231

A case-control study for evaluating long-cancer screening in Japan

Sobue T, Sttukl T, Naruke T. Departmenr ofFieldResearch, Research

Insfirure, Cemer for Aduh Diseases. Higashinari-ku, Osaka 537. Int J

Cancer 1992:50:230-7.

In order to evaluate the efficacy of lung-cancer screening, a case-

control study was conducted usmg the dala from 50 areas where

population-based lung-cancer screening programmes have been oper-

ated by local municipalities. In most areas, chest X-ray examinations

for all parucipants and sputum cytology for lngh-risk parttctpants were

offered annually. Case series consisted of 273 deceased lung-cancer

cases. For each case, 2 to 5 controls (a total of 1,269 controls) were

collected from those who were ahvc at the time of dlagnosls of the

correspondmg case, matched by sex, age, smoking status and lype of

health insurance. Cases and controls were hmited to a high-risk group

for males and a non-high-risk group for females. Screemng historles,

winch wereobtainedfrom the listofscreenees, werecompared between

case and matched controls for the ldenrtcal calendar period before the

time of diagnosis of the case. The odds ratio of dymg from lung cancer

for those screened within 12 months vs. those not scrccncd was 0.72

(95% confldencc interval 0.50-1.03: p = 0.07). The odds rauos I”-

creased towards unity, as the length of ume in which screening histories

were compared increased. After adjustrng for some other variables,

which appeared to be associated with the opportunities of chest X-ray

examination, the csumated odds ratio did not change. These results

suggest some bcncfits from lung-cancer screenmg m terms of reductmn

of lung-cancer mortality and should bc subject to further rcscarch.

Epidemiology and etiology A case-control study of lung cancer in a cohort of workers potcn-

tially exposed to slag wool tibres

Wong 0, Folian D, Trent LS. Applied Health Sciences, 181 Second

Avenue, San Maleo. CA 94401. Br J Ind Med 1991;48:818-24.

A cohortof men were IdentIfiedas having worked for more than

a year at nme slag wool plants. Some of these men were potentially

exposed LO man made vxreous fibres (MMVF). The vital status of the

entire cohort was ascertained to the end of 1989. Of the 504 deaths that

occurred between 1970 and 1989, 61 were attributed to lung cancer

(cases). Individually matchedcontrols were randomly selected from the

remammg deaths. Attempts were made to locate and interview the

surwving famlhes of the cases and controls. The families of three lung

cancer cases could not be located and no matched controls were found

for another three cases. Included in the final analysis were 55 cases and

98 controls. Estimates of mdwdual exposure to MMVF were based on

employment records and industrial hygiene surveys. Data on smoking

and hlstorlesofemploymentoutsrdetheMMVFindustrywereobtained

from telephone interwews and employment records. Relatwe risks

were calculated for cigarette smoking and exposure to MMVF. No

mcreased risk of lung cancer was found associated with exposure to

MMVF, and analysis by cumulative fibrccxposuredid not inthcate any

trend. As expcctcd. cigarette smoking was found to be responsible for

the observed mcrcasc in mortahly from lung cancer in this group of

MMVF workers, and the risk increased wth increasing pack-years of

clgarcttc smoking.

Lung asbestos fiber content and mesothelioma cell type, site, and survival

Lclgh J, Rogers AJ, Fcrguson DA, Mulder HB, Ackad M, Thompson R.

Nalwnal lnsr~fu@ of Occupalumal llealfh and Safely. GPO Box 58.

Sydney. NSW2001. Cancer 1991;68:135-41.

