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Lung Cancer Risk in Relatives of Early-Onset Lung Cancer Cases^*

^* From the Karmanos Cancer Institute, Detroit, MI.

Correspondence to: Michele L. Cote, MPH, Karmanos Cancer Institute, 110 E Warren Ave, Detroit, MI 48103; e-mail: schwarta{at}med.wayne.edu

The advent of lung cancer screening using spiral helical CT scanning has led to the fundamental issue of identifying high-risk populations that would most benefit from screening. Cigarette smoking has been used as an entry criterion for a variety of screening programs, however, other risk factors should be considered.

This study evaluated lung cancer risk in 2,977 first-degree relatives of 565 patients in whom lung cancer had been diagnosed prior to age 50 years from the Surveillance, Epidemiology, and End Results (or SEER) program registry in metropolitan Detroit and compared it with the risk among 3,421 relatives of 715 population-based control subjects under the age of 50 years, who had been identified through random digit telephone dialing. After adjusting for age, race, sex, and pack-years of smoking in generalized estimating equation models, the relatives of patients had a 2.6 times greater risk of developing lung cancer than did the relatives of control subjects (95% confidence interval, 1.8 to 3.8). African-American (AA) case relatives were at a 4.3-fold risk compared to AA control family members (95% confidence interval, 2.2 to 8.5). The cumulative incidence of lung cancer development among relatives was examined using Kaplan-Meier survival curves. By age 70 years, 11.1% of AA smokers with a family history developed lung cancer, compared to 2.7% of AA smokers without a family history. In whites, 4% of smokers with a family history of lung cancer developed lung cancer, compared to 2.2% of smokers without a family history. When pack-years and family history of early-onset lung cancer were considered, heavy smokers (ie, > 33 pack-years) with a family history of lung cancer had a 6.7% risk of developing lung cancer by age 70 years, while those without a family history had a 2.9% risk of developing lung cancer. These findings provide support for the familial aggregation of lung cancer and the role of gene-environment interactions in lung cancer, and they underscore the need for the continuation of studies of genetic susceptibility that include AAs.

	Footnotes

 
Abbreviation: AA = African-American

This research was supported by National Cancer Institute grant RO1-CA60691 and contract NO1-CN-65–064.

This Article Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cote, M. L. Articles by Schwartz, A. G. Search for Related Content PubMed PubMed Citation Articles by Cote, M. L. Articles by Schwartz, A. G.