Skip to main content
Environmental Health Perspectives logoLink to Environmental Health Perspectives
. 1995 Jan;103(1):58–63. doi: 10.1289/ehp.9510358

Design issues in studies of radon and lung cancer: implications of the joint effect of smoking and radon.

M Upfal 1, G Divine 1, J Siemiatycki 1
PMCID: PMC1519048  PMID: 7628427

Abstract

Many case-control studies have been undertaken to assess whether and to what extent residential radon exposure is a risk factor for lung cancer. Nearly all these studies have been conducted in populations including smokers and nonsmokers. In this paper, we show that, depending on the nature of the joint effect of radon and tobacco on lung cancer risk, it may be very difficult to detect a main effect due to radon in mixed smoking and nonsmoking populations. If the joint effect is closer to additive than multiplicative, the most cost-effective way to achieve adequate statistical power may be to conduct a study among never-smokers. Because the underlying joint effect is unknown, and because many studies have been carried out among mixed smoker and nonsmoker populations, it would be desirable to conduct some studies with adequate power among never-smokers only.

Full text

PDF
58

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Archer V. E. Association of lung cancer mortality with precambrian granite. Arch Environ Health. 1987 Mar-Apr;42(2):87–91. doi: 10.1080/00039896.1987.9935801. [DOI] [PubMed] [Google Scholar]
  2. Axelson O., Andersson K., Desai G., Fagerlund I., Jansson B., Karlsson C., Wingren G. Indoor radon exposure and active and passive smoking in relation to the occurrence of lung cancer. Scand J Work Environ Health. 1988 Oct;14(5):286–292. doi: 10.5271/sjweh.1918. [DOI] [PubMed] [Google Scholar]
  3. Axelson O., Edling C., Kling H. Lung cancer and residency--a case-referent study on the possible impact of of exposure to radon and its daughters in dwellings. Scand J Work Environ Health. 1979 Mar;5(1):10–15. doi: 10.5271/sjweh.2671. [DOI] [PubMed] [Google Scholar]
  4. Edling C., Comba P., Axelson O., Flodin U. Effects of low-dose radiation - a correlation study. Scand J Work Environ Health. 1982;8 (Suppl 1):59–64. [PubMed] [Google Scholar]
  5. Edling C., Kling H., Axelson O. Radon in homes--a possible cause of lung cancer. Scand J Work Environ Health. 1984 Feb;10(1):25–34. doi: 10.5271/sjweh.2366. [DOI] [PubMed] [Google Scholar]
  6. Fleischer R. L. A possible association between lung cancer and a geological outcrop. Health Phys. 1986 Jun;50(6):823–827. [PubMed] [Google Scholar]
  7. Harley N., Samet J. M., Cross F. T., Hess T., Muller J., Thomas D. Contribution of radon and radon daughters to respiratory cancer. Environ Health Perspect. 1986 Dec;70:17–21. doi: 10.1289/ehp.867017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Laurer G. R., Gang Q. T., Lubin J. H., Jun-Yao L., Kan C. S., Xiang Y. S., Jian C. Z., Yi H., De G. W., Blot W. J. Skeletal 210Pb levels and lung cancer among radon-exposed tin miners in southern China. Health Phys. 1993 Mar;64(3):253–259. doi: 10.1097/00004032-199303000-00003. [DOI] [PubMed] [Google Scholar]
  9. Lees R. E., Steele R., Roberts J. H. A case-control study of lung cancer relative to domestic radon exposure. Int J Epidemiol. 1987 Mar;16(1):7–12. doi: 10.1093/ije/16.1.7. [DOI] [PubMed] [Google Scholar]
  10. Lubin J. H., Gail M. H., Ershow A. G. Sample size and power for case-control studies when exposures are continuous. Stat Med. 1988 Mar;7(3):363–376. doi: 10.1002/sim.4780070302. [DOI] [PubMed] [Google Scholar]
  11. Lubin J. H., Samet J. M., Weinberg C. Design issues in epidemiologic studies of indoor exposure to Rn and risk of lung cancer. Health Phys. 1990 Dec;59(6):807–817. doi: 10.1097/00004032-199012000-00004. [DOI] [PubMed] [Google Scholar]
  12. Neuberger J. S. Residential radon exposure and lung cancer: an overview of ongoing studies. Health Phys. 1992 Nov;63(5):503–509. doi: 10.1097/00004032-199211000-00001. [DOI] [PubMed] [Google Scholar]
  13. Neuberger J. S. Residential radon exposure and lung cancer: an overview of published studies. Cancer Detect Prev. 1991;15(6):435–443. [PubMed] [Google Scholar]
  14. Rothman K. J., Poole C. A strengthening programme for weak associations. Int J Epidemiol. 1988 Dec;17(4):955–959. doi: 10.1093/ije/17.4.955. [DOI] [PubMed] [Google Scholar]
  15. Samet J. M. Radon and lung cancer. J Natl Cancer Inst. 1989 May 10;81(10):745–757. doi: 10.1093/jnci/81.10.745. [DOI] [PubMed] [Google Scholar]
  16. Schoenberg J. B., Klotz J. B., Wilcox H. B., Nicholls G. P., Gil-del-Real M. T., Stemhagen A., Mason T. J. Case-control study of residential radon and lung cancer among New Jersey women. Cancer Res. 1990 Oct 15;50(20):6520–6524. [PubMed] [Google Scholar]
  17. Svensson C., Eklund G., Pershagen G. Indoor exposure to radon from the ground and bronchial cancer in women. Int Arch Occup Environ Health. 1987;59(2):123–131. doi: 10.1007/BF00378490. [DOI] [PubMed] [Google Scholar]
  18. Walker A. M., Rothman K. J. Models of varying parametric form in case-referent studies. Am J Epidemiol. 1982 Jan;115(1):129–137. doi: 10.1093/oxfordjournals.aje.a113267. [DOI] [PubMed] [Google Scholar]
  19. Weinberg C. R., Sandler D. P. Randomized recruitment in case-control studies. Am J Epidemiol. 1991 Aug 15;134(4):421–432. doi: 10.1093/oxfordjournals.aje.a116104. [DOI] [PubMed] [Google Scholar]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Sciences

RESOURCES