Journal of Preventive Medicine and Public Health

Original Articles

Lung Cancer Screening With Low-dose Chest Computed Tomography: Experience From Radon-contaminated Regions in Kazakhstan: Alexandra Panina, Dilyara Kaidarova, Zhamilya Zholdybay, Akmaral Ainakulova, Jandos Amankulov, Dias Toleshbayev, Zhanar Zhakenova, Arman Khozhayev; J Prev Med Public Health. 2022;55(3):273-279. Published online April 14, 2022; DOI: https://doi.org/10.3961/jpmph.21.600

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Objectives
The aim of this study was to present the baseline results of a pilot project conducted to evaluate the effectiveness of lung cancer screening using low-dose chest computed tomography (CT) in regions with excessive radon levels in the Republic of Kazakhstan.
Methods
In total, 3671 participants were screened by low-dose chest CT. Current, former, and never-smokers who resided in regions with elevated levels of radon in drinking water sources and indoor air, aged between 40 and 75 with no history of any cancer, and weighing less than 140 kg were included in the study. All lung nodules were categorized according to the American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS 1.0).
Results
Overall, 614 (16.7%) participants had positive baseline CT findings (Lung-RADS categories 3 and 4). Seventy-four cancers were detected, yielding an overall cancer detection rate of 2.0%, with 10.8% (8/74) stage I and a predominance of stage III (59.4%; 44/74). Women never-smokers and men current smokers had the highest cancer detection rates, at 2.9% (12/412) and 6.1% (12/196), respectively. Compared to never-smokers, higher odds ratios (ORs) of lung cancer detection were found in smokers (OR,2.48; 95% confidence interval [CI], 1.52 to 4.05, p<0.001) and former smokers (OR, 2.32; 95% CI, 1.06 to 5.06, p=0.003). The most common histologic type of cancer was adenocarcinoma (58.1%).
Conclusions
Implementation of low-dose CT screening for lung cancer in regions with elevated radon levels is an effective method for both smokers and never-smokers.

Summary

Citations

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Lung cancer screening for never smokers: current evidence and future directions
Kay Choong See
Singapore Medical Journal.2024;[Epub] CrossRef
Secondary prevention and treatment innovation of early stage non-small cell lung cancer: Impact on diagnostic-therapeutic pathway from a multidisciplinary perspective
Giulia Pasello, Daniela Scattolin, Laura Bonanno, Francesca Caumo, Andrea Dell'Amore, Elena Scagliori, Mariaenrica Tinè, Fiorella Calabrese, Gaetano Benati, Matteo Sepulcri, Cristina Baiocchi, Michele Milella, Federico Rea, Valentina Guarneri
Cancer Treatment Reviews.2023; 116: 102544. CrossRef
Performance of Lung-RADS in different target populations: a systematic review and meta-analysis
Yifei Mao, Jiali Cai, Marjolein A. Heuvelmans, Rozemarijn Vliegenthart, Harry J. M. Groen, Matthijs Oudkerk, Marleen Vonder, Monique D. Dorrius, Geertruida H. de Bock
European Radiology.2023; 34(3): 1877. CrossRef

Association Between Angiotensin II Receptor Blockers and the Risk of Lung Cancer Among Patients With Hypertension From the Korean National Health Insurance Service-National Health Screening Cohort: Sungji Moon, Hae-Young Lee, Jieun Jang, Sue K. Park; J Prev Med Public Health. 2020;53(6):476-486. Published online November 3, 2020; DOI: https://doi.org/10.3961/jpmph.20.405

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Abstract PDF Supplementary Material

