Cancer diagnosis in first-degree relatives and non-small cell lung cancer risk: results from a multi-centre case-control study in Europe

Our plain-English summary of Cancer diagnosis in first-degree relatives and non-small cell lung cancer risk: results from a multi-centre case-control study in Europe, by A. Cassidy, J. Balsan, A. Vesin, et al (European Journal of Cancer, 2009).

The study

• Authors: A. Cassidy, J. Balsan, A. Vesin, X. Wu, T. Liloglou, C. Brambilla, J.F. Timsit, J.K. Field, EUELC Consortium
• Journal: European Journal of Cancer
• Published: 2009;45(17):3047-53
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Because aggregation of cancers at different sites can occur in families, cancer could be considered as a broad phenotype with shared genetic factors. Here, we report results from a multi-centre case-control study of non-small cell lung cancer (NSCLC), with particular emphasis on a history of cancer in first-degree relatives and the risk of lung cancer. From 2002 to 2006, 733 NSCLC patients treated surgically were recruited in 8 European countries and matched to 1312 controls, by centre, sex and age. We used multivariate conditional logistic regression models to test the association between a history of cancer in first-degree relatives and risk of NSCLC. A family history of lung cancer was associated with an odds ratio (OR) for early-onset (54 years or younger) NSCLC of 4.72 (95% confidence interval [CI]=1.02-21.90). A family history of gastric cancer was associated with an OR for NSCLC of 1.82 (95% CI=1.08-3.06) and for late-onset (55 years or older) NSCLC of 2.92 (95% CI=1.10-7.75). Our findings provide further evidence of a familial predisposition to lung cancer and support the hypothesis that family history is a significant risk factor for the disease. Because of the inherent potential for bias in familial case-control study design, cautious interpretation is warranted.

In plain English

This was a case-control study within the European Early Lung Cancer study. It asked whether having a parent, sibling or child with cancer was linked to non-small cell lung cancer (NSCLC). Between 2002 and 2006, 733 NSCLC patients whose tumours had been surgically removed were matched by centre, sex and age to 1312 cancer-free controls in eight European countries. Asbestos was not the main subject. Participants were asked about occupational exposure to asbestos, which 20.8% of patients and 10.6% of controls reported. The analyses were adjusted for it, along with smoking, education and family size. Any cancer in a first-degree relative was associated with NSCLC (odds ratio 1.16, 95% CI 1.02 to 1.33). Lung cancer in a relative was associated with NSCLC diagnosed at age 54 or younger (odds ratio 4.72, 95% CI 1.02 to 21.90). Gastric cancer in a relative was associated with NSCLC overall (odds ratio 1.82, 95% CI 1.08 to 3.06). The authors concluded that their findings support family history as a risk factor. They noted possible selection and recall bias, shared family smoking habits, and chance.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Multi-centre case-control study (European Early Lung Cancer study), analysed with conditional logistic regression
• Who was studied: 733 patients with surgically treated non-small cell lung cancer and 1312 cancer-free controls (2045 Caucasian participants), recruited 2002 to 2006 in 8 European countries and matched by centre, sex and age
• Exposure: Self-reported history of cancer in first-degree relatives (parents, siblings, biological children). Occupational exposure to asbestos was collected by questionnaire and used as an adjustment factor, along with age, sex, centre, family size, pack-years of smoking and education. No fiber types are named.
• Main results:
  • Occupational asbestos exposure was reported by 143 patients (20.8%) and 137 controls (10.6%). The difference between patients and controls was significant (p less than 0.0001).
  • Table 1 percentages for occupational asbestos exposure: patients 20.8%, controls 10.6%
  • Among all patients, a family history of any cancer was associated with NSCLC risk (OR 1.16, 95% CI 1.02 to 1.33)
  • Overall, the association between a family history of lung cancer and NSCLC was borderline (OR 1.33, 95% CI 0.97 to 1.81)
  • Among patients diagnosed at 54 years or younger, a family history of lung cancer was associated with NSCLC (OR 4.72, 95% CI 1.02 to 21.90). This was based on 10 patients and 4 controls with an affected relative.
  • Overall, a family history of gastric cancer was associated with NSCLC (OR 1.82, 95% CI 1.08 to 3.06)
  • Among patients diagnosed at 55 years or older, a family history of gastric cancer was associated with NSCLC (OR 2.92, 95% CI 1.10 to 7.75)
  • For squamous cell lung carcinoma, two family histories showed associations. A family history of cancers unrelated to smoking had an OR of 1.62 (95% CI 1.10 to 2.39). A family history of gastric cancer had an OR of 2.18 (95% CI 1.01 to 4.02).
  • Squamous cell lung carcinoma and family history of gastric cancer: OR 2.18 (95% CI 1.01 to 4.02)
  • No association was observed between a family history of smoking-related cancers and NSCLC
• The authors' conclusion: The authors concluded that their findings provide further evidence of a familial predisposition to lung cancer in some individuals. They said the findings support the hypothesis that family history is a significant risk factor.
• Limitations the authors state:
  • Only surgically resected patients were recruited. These are 20 to 25% of all NSCLC patients, so selection bias is possible.
  • Family history was self-reported, which may have produced imprecise estimates and recall bias
  • Controls recruited from hospitals may not represent unaffected people
  • Shared smoking habits within families could have produced the elevated risks
  • The gastric cancer association could be a chance finding

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Non-Small Cell Lung Cancer, Case-Control Study, Lung Cancer, Odds Ratio, confidence interval, Stomach Cancer.

Related studies

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• Familial mesothelioma in first degree relatives — A.M. Kalogeraki, D.J. Tamiolakis, et al. (2013)
• Chronic obstructive lung diseases and risk of non-small cell lung cancer in women — A.G. Schwartz, M.L. Cote, et al. (2009)
• Malignant pleural mesothelioma: two cases in first degree relatives — A. Wilkins, S. Popat, et al. (2007)
• Occupational exposure to asbestos and man-made vitreous fibres and risk of lung cancer: a multicentre case-control study in Europe — R. Carel, A.C. Olsson, et al. (2007)
• Hot spot mutations in Finnish non-small cell lung cancers — S. Mäki-Nevala, V.K. Sarhadi, et al. (2016)

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