Lung Cancer Death Rates in Lifelong Nonsmokers

Background: Few studies have directly measured the age-, sex-, and race-specific risks of lung cancer incidence and mortality among never tobacco smokers. Such data are needed to quantify the risks associated with smoking and to understand racial and sex disparities and temporal trends that are due...

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Bibliographic Details
Published in:JNCI : Journal of the National Cancer Institute 2006-05, Vol.98 (10), p.691-699
Main Authors: Thun, Michael J., Henley, S. Jane, Burns, David, Jemal, Ahmedin, Shanks, Thomas G., Calle, Eugenia E.
Format: Article
Language:English
Subjects:
Adult
African Americans - statistics & numerical data
Age Distribution
Aged
Aged, 80 and over
Biological and medical sciences
European Continental Ancestry Group - statistics & numerical data
Female
Gender
Humans
Incidence
Lung cancer
Lung Neoplasms - epidemiology
Lung Neoplasms - mortality
Male
Medical sciences
Middle Aged
Mortality
Mortality - trends
Pneumology
Poisson Distribution
Proportional Hazards Models
Race
Regression analysis
Risk factors
Sex Distribution
Smoking - adverse effects
Trends
Tumors
Tumors of the respiratory system and mediastinum
United States - epidemiology
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Summary:Background: Few studies have directly measured the age-, sex-, and race-specific risks of lung cancer incidence and mortality among never tobacco smokers. Such data are needed to quantify the risks associated with smoking and to understand racial and sex disparities and temporal trends that are due to factors other than active smoking. Methods: We measured age-, sex-, and race-specific rates (per 100 000 person-years at risk) of death from lung cancer among more than 940 000 adults who reported no history of smoking at enrollment in either of two large American Cancer Society Cancer Prevention Study cohorts during 1959–1972 (CPS-I) and 1982–2000 (CPS-II). We compared lung cancer death rates between men and women and between African Americans and whites and analyzed temporal trends in lung cancer death rates among never smokers across the two studies by using directly age-standardized rates as well as Poisson and Cox proportional hazards regression analyses. All statistical tests were two-sided. Results: The age-standardized lung cancer death rates among never-smoking men and women in CPS-II were 17.1 and 14.7 per 100 000 person-years, respectively. Men who had never smoked had higher age-standardized lung cancer death rates than women in both studies (CPS-I: hazard ratio [HR] = 1.52, 95% confidence interval [CI] = 1.28 to 1.79; CPS-II: HR = 1.21, 95% CI = 1.09 to 1.36). The rate was higher among African American women than white women in CPS-II (HR = 1.43, CI = 1.11 to 1.85). A small temporal increase (CPS-II versus CPS-I) in lung cancer mortality was seen for white women (HR = 1.25, CI = 1.12 to 1.41) and African American women (HR = 1.22, CI = 0.64 to 2.33), but not for white men (HR = 0.89, CI = 0.74 to 1.08). Among white and African American women combined, the temporal increase was statistically significant only among those aged 70–84 years (P
ISSN:0027-8874
1460-2105
DOI:10.1093/jnci/djj187