Objectives
The objective of this study was to estimate the risk of lung cancer in relation to angiotensin II receptor blocker (ARB) use among patients with hypertension from the Korean National Health Insurance Service-National Health Screening Cohort. Methods: We conducted a retrospective cohort study of patients with hypertension who started to take antihypertensive medications and had a treatment period of at least 6 months. We calculated the weighted hazard ratios (HRs) and their 95% confidence intervals (CIs) of lung cancer associated with ARB use compared with calcium channel blocker (CCB) use using inverse probability treatment weighting. Results: Among a total of 60 469 subjects with a median follow-up time of 7.8 years, 476 cases of lung cancer were identified. ARB use had a protective effect on lung cancer compared with CCB use (HR, 0.75; 95% CI, 0.59 to 0.96). Consistent findings were found in analyses considering patients who changed or discontinued their medication (HR, 0.50; 95% CI, 0.32 to 0.77), as well as for women (HR, 0.56; 95% CI, 0.34 to 0.93), patients without chronic obstructive pulmonary disease (HR, 0.75; 95% CI, 0.56 to 1.00), never-smokers (HR, 0.64; 95% CI, 0.42 to 0.99), and non-drinkers (HR, 0.69; 95% CI, 0.49 to 0.97). In analyses with different comparison antihypertensive medications, the overall protective effects of ARBs on lung cancer risk remained consistent. Conclusions: The results of the present study suggest that ARBs could decrease the risk of lung cancer. More evidence is needed to establish the causal effect of ARBs on the incidence of lung cancer.

Summary

Citations

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Ayako Maeda-Minami, Masayuki Takagi, Yasunari Mano, Hideki Ishikawa, Yutaka Matsuyama, Michihiro Mutoh
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Angiotensin Receptor Blocker Associated with a Decreased Risk of Lung Cancer: An Updated Meta-Analysis
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Medicine.2023; 102(36): e34901. CrossRef
Angiotensin-Converting Enzyme Inhibitors or Angiotensin Receptor Blockers and Cancer Risk: An Updated Meta-Analysis of Observational Studies
Kayeong Shin, Jiwoo Yang, Yeuni Yu, Eunjeong Son, Kihun Kim, Yun Hak Kim
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Brief Report

Estimating the Survival of Patients With Lung Cancer: What Is the Best Statistical Model?: Siavosh Abedi, Ghasem Janbabaei, Mahdi Afshari, Mahmood Moosazadeh, Masoumeh Rashidi Alashti, Akbar Hedayatizadeh-Omran, Reza Alizadeh-Navaei, Ehsan Abedini; J Prev Med Public Health. 2019;52(2):140-144. Published online February 18, 2019; DOI: https://doi.org/10.3961/jpmph.17.090

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Abstract PDF

Objectives
Investigating the survival of patients with cancer is vitally necessary for controlling the disease and for assessing treatment methods. This study aimed to compare various statistical models of survival and to determine the survival rate and its related factors among patients suffering from lung cancer.
Methods
In this retrospective cohort, the cumulative survival rate, median survival time, and factors associated with the survival of lung cancer patients were estimated using Cox, Weibull, exponential, and Gompertz regression models. Kaplan-Meier tables and the log-rank test were also used to analyze the survival of patients in different subgroups.
Results
Of 102 patients with lung cancer, 74.5% were male. During the follow-up period, 80.4% died. The incidence rate of death among patients was estimated as 3.9 (95% confidence [CI], 3.1 to 4.8) per 100 person-months. The 5-year survival rate for all patients, males, females, patients with non-small cell lung carcinoma (NSCLC), and patients with small cell lung carcinoma (SCLC) was 17%, 13%, 29%, 21%, and 0%, respectively. The median survival time for all patients, males, females, those with NSCLC, and those with SCLC was 12.7 months, 12.0 months, 16.0 months, 16.0 months, and 6.0 months, respectively. Multivariate analyses indicated that the hazard ratios (95% CIs) for male sex, age, and SCLC were 0.56 (0.33 to 0.93), 1.03 (1.01 to 1.05), and 2.91 (1.71 to 4.95), respectively.
Conclusions
Our results showed that the exponential model was the most precise. This model identified age, sex, and type of cancer as factors that predicted survival in patients with lung cancer.

