Small cell carcinoma of the lung risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2] Mirdula Sharma, MBBS [3]

Overview

Tobacco smoking is the leading risk factor of lung cancer. Other risk factors for lung cancer include environmental exposures, air pollution, and certain host-related factors.

Risk Factors

Tobacco Smoking

  • Cigarette smoking: Cigarette smoking is by far the leading risk factor for lung cancer, especially for small cell lung cancer, accounting for 80% to 90% of the cases in the United States and other countries.[1]
  • Cigar smoking: Cigar smoking is also an established risk factor of lung cancer, but the risk is less than that of cigarette smoking because of the differences in smoking frequency and depth of inhalation.[2]
  • Pipe smoking: Pipe smoking is another risk factor of lung cancer, which holds the same pattern as cigar smoking when compared to cigarette smoking in terms of risk.[3]
  • Menthol cigarette smoking: Although not a greater risk factor when compared to nonmenthol cigarette smoking, menthol cigarette smoking contributes as a risk factor of small cell lung cancer by increasing the number of smokers and the duration of smoking, resulting in increased smoking prevalence.[4]
    • Second hand smoking: Regardless of the source of exposure, passive smoking or secondhand smoking is associated with a 20% to 30% increased risk of lung cancer.[5]

Environmental Exposures

  • Occupational exposures: Lung cancer is the most common cancer associated with occupational exposure that is usually potentiated by cigarette smoking.[6][7]
  • Asbestos: Epidemiological survey suggests that people who are exposed to asbestos have a five fold increase in risk for developing lung cancer, especially for small cell lung cancer.[8] Asbestos in combination with cigarette smoking can markedly increase the risk of small cell lung cancer.[8]
  • Benzopyrene: Occupational exposure to tar and soot that contains benzopyrene, increases the risk of developing lung cancer.[9]
  • Diesel: Diesel exhaust exposure has a weak association with lung cancer as a risk factor.[10]
  • Metals: Exposure to metals such as arsenic, chromium, and nickel also increases the risk of developing lung cancer.[11]
  • Silica: The evidence of silica as a risk factor for lung cancer is less clear.

Radiation

  • Ionizing radiation is one among the significant risk factors for lung cancer. High linear energy transfer (LET) radiations such as neutrons, and radon independently as well as synergistically along with cigarette smoking influence small cell lung cancer risk.[12] Low linear energy transfer (LET) radiations such as X-rays and γ-rays can also lead to lung cancer.[13]

Air Pollution

Host Factors

References

  1. "Smoking - Developed countries".
  2. "Smoking - Cancer" (PDF).
  3. Boffetta P, Pershagen G, Jöckel KH, Forastiere F, Gaborieau V, Heinrich J; et al. (1999). "Cigar and pipe smoking and lung cancer risk: a multicenter study from Europe". J Natl Cancer Inst. 91 (8): 697–701. PMID 10218507.
  4. "Menthol - Lung cancer".
  5. "Tobacco - Health consequences" (PDF).
  6. Doll R, Peto R (1981). "The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today". J Natl Cancer Inst. 66 (6): 1191–308. PMID 7017215.
  7. Saracci R (1987). "The interactions of tobacco smoking and other agents in cancer etiology". Epidemiol Rev. 9: 175–93. PMID 3315716.
  8. 8.0 8.1 Newhouse ML, Berry G (1979). "Patterns of mortality in asbestos factory workers in London". Ann N Y Acad Sci. 330: 53–60. PMID 294204.
  9. Lloyd JW (1971). "Long-term mortality study of steelworkers. V. Respiratory cancer in coke plant workers". J Occup Med. 13 (2): 53–68. PMID 5546197.
  10. Olsson AC, Gustavsson P, Kromhout H, Peters S, Vermeulen R, Brüske I; et al. (2011). "Exposure to diesel motor exhaust and lung cancer risk in a pooled analysis from case-control studies in Europe and Canada". Am J Respir Crit Care Med. 183 (7): 941–8. doi:10.1164/rccm.201006-0940OC. PMID 21037020.
  11. Straif K, Benbrahim-Tallaa L, Baan R, Grosse Y, Secretan B, El Ghissassi F; et al. (2009). "A review of human carcinogens--part C: metals, arsenic, dusts, and fibres". Lancet Oncol. 10 (5): 453–4. PMID 19418618.
  12. Lubin JH, Boice JD, Edling C, Hornung RW, Howe GR, Kunz E; et al. (1995). "Lung cancer in radon-exposed miners and estimation of risk from indoor exposure". J Natl Cancer Inst. 87 (11): 817–27. PMID 7791231.
  13. Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH; et al. (2009). "Exposure to low-dose ionizing radiation from medical imaging procedures". N Engl J Med. 361 (9): 849–57. doi:10.1056/NEJMoa0901249. PMC 3707303. PMID 19710483.
  14. Luce D, Stücker I, ICARE Study Group (2011). "Investigation of occupational and environmental causes of respiratory cancers (ICARE): a multicenter, population-based case-control study in France". BMC Public Health. 11: 928. doi:10.1186/1471-2458-11-928. PMC 3274482. PMID 22171573.
  15. Pope CA, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K; et al. (2002). "Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution". JAMA. 287 (9): 1132–41. PMC 4037163. PMID 11879110.
  16. Chen BH, Hong CJ, Pandey MR, Smith KR (1990). "Indoor air pollution in developing countries". World Health Stat Q. 43 (3): 127–38. PMID 2238693.
  17. Lissowska J, Foretova L, Dabek J, Zaridze D, Szeszenia-Dabrowska N, Rudnai P; et al. (2010). "Family history and lung cancer risk: international multicentre case-control study in Eastern and Central Europe and meta-analyses". Cancer Causes Control. 21 (7): 1091–104. doi:10.1007/s10552-010-9537-2. PMID 20306329.
  18. Enewold L, Mechanic LE, Bowman ED, Platz EA, Alberg AJ (2012). "Association of matrix metalloproteinase-1 polymorphisms with risk of COPD and lung cancer and survival in lung cancer". Anticancer Res. 32 (9): 3917–22. PMC 3647250. PMID 22993337.
  19. Daniels CE, Jett JR (2005). "Does interstitial lung disease predispose to lung cancer?". Curr Opin Pulm Med. 11 (5): 431–7. PMID 16093818.
  20. Wu CY, Hu HY, Pu CY, Huang N, Shen HC, Li CP; et al. (2011). "Pulmonary tuberculosis increases the risk of lung cancer: a population-based cohort study". Cancer. 117 (3): 618–24. doi:10.1002/cncr.25616. PMID 20886634.
  21. Shiels MS, Cole SR, Kirk GD, Poole C (2009). "A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals". J Acquir Immune Defic Syndr. 52 (5): 611–22. doi:10.1097/QAI.0b013e3181b327ca. PMC 2790038. PMID 19770804.


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