Rodríguez-Martínez Ángeles, Ruano-Ravina Alberto, Torres-Durán María, Provencio Mariano, Parente-Lamelas Isaura, Vidal-García Iria, Martínez Cristina, Hernández-Hernández Jesús, Abdulkader-Nallib Ihab, Castro-Añón Olalla, Varela-Lema Leonor, Piñeiro-Lamas María, Fidalgo Paula Sales, Fernández-Villar Alberto, Barros-Dios Juan, Pérez-Ríos Mónica
Service of Medical Oncology, University Hospital Complex of Pontevedra, Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain.
Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública, CIBERESP), Spain; Instituto de Investigaciones Sanitarias de Santiago de Compostela (IDIS), Spain.
Arch Bronconeumol (Engl Ed). 2021 Feb 13. doi: 10.1016/j.arbres.2021.01.027.
Residential radon is considered the second cause of lung cancer and the first in never smokers. Nevertheless, there is little information regarding the association between elevated radon levels and small cell lung cancer (SCLC). We aimed to assess the effect of residential radon exposure on the risk of SCLC in general population through a multicentric case-control study.
A multicentric hospital-based case-control study was designed including 9 hospitals from Spain and Portugal, mostly including radon-prone areas. Indoor radon was measured using Solid State Nuclear Track Detectors at the Galician Radon Laboratory.
A total of 375 cases and 902 controls were included, with 24.5% of cases being women. The median number of years living in the measured dwelling was higher than 25 years for both cases and controls. There was a statistically significant association for those exposed to concentrations higher than the EPA action level of 148Bq/m, with an Odds Ratio of 2.08 (95%CI: 1.03-4.39) compared to those exposed to concentrations lower than 50Bq/m. When using a dose-response model with 100Bq/m as a reference, it can be observed a linear effect for small cell lung cancer risk. Smokers exposed to higher radon concentrations pose a much higher risk of SCLC compared to smokers exposed to lower indoor radon concentrations.
Radon exposure seems to increase the risk of small cell lung cancer with a linear dose-response pattern. Tobacco consumption may also produce an important effect modification for radon exposure.
室内氡气被认为是肺癌的第二大病因，在从不吸烟者中则是首要病因。然而，关于氡气水平升高与小细胞肺癌（SCLC）之间关联的信息却很少。我们旨在通过一项多中心病例对照研究，评估室内氡气暴露对一般人群中小细胞肺癌风险的影响。
设计了一项基于医院的多中心病例对照研究，纳入了来自西班牙和葡萄牙的9家医院，这些医院大多位于氡气易发地区。在加利西亚氡气实验室使用固态核径迹探测器测量室内氡气。
共纳入375例病例和902例对照，其中24.5%的病例为女性。病例组和对照组在测量住所居住的中位年数均高于25年。对于暴露于高于美国环境保护局（EPA）行动水平148贝克勒尔/立方米浓度的人群，与暴露于低于50贝克勒尔/立方米浓度的人群相比，存在统计学显著关联，优势比为2.08（95%置信区间：1.03 - 4.39）。当以100贝克勒尔/立方米作为参考使用剂量反应模型时，可以观察到小细胞肺癌风险呈线性效应。与暴露于较低室内氡气浓度的吸烟者相比，暴露于较高氡气浓度下的吸烟者患小细胞肺癌的风险要高得多。
氡气暴露似乎会增加小细胞肺癌的风险，且呈线性剂量反应模式。烟草消费也可能对氡气暴露产生重要的效应修正作用。