Summary

Citations

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Slavisa Tubin, Mohammad K. Khan, Seema Gupta, Branislav Jeremic
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Review

Hormonal Replacement Therapy and the Risk of Lung Cancer in Women: An Adaptive Meta-analysis of Cohort Studies: Jong-Myon Bae, Eun Hee Kim; J Prev Med Public Health. 2015;48(6):280-286. Published online November 9, 2015; DOI: https://doi.org/10.3961/jpmph.15.054

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Abstract PDF

Objectives
Approximately 10% to 15% of lung cancer cases occur in never-smokers. Hormonal factors have been suggested to lead to an elevated risk of lung cancer in women. This systematic review (SR) aimed to investigate the association between hormonal replacement therapy (HRT) and the risk of lung cancer in women using cohort studies.
Methods
We first obtained previous SR articles on this topic. Based on these studies we made a list of refereed, cited, and related articles using the PubMed and Scopus databases. All cohort studies that evaluated the relative risk of HRT exposure on lung cancer occurrence in women were selected. Estimate of summary effect size (sES) with 95% confidence intervals (CIs) were calculated.
Results
A total of 14 cohort studies were finally selected. A random effect model was applied due to heterogeneity (I-squared, 64.3%). The sES of the 14 articles evaluating the impact of HRT exposure on lung cancer occurrence in women indicated no statistically significant increase in lung cancer risk (sES, 0.99; 95% CI, 0.90 to 1.09).
Conclusions
These results showed that HRT history had no effect on the risk of lung cancer in women, even though the sES of case-control studies described in previous SR articles indicated that HRT had a protective effect against lung cancer. It is necessary to conduct a pooled analysis of cohort studies.

Summary

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Original Articles

Exposure to Cerium Oxide Nanoparticles Is Associated With Activation of Mitogen-activated Protein Kinases Signaling and Apoptosis in Rat Lungs: Kevin M. Rice, Siva K. Nalabotu, Nandini D.P.K. Manne, Madhukar B. Kolli, Geeta Nandyala, Ravikumar Arvapalli, Jane Y. Ma, Eric R. Blough; J Prev Med Public Health. 2015;48(3):132-141. Published online May 18, 2015; DOI: https://doi.org/10.3961/jpmph.15.006

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Abstract PDF

Objectives
With recent advances in nanoparticle manufacturing and applications, potential exposure to nanoparticles in various settings is becoming increasing likely. No investigation has yet been performed to assess whether respiratory tract exposure to cerium oxide (CeO₂) nanoparticles is associated with alterations in protein signaling, inflammation, and apoptosis in rat lungs.
Methods
Specific-pathogen-free male Sprague-Dawley rats were instilled with either vehicle (saline) or CeO₂ nanoparticles at a dosage of 7.0 mg/kg and euthanized 1, 3, 14, 28, 56, or 90 days after exposure. Lung tissues were collected and evaluated for the expression of proteins associated with inflammation and cellular apoptosis.
Results
No change in lung weight was detected over the course of the study; however, cerium accumulation in the lungs, gross histological changes, an increased Bax to Bcl-2 ratio, elevated cleaved caspase-3 protein levels, increased phosphorylation of p38 MAPK, and diminished phosphorylation of ERK-1/2-MAPK were detected after CeO₂ instillation (p<0.05).
Conclusions
Taken together, these data suggest that high-dose respiratory exposure to CeO₂ nanoparticles is associated with lung inflammation, the activation of signaling protein kinases, and cellular apoptosis, which may be indicative of a long-term localized inflammatory response.

