400 Abstracts/Lung Cancer 10 (1994) 395-430

stxdifferences ialung+ancerriskawciatedwithcigar&exmoking Osaae KE, Anton-Culver H. Kumsaki T, Taylor T. Clinical Cuncer Center, 3758 Med. Surge II, University of Caljfornia. Irvine. CA 92717. lnt J Cancer 199354&l-8.

The importance of cigarette smokieg as a risk factor for specific histologic types of lung cancer in men and women has been examined in a case-control analysis of data from the Cancer Surveillauce Program of Omnge County, a population-based registry. Smoking habits wen abstracted Born medical mcords for 1153 man and 833 women diagnosed withprimary lungcancerin 19841986and 1851 menand 1656women aged 30 or older diagnosed with cancers not associated with smoking. Ninety-six percent of men and 89% of women with lung cancer were current or former smokers, as compared with 55 % of men and 34 I of women with other cancers. The age and ethnicity-adjutcd odds ratio (OR) forever-smokingwere 19.7 formenand 150forwomen. Menand women who smoked 2 or more packs per day experienced nwly equal risks. Comparison of the most common cell types showed that women smokers had equal or lower ORs for squamous-cell carcinoma and adenocarcinoma, but higher OR For small-cell carcinoma, as compared with men smokers. While the smoking-associated GR were equal for small-cell and squamous-cell carcinomas in men. the OR for women were significantly higher for small-cell carcinoma than for squamous- cell carcinoma.

Risk of mcsothelioma after environmmtal exposure to asbestos De Klerk NH, Musk AW, Eccles JL. Armstrong BK, Hobbs MST. Dept. of Public Heakh, University of Western Australia. Nedlanak, WA 6009. Eur Respir Rev 1993;3: 108-10.

The risks of contracting the three main asbestos-related diseases. malignant mesotbelioma of the pleura and peritoneum. lung cancer and

subject of much study but are still imprecisely known. The studies clearly indicate. however, that the larger the amount of asbestos to which one is exposed, the greater the probability of contracting these diseases. There has also been a great variation in risks of the different diseases depending on both the type ofasbestos and the process in which it is being used. The associations between other cancers and exposure to asbestos are still speculative. The risks of contracting mesothelioma Fromrnvironmentalexposurealonearesubjcct toeven more imprecision due to small numbers of cases and poor qualitative and quantitative exposure data. In addition, it has only been possible to estimate these risks by extrapolation from risk models derived from occupational data. Based on studies of the workforce of the Wittenoom crocidolite industry, where axposure was only to crocidolite. various similar models relating exposure and disesse have been estimated. Together with recent surveys of levels of libres, both in schools built from Western Australian asbestos-ccmentproducts (which contain substantial amounts of crocidolite) and in the general environment. risks of mesothelioma From environmcotal exposure to crocidolitc asbestos are Found to be, at most, < 1 per million person-years. In comparison, risks from past occupational exposure arc at present up to _5.000- 10,000 times higher.

Lung cancer pattems in Switzerland: A search forgeogmphicul and occupational patterm Schuller C, Bopp M, Schuler D. Cantonal CancerRegimy, Institute of Pathology, University of Zurich. CH-8091 Zurich. Public Health Rev 1991;1992;19:163-78.

Simple descriptive methods (geographical correlation, variance and covatianca analysis; gradients of mortality by quantiles; proportionate ratio methods) have been used to chamcrerixe the distribution patterns of lung cancer in Switrerland since 1969: Geographical patterns. In

males, the temporo-spatial disttibutionofhmgcancer mortality indicates that male smoking bacame prevalent earlier in the comubations than in the countryside. The culturolinguistic gap between the German and Frencb/Italian-spc&ng parts is mitrorcd by higher lung cancer rates in the latter. For female lung cancer the urban-rural gradient overshadows differences between the linguistic regions. Occupational patterns. The consistency of occupationally associated lung cancer risks within Switzerland is remarkable, even in small occupational groups with only a Few deaths, and parallels the patterns known From international statistics. An analysis of lung cancer incidence within the Zurich cancer registry by histological types reveals the same consistent patterns with high risks in blue-collar trades.

Lung cancer’s persistent association with population density in Los Angeki County nwnmtitics Goldsmith JR. Epidemiology Unit. Facully of Health Sciences, Ben- Gm’on University of the Negev. P. 0. B. 653, Beer Sheva 84120. Public Health Rev 1991;1992;19:147-61.

investigated in an ecologic study, using as the dependent variable age- adjusted lung cancer in both sexes, 1970 (CA); independent variables arc: population denisty (PD). 46 white (Anglo) (WH). 96 Spanish surname (SP), % black (BL), 96 Oriental (OR), mean income percapita (IN), 46 of dwelling units with 1 + persons/room (CR), 46 annoyed by air pollution 1956 (AP), and male/female population ages 55-64 (M/F). Except for CA and AP all data are from 1970 census, compiled by John Chapman and Anne Coulson. Variables given in percent except For AP are arcsine transformed in order to more closely approximate Gaussian normality. AP is approximately normal already. The association of CA with AP is negative and small. and inclusion of other variables and structures never leads to an interesting or significant association. PositiveassociationswithCAarewithPD (r = 0.3OO)and WH(0.228). M/F has the high& negative association with CA (-0.285). and is positively associated with WH (0.273)and lN(0.388). M/F hasastrong negative association with PD (-0.549). CR is negatively associated with CA (-0.173). In testing for the independent contribution of PD, we use the strategy of tesing whether divergent methods give convergent results. Path analysis is used to reflect a numberofstiuctural assumptions among independent variables, and the association oFCA and PD remains consistent and positive. After recoding the vanables PD. WH, SP, BL. OR, IN, and CR into Five classes of 20 and one of 19, a multiple classification analysis (MCA) is perform& using MF as a continuous co-variable. Although the unadjusted PD has a slightly greater eta than the other variables, WH and IN have a larger beta after adjustment. and the multiple R is similar to that found by path analysis, reflecting explained variance ofabout 0.5. The deviations of PD. CR, and BL are not monotonic but those oFWH and IN are. Analysis is repeated For the 20 communities with highest IN and For the 20 with lowest IN, and the correlations (r) of CA with PD are 0.561 and 0.376 respectively. For the 20 communities with highest proportion SP. the association is a non- significant 0.108, for the 20 with highest BL, it is 0.196 and for the the 40 highest WH. the CA association with PD is 0.772. Data for the 40 most white communities arc presented in a path analysis. Smoking, unevaluated in this study, is the most important determinant of lung cancer risk, and smoking is usually more prevalent in persons with lower income and education. The stable and substantial associations of PD and CA especially among whites. by these divergent methods. with their different assumptions, are difficult to explain on any other basis than the importance of population density. Along with other studies, this suggests population density makes an independent contribution to the epidemiology of lung cancer. Such methods as these would be suitable For other ecological analyses.