Identification of adults at high risk of lung cancer

Our plain-English summary of Identification of adults at high risk of lung cancer, by A.B. Miller (Canadian Medical Association Journal, 1980).

The study

• Author: A.B. Miller
• Journal: Canadian Medical Association Journal
• Published: 1980;122(9):985-7
• Type of article: Review
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 002043).

In plain English

This was an editorial, not an original study. The author used published data to identify Canadian adults at highest risk of lung cancer. Assuming risk ratios from a study of British doctors applied to Canadians, the author calculated that 86% of lung cancer cases in men and 81% in women aged 45 to 64 were likely attributable to cigarette smoking. The author also calculated that within 5 years about 53 per 1000 men and 21 per 1000 women of that age smoking 25 or more cigarettes a day could be expected to develop lung cancer. The editorial described earlier work by Selikoff and Hammond. Of 632 asbestos insulation workers alive in 1943, 89 had died of lung cancer by 1974 against 12 expected, and 35 more had died of pleural or peritoneal mesotheliomas. Assuming the effects of smoking and asbestos multiply, the author estimated a risk roughly 100 times higher for asbestos workers who smoked than for unexposed nonsmokers. The author concluded that heavy-smoking men aged 45 to 64 exposed to asbestos, radiation or nickel are suitable groups for studies of preventive agents.

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: Editorial, adapted from a workshop paper. It discusses published studies and statistics and includes the author's own estimates calculated from them. It is not an original study.
• Who was studied: No study population of its own. The editorial focused on Canadian men and women aged 45 to 64, using 1975 national smoking survey figures and published cohort studies, including asbestos insulation workers studied by Selikoff and Hammond.
• Exposure: Cigarette smoking, and occupational carcinogens including asbestos (among insulation, mining, milling, textile, shipyard, construction and demolition workers), polycyclic aromatic hydrocarbons, radon daughters and nickel. No specific asbestos fiber type was named in the text.
• Main results:
  • The author's calculation, assuming the British doctors' risk ratios applied to Canadians: 86% of lung cancer cases in men and 81% in women aged 45 to 64 were likely attributable to cigarette smoking.
  • The author's estimate for regular cigarette smokers aged 45 to 64: over the next 5 years, about 11 lung cancer cases per 1000 men and 3 per 1000 women.
  • The author's estimate for those smoking 25 or more cigarettes a day: 53 cases per 1000 men and 21 per 1000 women over 5 years, roughly 1 in 20 men and 1 in 50 women aged 45 to 64.
  • Reported from Selikoff and Hammond (not this article's own data): of 632 asbestos insulation workers in New York and New Jersey alive Jan. 1, 1943, 89 had died of lung cancer by Dec. 31, 1974, against 12 expected. Another 35 had died of pleural or peritoneal mesotheliomas.
  • Reported from Selikoff's updated analysis (not this article's own data): when nonsmokers in both groups were used as the basis for comparison, the ratio of observed to expected lung cancer deaths in asbestos workers was approximately 5:1.
  • The author's calculation from Selikoff's data: among asbestos workers, cigarette smokers had about 20 times the lung cancer risk of non-smokers. Assuming a multiplicative interaction, asbestos workers who smoke would have a risk ratio of about 100:1 compared with people not exposed to asbestos who do not smoke.
• The authors' conclusion: The author concluded that the high-risk groups in Canada on which studies of preventive (prophylactic) agents might concentrate are men aged 45 to 64 who smoke 25 or more cigarettes a day and are exposed to certain occupational agents, in particular asbestos, radiation and nickel. Foundry workers might also be included.
• Limitations the authors state:
  • The author's estimates rest on stated assumptions: that the risk ratios from the British doctors study apply to the Canadian population, and that similar risk ratios apply at all ages.

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: Lung Cancer.

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