All asccrtamable cases of malignant mcsothchoma in Australia wcrc

nollfied to a national survctllance program in the period January I, 1980 lo December 3 I, 1985. There were 854 cases obtained and 823 con-

fIrmed on clinical (77) or hwologic (746) grounds. Tumor site was

known in 759 cases (685 pleural and 74 peritoneal). Lung fiber content

analyses by hght microscopy and analytic transmlwon clcctron rn-

croscopy with energy- dispersive x-ray analysis were done on 226 cases

in which postmortem material was avadable, using the method of

Rogers. Cell type was determmed by a five-member expert panel of

pathologists appointed by the Royal College of Pathologrsts of Aus-

tralasia. There was a slatistically significant trend between lung fiber

content (fibers/g dry lung) and cell type from epithclial (low fiber

content) through mixed to sarcomatous (high fibercontcnt). Tlus trend

was most apparent for total uncoated fibers (chl-square = 6.8, df = I. P

less thanO.Ol)andcrocidolite(chi-square=6,7,df= I ,PlessthanO.Ol).

Lung fibercontentalsowasassociated with tumorsite; higher lung fiber

content being associated with peritoneal tumors. Tlus relationship was

significant for all fiber content measures except chrysotlle and was

independentofthe fibercontent-cell typcrclationship(log-linearanaly-

SIS). Survival from time of provisional diagnosis was significantly

longer for cplthehal (mean, 13 months; standard deviation [SD], 12.X)

and mixed (mean, 10.2 months; SD, 8.7) types than sarcomatow cell

types (mean, 5.8 months: SD, 6.5; P less than 0.0001, by analysis of

variance on log,, survival time). Survival tune was sigruficantly grcatcr

for pleural tumors (mean, II .4 months; SD, 13.4) than pwtoncal

tumors (mean, 8.6 months; SD, 12.5) (P less than 0.005, by Student’\ t

test on log,, survival time).

Lang cancer in filling station attendants

Grandjean P, Andersen 0. lnsrirule of Communuy Heailh, Odrnse

University, J.B WinslowsveJ 17. 5000 Odense C. Am J Ind Med

1991:20:763-8.

A1 the Damsh census on 9 November 1970,4,055 men and 1,195

women aged 20-64 years Indicated an employment tbat was coded =

retail sale ofoil and gasoline: almost all indwiduals probably worked as

filling slation attendants. Record linkage at Danmarks Stattstik showed

that 529 of :he men had died during the following 17 years. Respiratory

cancer (75 deaths) was the only cause ofdcath that showed a sigmfxant

~XCCSS (standardized mortahty ratto, I .58; 95% confidcncc rntcrval,

I .25-2.00) when compared to all men gamfully employed at the tlmc of

the census. An mcreased mortality due to carthovascular disca could

not be related to any parucular diagnosw subgroup; the mortahty in

women did not differ from cxpxted rates. These results arc in accor-

dance wth data from other countries on occupauonal groups exposed to

lngh levels of exhaust fumes.

Long cancer and smoking trends in the United States over the past

25 years

Garfinkel L.SilverbergE.AmerrcanCanterSuc~ely.New York,NY.CA

Cancer J Chn 1991;41/3 (137.145)

Lung cancer rcmams the leading cause of cancer incidence and death

in the United States. Uslng data from the National Center for Health

Statistics and the American Cancer Soclcty’s two large-scale prospec-

tlve Cancer Prevention Studies, tbc authors analyz the 25.year trends

in lung cancer incidence and mortality, smoking patterns, and the

growmg problem of clgarcttc exports to other countries.

The occupational cancer incidence surveillance study (OCISS):

Risk of long cancer by usual occupation and industry in the Detroit

metropolitan area

Bums PB, Swanson GM. College of fluman Medlcme, A21 I Easr Fee

Hall, Michigan Stale Unruersiry, East Lansmg, MI 4X824-1316. Am J

Ind Med 1991;19:655-71.

This case-referent study assesses occupational risk factors associated

with lung cancer, utilizingcolonandrectum cancer referents. Complete

occupational and tobacco use histories were obtained by telephone

interview for 5,935 inctdent lung cancer cases and 3,956 incrdent colon

and rectum cancer referents. The analysis mcludcd 43 usual occupa-

tional groups and 48 usual industry groups comprised of at least IO

cases. Among all cases, there were signil’lcant clcvated risks for

excavating and minmg workers (OR = 4.01). furnace workers (OR =