Summary

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Minghao Wang, Lailai Yan, Siqi Dou, Liu Yang, Yiwen Zhang, Wenzhong Huang, Shanshan Li, Peng Lu, Yuming Guo
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Xiaoying He, Ting Yuan, Xinying Jiang, Hui Yang, Chun Li Zheng
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Mohammed Junaid Hussain Dowlath, Sathish Kumar Karuppannan, Pamela Sinha, Nihala Sultana Dowlath, Kantha Deivi Arunachalam, B. Ravindran, S. Woong Chang, Phuong Nguyen-Tri, D. Duc Nguyen
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Gaurang Patel, Chayan Patra, S. P. Srinivas, Mamta Kumawat, P. N. Navya, Hemant Kumar Daima
Environmental Chemistry Letters.2021; 19(6): 4253. CrossRef
Biocompatible dextran-coated gadolinium-doped cerium oxide nanoparticles as MRI contrast agents with high T1 relaxivity and selective cytotoxicity to cancer cells
A. L. Popov, M. A. Abakumov, I. V. Savintseva, A. M. Ermakov, N. R. Popova, O. S. Ivanova, D. D. Kolmanovich, A. E. Baranchikov, V. K. Ivanov
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Association Between MicroRNA196a2 rs11614913 Genotypes and the Risk of Non-Small Cell Lung Cancer in Korean Population: Young-Seoub Hong, Ho-Jin Kang, Jong-Young Kwak, Byung Lae Park, Chang-Hun You, Yu-Mi Kim, Heon Kim; J Prev Med Public Health. 2011;44(3):125-130. Published online May 17, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.3.125

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Abstract PDF

Objectives

The microRNA (miRNA) miR-196a2 may play an important role in lung cancer development and survival by altering binding activity of target mRNA. In this study, we evaluated their associations with the susceptibility of non-small cell lung cancers (NSCLC) by case-control study in a Korean population.

Methods

We performed genotyping analyses for miR-196a2 rs11614913 T/C at miRNA regions in a case-control study using blood samples of 406 NSCLC patient and 428 cancer-free control groups.

Results

The total C allele frequencies for miR-196a2 were 48.8% for the patients and 45.6% for the controls; and the genotype frequencies of TT, TC, and CC were 23.7%, 55.2%, and 21.1% for the patients and 31.1%, 46.35%, and 22.4% for the controls (p<0.05). Participants who possesses TC/CC genotypes showed high risk for NSCLC compared to those possessed TT genotypes (OR, 1.42; 95% CI, 1.03 to 1.96). The association was persisted in 60 and older age group, male, smokers, those without family history for cancer. However, no significant association of CC genotypes in recessive genetic model was observed.

Conclusions

In conclusion, this case-control study provides evidence that miR-196a2 rs11614913 C/T polymorphisms are associated with a significantly increased risk of NSCLC in a dominant model, indicating that common genetic polymorphisms in miR-196a2 rs11614913 are associated with NSCLC. The association of miR196a2 rs11614913 polymorphisms and NSCLC risk require confirmation through additional larger studies.

Summary

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The Mechanism of Iron Transport after Intratracheal Instillation of Iron in Rats.: Min Kwon, Byung Sun Choi, Eon Sub Park, Nam Hyun Chung, Sungjo Park, Young Lim, Jung Duck Park; J Prev Med Public Health. 2004;37(4):329-336. Published online November 30, 2004

