skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: CT screening for lung cancer: Importance of emphysema for never smokers and smokers

; ; ; ; ; ; ; ;
Publication Date:
Sponsoring Org.:
OSTI Identifier:
Grant/Contract Number:
Resource Type:
Journal Article: Publisher's Accepted Manuscript
Journal Name:
Lung Cancer
Additional Journal Information:
Journal Volume: 88; Journal Issue: 1; Related Information: CHORUS Timestamp: 2017-05-22 21:04:59; Journal ID: ISSN 0169-5002
Country of Publication:

Citation Formats

Henschke, Claudia I., Yip, Rowena, Boffetta, Paolo, Markowitz, Steven, Miller, Albert, Hanaoka, Takaomi, Wu, Ning, Zulueta, Javier J., and Yankelevitz, David F.. CT screening for lung cancer: Importance of emphysema for never smokers and smokers. Ireland: N. p., 2015. Web. doi:10.1016/j.lungcan.2015.01.014.
Henschke, Claudia I., Yip, Rowena, Boffetta, Paolo, Markowitz, Steven, Miller, Albert, Hanaoka, Takaomi, Wu, Ning, Zulueta, Javier J., & Yankelevitz, David F.. CT screening for lung cancer: Importance of emphysema for never smokers and smokers. Ireland. doi:10.1016/j.lungcan.2015.01.014.
Henschke, Claudia I., Yip, Rowena, Boffetta, Paolo, Markowitz, Steven, Miller, Albert, Hanaoka, Takaomi, Wu, Ning, Zulueta, Javier J., and Yankelevitz, David F.. 2015. "CT screening for lung cancer: Importance of emphysema for never smokers and smokers". Ireland. doi:10.1016/j.lungcan.2015.01.014.
title = {CT screening for lung cancer: Importance of emphysema for never smokers and smokers},
author = {Henschke, Claudia I. and Yip, Rowena and Boffetta, Paolo and Markowitz, Steven and Miller, Albert and Hanaoka, Takaomi and Wu, Ning and Zulueta, Javier J. and Yankelevitz, David F.},
abstractNote = {},
doi = {10.1016/j.lungcan.2015.01.014},
journal = {Lung Cancer},
number = 1,
volume = 88,
place = {Ireland},
year = 2015,
month = 4

Journal Article:
Free Publicly Available Full Text
Publisher's Version of Record at 10.1016/j.lungcan.2015.01.014

Citation Metrics:
Cited by: 22works
Citation information provided by
Web of Science

