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. 2019 Aug 1;111(8):811-819.
doi: 10.1093/jnci/djy206.

Racial/Ethnic Differences in Lung Cancer Incidence in the Multiethnic Cohort Study: An Update

Daniel O Stram  1 , S Lani Park  1 , Christopher A Haiman  1 , Sharon E Murphy  1 , Yesha Patel  1 , Stephen S Hecht  1 , Loic Le Marchand  1
Affiliations

Racial/Ethnic Differences in Lung Cancer Incidence in the Multiethnic Cohort Study: An Update

Daniel O Stram et al. J Natl Cancer Inst. .

Abstract

Background: We previously found that African Americans and Native Hawaiians were at highest lung cancer risk compared with Japanese Americans and Latinos; whites were midway in risk. These differences were more evident at relatively low levels of smoking intensity, fewer than 20 cigarettes per day (CPD), than at higher intensity.

Methods: We apportioned lung cancer risk into three parts: age-specific background risk (among never smokers), an excess relative risk term for cumulative smoking, and modifiers of the smoking effect: race and years-quit smoking. We also explored the effect of replacing self-reports of CPD with a urinary biomarker-total nicotine equivalents-using data from a urinary biomarker substudy.

Results: Total lung cancers increased from 1979 to 4993 compared to earlier analysis. Estimated excess relative risks for lung cancer due to smoking for 50 years at 10 CPD (25 pack-years) ranged from 21.9 (95% CI = 18.0 to 25.8) for Native Hawaiians to 8.0 (95% CI = 6.6 to 9.4) for Latinos over the five groups. The risk from smoking was higher for squamous cell carcinomas and small cell cancers than for adenocarcinomas. Racial differences consistent with earlier patterns were seen for overall cancer and for cancer subtypes. Adjusting for predicted total nicotine equivalents, Japanese Americans no longer exhibit a lower risk, and African Americans are no longer at higher risk, compared to whites. Striking risk differences between Native Hawaiians and Latinos persist.

Conclusions: Racial differences in lung cancer risk persist in the Multiethnic Cohort study that are not easily explained by variations in self-reported or urinary biomarker-measured smoking intensities.

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Figures

Figure 1.
Figure 1.
Plot of the model-predicted lung cancer risk for current smokers by age and racial/ethnic group and reported smoking intensity. A) Risk at 10 cigarettes per day and (B) at 35 cigarettes per day is shown. CPD = cigarettes per day; AA= African Americans; CPD = cigarettes per day; JA = Japanese Americans; LA = Latino Americans; NH = Native Hawaiians.
Figure 2.
Figure 2.
Plot of the model-predicted lung cancer risk by age for current smokers according to racial/ethnic group and predicted total nicotine equivalents. A) Risk at 35 nmol/mL and (B) at 65 nmol/mL is shown. TNE = total nicotine equivalents; AA= African Americans; CPD = cigarettes per day; JA = Japanese Americans; LA = Latino Americans; NH = Native Hawaiians; TNE = total nicotine equivalents.
See this image and copyright information in PMC

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References

    1. Siegel RL, Miller KD, Jemal A.. Cancer statistics, 2017. CA Cancer J Clin. 2017;671:7–30. - PubMed
    1. Haiman CA, Stram DO, Wilkens LR, et al. Ethnic and racial differences in the smoking-related risk of lung cancer. N Engl J Med. 2006;3544:333–342. - PubMed
    1. Murphy SE, Park SS, Thompson EF, et al. Nicotine N-glucuronidation relative to N-oxidation and C-oxidation and UGT2B10 genotype in five ethnic/racial groups. Carcinogenesis. 2014;3511:2526–2533. - PMC - PubMed
    1. Kolonel LN, Henderson BE, Hankin JH, et al. A multiethnic cohort in Hawaii and Los Angeles: baseline characteristics. Am J Epidemiol. 2000;1514:346–357. - PMC - PubMed
    1. Noone A, Howlader N, Krapcho M, et al. SEER Cancer Statistics Review (CSR) 1975–2015. Bethesda, MD: National Cancer Institute; 2017.

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