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Abstract PDF: OBJECTIVES
Iron (Fe) is an essential element in biological processes; however excessive Fe is harmful to human health. Some air pollutants contain a high level of Fe, and the human lung could therefore be over-exposed to Fe through inhaled air pollutants. This study was performed to investigate the role of metal transporters (divalent metal transporter 1, DMT1, and metal transporter protein 1, MTP1) in the lung under the environments of Fe deficiency in the body and Fe over-exposure in the lung. METHODS: Rats were fed Fe deficient (FeD, 2-6 mg Fe/kg) or Fe supplemented (FeS, 120 mg Fe/kg) diet for 4 weeks, followed by a single intratracheal instillation of ferrous sulfate at low (10 mg/kg) or high (20 mg/kg) dose. Fe concentration was analyzed in the serum, lung and liver, and histopathological findings were observed in the lung at 24 hours after Fe administration. The level of DMT1 and MTP1 expression in the lung was analyzed by RT-PCR. Also, the effect of Fe deficiency in the body was evaluated on the level of Fe concentration and metal transporters compared to FeS-diet fed rats at the end of 4-week FeD or FeS diet. RESULTS: The 4-week FeD diet in rats induced an Fe deficiency anemia with decreased serum total Fe, increased unsaturated Fe binding capacity and hypochromic microcytic red blood cells. The concentration of Fe in the lung and liver was lower in the FeD-diet fed rats than in the FeS-diet fed rats. The level of metal transporters mRNA expression was higher in the FeD-diet fed rats than in the FeS-diet. The concentration of Fe in the lung was increased in a dose-dependent pattern after intratracheal instillation of Fe into the rats, while the level of Fe in the serum and liver was not increased in the low-dose Fe administered rats. Therefore, DMT1 and MTP1 mRNA was highly expressed in both FeD-diet and FeS-diet fed rats, after intratracheal instillation of Fe. CONCLUSIONS: DMT1 and MTP1 mRNA were more highly expressed in FeD-diet fed rats than in FeS-diet fed rats. The over-exposure of Fe intratracheally induced high expression of metal transporters and increased Fe deposition in the lung in both FeD-diet and FeS-diet fed rats, but did not increase the Fe level of the serum and liver in low-dose Fe administered rats. These results suggest that the role of metal transporters in the lung might be different in a part from the duodenum under the environment of over-exposure to Fe.; Summary

Editorial

Association Between Green Tea Consumption and Lung Cancer Risk.: Andy H Lee, Wenbin Liang, Fumi Hirayama, Colin W Binns; J Prev Med Public Health. 2010;43(4):366-367.; DOI: https://doi.org/10.3961/jpmph.2010.43.4.366

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Abstract PDF

Green tea is a popular beverage and its health benefits are well known. However, inconsistent results have been reported in observational studies concerning the association between green tea consumption and the lung cancer risk. In this commentary, several methodological issues underlying the measurement of tea exposure are highlighted. The recommendations should be useful for designing and planning prospective cohort studies to ascertain the protective effect of green tea against lung cancer.

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English Abstract

Ten Year Trend of Cancer Incidence in Seoul, Korea: 1993-2002.: Myung Hee Shin, Hyun Kyung Oh, Yoon Ok Ahn; J Prev Med Public Health. 2008;41(2):92-99.; DOI: https://doi.org/10.3961/jpmph.2008.41.2.92

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Abstract PDF

OBJECTIVES
Effective cancer prevention and control measures can only be done when dependable data on the cancer incidence is available. The Seoul Cancer Registry (SCR) was founded to provide valid, comparable and representative cancer incidence data for Koreans. We aimed to compare the cancer incidence in the first (1993-1997) and second term (1998-2002) of the SCR, and we analyzed the annual incidence trend during that 10 years. METHODS: The SCR detects potential cancer cases through the Korean Central Cancer Registry (KCCR) data, the health insurance claims, the individual hospital's discharge records and the death certificates. About 87% of the SCR data is registered through the KCCR. The rest of the data is registered by SCR registrars who visit about 70~80 mid-sized hospitals in Seoul to review and abstract the medical records of the potential cancer patients. RESULTS: The total number of new cancer cases was higher in 1998~2002 than in 1993~1997 by 20.6% for men and 18.4% for women, respectively. The age-standardized rate (ASR) of total cancer per 100,000 increased 1% (from 295.4 to 298.3) for men and 5.1% (from 181.5 to 190.7) for women, between the two periods. The commonest cancer sites during 1998-2002 for men were stomach, liver, bronchus/lung, colorectum, bladder and prostate, and the commonest cancer sites for women were breast, stomach, colorectum, cervix uteri, thyroid and bronchus/lung. Compared with the ASRs in 1993, the ASRs in 2002 increased for colorectum (58.4% for men, 27.1% for women), prostate (81.5%), breast (58.3% for women), thyroid (141% for women), and bronchus/lung (15.4% for women). The ASRs for stomach (-18.7% for men, -20.7% for women) and uterine cervix cancer (-39.7%) had decreased. CONCLUSIONS: The cancer incidence is increasing in Seoul, Korea, especially for the colorectum and prostate for men, and for the breast, colorectum, bronchus/lung and thyroid for women.