Save / Share:
  • We aim to assess the relationship between leisure time activities related to exposure to carcinogenic substances and lung cancer risk in a hospital-based case-control study performed in never smokers. We included never smoking cases with anatomopathologically confirmed lung cancer and never smoking controls undergoing trivial surgery, at 8 Spanish hospitals. The study was conducted between January 2011 and June 2013. Participants were older than 30 and had no previous neoplasms. All were personally interviewed focusing on lifestyle, environmental tobacco smoke exposure, occupational history and leisure time activities (including duration of such activities). Results were analyzed through logistic regression and adjustedmore » also by residential radon and education level. We included 513 never smokers, 191 cases and 322 controls. The OR for those performing the studied leisure time activities was 1.43 (95%CI 0.78–2.61). When we restricted the analysis to those performing do-it-yourself activities for more than 10 years the OR was 2.21 (95%CI 0.93–5.27). Environmental tobacco smoke exposure did not modify this association. The effect for the different lung cancer histological types was very close to significance for adenocarcinoma but only when these activities were performed for more than 10 years. We encourage health professionals to recommend protective measures for those individuals while performing these hobbies to reduce the risk of lung cancer. - Highlights: • Some leisure time activities are associated with the exposure to carcinogenic substances. • These activities are model-making, painting (artistic or not), furniture refinishing or wood working. • Few studies have assessed lung cancer risk due to these hobbies and none in never-smokers. • Leisure activities related to exposure to carcinogenic substances present higher lung cancer risk. • The risk is higher when these activities are performed for more than 10 years.« less
  • Two cohorts of never-smoking residents of Los Angeles were studied on two occasions five years apart. One cohort (N = 1099) lived in a community with moderate levels of photochemical pollution and low levels of other pollutants, and the second (N = 1117) lived in a community with very high levels of photochemical oxidant and relatively high levels of sulfates and particulates. Studies included measurement of forced expiratory volumes and flow rates and single-breath nitrogen washout, as well as use of a standardized questionnaire. The data represent 47 percent of 2340 and 58 percent of 1935 residents, respectively, of themore » original community samples. Mean baseline spirometry and nitrogen washout for those who were and those who were not retested were similar, reflecting the fact that loss to follow-up was primarily due to changes of residence. In the more polluted area there were significantly worse lung function test results for both men and women at baseline and significantly more rapid deterioration at follow-up. Mean changes in nitrogen washout were significantly greater in the more polluted community for both sexes and for all age groups including children. Most of the spirometric test results showed significantly more rapid decline among adults in the more polluted community. These results are consistent with the hypothesis that chronic exposures to a mix of photochemical oxidants, sulfates and particulates are associated with increased loss of lung function, which is especially marked among tests that reflect function of the small airways.« less
  • Tobacco smoking and some types of occupational exposures have consistently been considered as important etiologic factors of lung cancer in industrial countries. At the First World Conference of Lung Cancer (Wyndwer, 1983), it was stressed that more attention should be paid to finding out the causes of lung cancer in non-smokers. In Xuanwei County, Yunnan Province, annual lung cancer death rate was 27.7 per 100,000 in males, among China's highest, and 25.3 per 100,000 in females, the China's highest. The female's lung cancer death rate in Xuanwei County was even much higher than that of the same period in USAmore » white women (ECACM, 1979; Mulvihill, 1976). Marked district variation in cancer mortality exists within Xuanwei County. The county can be divided into high-, medium- and low-mortality areas. Over 90% of the population are farmers. The local residents traditionally burned three major kinds of fuels: smoky coal, smokeless coal and wood, for heating and cooking. The three lung cancer high mortality areas, including Chengguan, Rongcheng and Laibin communes, mainly burned the smoky coal from Laibin smoky-coal mine. The fuel was burned in a shallow, unventilated fire pit in the floor of the dwelling. Fuel burning in shallow unventilated pits has resulted in high indoor air pollution levels. The concentrations of airborne particles (pm 10) inside houses during smoky coal and wood combustion were very high. Indoor concentration of suspended particulates and dichloromethane extractable organics were 24.4mg/m3 and 17.6mg/m3 in burning of smoky coal; 22.3mg/m3, 12.3mg/m3 for burning wood; and 1.8mg/m3, 0.5mg/m3 for burning of smokeless coals.« less
  • The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Undermore » the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan parameters. This session will review the results and summarize the individualized doses to major organs and the mean effective dose and CTDIvol estimate for 66,157 PA chest and 23,773 CT examinations respectively, using size-dependent computational phantoms coupled with Monte Carlo calculations. Learning Objectives: Review and summarize relevant NLST findings and conclusions. Understand the scope and scale of the NLST specific to participant dosimetry. Provide a comprehensive review of NLST participant dosimetry assessments. Summarize the results of an investigation providing individualized organ dose estimates for NLST participant cohorts.« less
  • Questionnaires, spirometry, and the single-breath nitrogen test were administered to 3,192 participants 25 to 39 yr of age in area exposed to low concentrations of all pollutants (Lancaster, California) and to 2,369 similar participants living in an area exposed to high concentrations of photochemical oxidants, nitrogen dioxide, and sulfates (Glendora, California). The prevalence of symptoms and results in the majority of the tests were worse in the polluted area between current and never smokers and men and women. Those tests associated primarily with small airways (Vmax50, Vmax75, delta N 2(750-1250) showed little or no difference between areas. The difference inmore » the prevalence of participants with a poor FEV1 and/or poor FEV1 and/or poor FVC and in the mean Vmax and closing volume was greater between areas than between smoking categories. These results suggest that long-term exposure to high concentrations of photochemical oxidants, NO2, and sulfates at place of residence may result in measurable impairment in both current smokers and never smokers. Firmer documentation of this effect will require following these populations for changes in lung function that correlate with pollutant exposures.« less