologic types.


METHODS
This study included all histologically confirmed lung cancer cases diagnosed consecutively in two French University hospitals from 1997 to 2006. All medical data were obtained by face-to-face patient interviews. Occupational carcinogen exposures of each patient were assessed by an industrial hygienist. Relationships between risk factors and adenocarcinoma were analyzed by case-case comparisons using unconditional logistic regressions (ULRs).


RESULTS
A total of 1493 subjects were enrolled in this study, comprising 1303 men (87.3%), 67 nonsmokers (4.5%) and 489 adenocarcinomas (32.7%). Using ULR, no associations were observed between adenocarcinoma and age, gender or smoking characteristics except for a negative relationship with smoking duration (p<0.0001). Significant associations were observed between ADC and exposure to welding fumes and silica in the whole population and with polycyclic aromatic hydrocarbons in ever smokers.


CONCLUSIONS
This study demonstrated that some risk factors, such as duration of smoking and certain occupational exposures but not gender or age, have a more important influence on the incidence of lung ADC than on other histologic types. As the distribution of histologic types may reflect underlying biological mechanisms, these findings also suggest that lung carcinogenesis pathways should be studied in relation to smoking duration and other lung cancer risk factors.
Paris
C
C
INSERM U954, 54505 Vandoeuvre Les Nancy, France. christophe.paris@nancy.inserm.fr
Clement-Duchene
C
C
Vignaud
J M
JM
Gislard
A
A
Stoufflet
A
A
Bertrand
O
O
Thiberville
L
L
Grosdidier
G
G
Martinet
Y
Y
Benichou
J
J
Hainaut
P
P
D000230:Adenocarcinoma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D011084:Polycyclic Aromatic Hydrocarbons / Q000009:adverse effects; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D014896:Welding
D011084:Polycyclic Aromatic Hydrocarbons