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Multicenter Study

Cigarette Smoking, Alcohol Consumption, Tuberculosis and Risk of Lung Cancer: The Korean Multi-center Cancer Cohort Study.: Jisuk Bae, Jin Gwack, Sue Kyung Park, Hai Rim Shin, Soung Hoon Chang, Keun Young Yoo; J Prev Med Public Health. 2007;40(4):321-328.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.321

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Abstract PDF

OBJECTIVES
The aim of this study was to evaluate the roles of cigarette smoking, alcohol consumption, tuberculosis, and their interactions in the risk of lung cancer in a Korean cohort. METHODS: The study subjects comprised 13,150 males and females aged above 20 years old. During the follow up period from 1993 to 2002, 79 lung cancer cases were identified by the central cancer registry and the national death certificate database. Information on cigarette smoking, alcohol consumption and the history of physiciandiagnosed tuberculosis was obtained by interview. Indirect chest X-ray findings were also evaluated to ascertain tuberculosis cases. Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) after adjusting for age and gender. RESULTS: Cigarette smoking was statistically significantly associated with an increased risk of lung cancer [for current smokers, RR = 2.33 (95% CI = 1.23 - 4.42) compared to non-smokers]. After further adjustment for cigarette smoking, both alcohol consumption and tuberculosis showed no statistically significant association with the risk of lung cancer [for current drinkers, RR = 0.80 (95% CI = 0.48 - 1.33) compared to non-drinkers] [for tuberculosis cases, RR = 1.17 (95% CI = 0.58 - 2.36) compared to noncases]. There was no statistically significant interaction between cigarette smoking and alcohol consumption (pinteraction = 0.38), or cigarette smoking and tuberculosis (p-interaction = 0.74). CONCLUSIONS: Although cigarette smoking was confirmed as a risk factor of lung cancer in this cohort study, this study suggests that alcohol consumption and tuberculosis may not be associated with the risk of lung cancer.

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English Abstract

Spatial Analysis of Air Pollution and Lung Cancer Incidence and Mortality in 7 Metropolitan Cities in Korea. .: Seung Sik Hwang, Jin Hee Lee, Gyu Won Jung, Jeong Hun Lim, Ho Jang Kwon; J Prev Med Public Health. 2007;40(3):233-238.; DOI: https://doi.org/10.3961/jpmph.2007.40.3.233

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Abstract PDF

OBJECTIVES
We aimed to assess the relationship between long-term exposure to air pollution and lung cancer in the Republic of Korea. METHODS: Using the Annual Report of Ambient Air Quality in Korea, Annual Report of National Cancer Registration, and Annual Report on the Cause of Death Statistics, we calculated the standardized mortality ratio (SMR) and standardized incidence ratio (SIR) of lung cancer for both sexes in 74 areas from 7 Korean metropolitan cities. We performed random intercept, Poisson regression using empirical Bayes method. RESULTS: Both SMRs and SIRs in the 7 metropolitan cities were higher in women than in men. Mean SIRs were 99.0 for males and 107.0 for females. The association between PM(10) and lung cancer risk differed according to gender. PM(10) was not associated with the risk of lung cancer in males, but both incidence and mortality of lung cancer were positively associated with PM(10) in females. The estimated percentage increases in the rate of female lung cancer mortality and incidence were 27% and 65% at the highest PM(10) category (> or = 70 microgram/m(3)), compared to the referent category (<50 microgram/m(3)). CONCLUSIONS: Long-term exposure to PM(10) was significantly associated with female lung cancer incidence in 7 Korean metropolitan cities. Further study is undergoing to estimate the relative risk of PM(10) using multi-level analysis for controlling individual and regional confounders such as smoking and socioeconomic position.

