Residential Radon Exposure and Cigarette Smoking in Association with Lung Cancer: A Matched Case-Control Study in Korea

• Published in: International journal of environmental research and public health 2020-04, Vol.17 (8), p.2946
• Main Authors: Park, Eung Joo, Lee, Hokyou, Kim, Hyeon Chang, Sheen, Seung Soo, Koh, Sang Baek, Park, Ki Soo, Cho, Nam Han, Lee, Cheol-Min, Kang, Dae Ryong
• Format: Article
• Language: English
• Subjects: Aged; Air Pollution, Indoor; Carcinoma, Non-Small-Cell Lung - epidemiology; Case-Control Studies; Cigarette Smoking; Cigarettes; Confidence intervals; Environmental Exposure; Epidemiology; Exposure; Female; Health risk assessment; Health risks; Hospitals; Housing; Humans; Lung cancer; Lung Neoplasms - epidemiology; Male; Middle Aged; Neoplasms, Radiation-Induced; Non-small cell lung carcinoma; Radon; Republic of Korea - epidemiology; Risk analysis; Risk Factors; Smoking; Statistical analysis; Studies; Tobacco smoke
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph17082946

Residential radon exposure and cigarette smoking are the two most important risk factors for lung cancer. The combined effects thereof were evaluated in a multi-center matched case-control study in South Korea. A total of 1038 participants were included, comprising 519 non-small cell lung cancer cases and 519 age- and sex- matched community-based controls. Residential radon levels were measured for all participants. Multivariate logistic regression was used to calculate odds ratios (OR) for lung cancer according to radon exposure (high ≥ 100 Bq/m vs. low < 100 Bq/m ), smoking status, and combinations of the two after adjusting for age, sex, indoor hours, and other housing information. The median age of the participants was 64 years, and 51.3% were women. The adjusted ORs (95% confidence intervals [CIs]) for high radon and cigarette smoking were 1.56 (1.03-2.37) and 2.53 (1.60-3.99), respectively. When stratified according to combinations of radon exposure and smoking status, the adjusted ORs (95% CIs) for lung cancer in high-radon non-smokers, low-radon smokers, and high-radon smokers were 1.40 (0.81-2.43), 2.42 (1.49-3.92), and 4.27 (2.14-8.52), respectively, with reference to low-radon non-smokers. Both residential radon and cigarette smoking were associated with increased odds for lung cancer, and the difference in ORs according to radon exposure was much greater in smokers than in non-smokers.