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Original Articles

Therapeutic Compliance and Its Related Factors of Lung Cancer Patients.: Si Hyun Nam, Sin Kam, Jae Yong Park, Sang Chul Chae, Moon Seob Bae, Moo Chul Shin, Min Hae Yeh; Korean J Prev Med. 2002;35(1):13-23.

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Abstract PDF: OBJECTIVES
To investigate the therapeutic compliance and its related factors in lung cancer patients. METHODS: The subjects of this study comprised 277 patients first diagnosed with lung cancer at Kyungpook National University Hospital between Jan 1999 and Sept 1999. Of these, 141 (50.9%) participated in the study by properly replying to structured questionnaires. The data was analyzed using a simplified Health Decision Model. This model includes categories of variables covering therapeutic compliance, health beliefs, patient preferences, knowledge and experience, social interaction, sociodemographic and clinical characteristics. RESULTS: The therapeutic compliance rate of the 141 study subjects was 78.0%. An analysis of health beliefs and patient preferences revealed health concern (p<0.05), dependency on medicine (p<0.05), perceived susceptibility and severity (p<0.05) as well as preferred treatment (p<0.01) as factors related to therapeutic compliance. Factors from the sociodemographic characteristics and clinical factors that were related to therapeutic compliance were age (p<0.01), monthly income (p<0.05), histological type (p<0.05) and clinical stage (p<0.05) of cancer. CONCLUSIONS: In order to improve therapeutic compliance in lung cancer patients it is necessary to educate the aged, low-income patients, or patients who have small cell lung cancer or lung cancer of an advanced stage for which surgery is not indicated. Additionally, it is essential for medical personnel to have a deep concern about patients who have poor lifestyles, a low dependency on medicine, or a high perceived susceptibility and severity. Practically, early diagnosis of lung cancer and thoughtful considerations of low-income patients are important. By means of population-based education in a community, we may promote attention to health and enhance the early diagnosis of lung cancer.; Summary

Asbestos and Non-Asbestos Fiber Content in Lungs of Autopsied Subjects in Pohang with no Known History of Occupational Asbestos Exposure.: Hyun Sul Lim, Ji Yong Kim, Dong Hoon Kim, Kiyoshi Sakai, Naomi Hisanaga; Korean J Prev Med. 2000;33(4):477-483.

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Abstract PDF: OBJECTIVES
To obtain reference values for the pulmonary asbestos and non-asbestos fiber contents of residents in Korea and to compare them with similar results from Japan. METHODS: The autopsied lung specimens from 22 deceased people (20 males and 2 females) in Pohang, without any known occupational history of asbestos exposure, were analyzed for incidence of asbestos and non-asbestos fibers by transmission electron microscopy with energy dispersive X-ray analysis after using low temperature ashing procedures. RESULTS: Chrysotile fiber (46.2%) was the major fiber type found in the lungs of the subjects. The asbestos fiber concentrations found in males and females were 0.09x106 fibers/(g of dry lungs) and 0.30x106 fibers/(g of dry lungs), respectively, showing a geometric mean concentration 0.09x106 fibers/(g of dry lung tissue), due to the predominance of males in the sample. The non-asbestos fiber contents in males and females were 4.61x106 fibers/(g of dry lungs) and 17.79x106 fibers/(g of dry lungs), respectively, with a geometric mean concentration 5.21x106 fibers/(g of dry lung tissue). CONCLUSIONS: Residents in Pohang had significantly lower levels of both asbestos and non-asbestos fibers than urban residents in Korea. Furthermore, Koreans had significantly lower levels of both asbestos and non-asbestos fibers than Japanese.; Summary

Understanding the Occurrence of Lung Cancer in Foundry Workers through Health Insurance Data .: Yeon Soon Ahn, Jae Seok Song, Seong Kyu Kang, Ho Keun Chung; Korean J Prev Med. 2000;33(3):299-305.

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Abstract PDF: CONCLUSIONS: To investigate the difference in the occurrence of lung cancer between foundry workers and non-foundry workers by comparing the number of workers diagnosed with lung cancer through health insurance data. METHODS: The study population was comprised of 28,884 workers who had undergone at least one general or special medical examination between January 1995 and December 1997 at the occupational health center. All of the subjects had health insurance during this period. We combined the medical examination data with the health insurance data to compare the number of foundry workers diagnosed with lung cancer and the number of non-foundry workers diagnosed with lung cancer. RESULTS: Seven workers were diagnosed with lung cancer among the 1,591 foundry workers, compared to twelve workers among the 27,293 non-foundry workers (odds ratio: 10.04, 95% confidence interval: 3.95-25.55). The seven foundry workers diagnosed with lung cancer were all exposed to dust, and six out these seven workers were engaged in finishing or shake-out processes. CONCLUSIONS: Although the information for this study was obtained from health insurance data, which has limitations such as accuracy and completeness, the number of foundry workers diagnosed with lung cancer was significantly higher than that of non-foundry workers. Therefore, a well-designed cohort study should be followed to confirm the higher lung cancer rates in foundry workers.; Summary

A Case-Control Study on Effects of Genetic Polymorphisms of GSTM1, GSTT1, CYP1A1 and CYP2E1 on Risk of Lung Cancer.: Hong Mei Nan, Heon Kim, Jong Won Kang, Jang Whan Bae, Kang Hyeon Choe, Ki Hyeong Lee, Seung Taik Kim, Choong Hee Won, Yong Min Kim; Korean J Prev Med. 1999;32(2):123-129.

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Abstract PDF: OBJECTIVES
This study was performed to investigate effects of genetic polymorphisms of glutathione S-transferase M1 (GSTM1), glutathione S-transferase M1 (GSTT1), cytochrome P450 1A1 (CYP1A1) and cytochrome P450 2E1 (CYP2E1) on lung cancer development. METHODS: Ninety-eight lung cancer patients and 98 age-sex matched non-cancer patients hospitalized in Chungbuk National University Hospital from March 1997 to August 1998, were the subjects of this case-control study. Direct interview was done and genotypes of GSTM1, GSTT1, CYP1A1 and CYP2E1 were investigated using multiplex PCR or PCR-RFLP methods with DNA extracted from venous blood. Effects of the polymorphisms of GSTM1, GSTT1, CYP1A1 and CYP2E1, lifestyle factors including smoking, and their interactions on lung cancer were statistically analyzed. RESULTS: GSTM1 was deleted in 67.01% of the cases and 58.16% of the controls, and the odds ratio(95% CI) was 1.46(0.82-2.62). GSTT1 deletion was 58.76% for the lung cancer patients and 50.00% for the controls OR:1.43(0.81-2.51). The frequencies of Ile/Ile, Ile/Val and Val/Val of the CYP1A1 polymorphisms were 59.18%, 35.71%, and 5.10% for the cases, and 52.04%, 45.92%, 2.04% for the controls, respectively. Risk of lung cancer was not associated with polymorphism of CYP1A1 (x2trend=0.253, p-value>0.05). The respective frequency of c1/c1, c1/c2, c2/c2 genotypes for CYP2E1 were 50.00%, 42.86%, 7.14% for the lung cancer patients, and 66.33%, 30.61%, 3.06% for the controls (x2trend=5.783, p<0.05). c2 allele was a significant risk factor for lung cancer. We also observed a significant association of cigarette smoking history with lung cancer risk. The odds ratio(95% CI) of cigarette smoking was 3.03(1.58-5.81). In multiple logistic analysis including genotypes of GSTM1, GSTT1, CYP1A1 and CYP2E1, and smoking habit, only smoking habit came out to be a significant risk factor for lung cancer. CONCLUSION: Genetic polymorphisms of GSTM1, GSTT1, CYP1A1 and CYP2E1 are not so strongly associated with lung cancer as lifestyle factors including cigarette smoking.; Summary

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