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Abstract
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Objective: We analyzed the incidence data of lung cancer from 1978 to 1997 among men and women between 19 countries.
Methods: The data were collected from 18 countries in World Health Organization and Department of Health in Taiwan during in the period of 1978 to 1997. Age-standardized incidence rates（ASIR） were analyzed in five consecutive five-year periods and for each five-year age group in the age range 30 to 79. An age-period-cohort（APC） model were used to estimate the effects of age, generation and cohort of birth.
Results: The sex ratio of the ASIR for adenocarcinoma（AC） was lower than sex ratio of the ASIR for squamous cell carcinoma（SCC） in 19 countries. The sex ratio of the ASIR for adenocarcinoma and squamous cell carcinoma in Europe（AC 3.39±1.51, SCC 14.20±10.43）is higher than in Asia（AC 1.93±0.38, SCC 6.83±1.81） or in North America（AC 1.54±0.02, SCC 3.85±0.49）. The period effects（AC） for males and females from the APC model applied to the data from the 19 countries: an increasing trend in both sexes, seen in Taiwan, France, Japan and Slovakia; a gradual increasing trend in both sexes, seen in Singapore and India; a sharply increasing trend in women, and a sharply decreasing trend in men, seen in Estonia and Iceland; a more gradual increasing trend in women, but a gradual declining trend in men, seen in USA, Canada and Italy; a decreasing trend in both sexes, seen in Spain and Australia; a gradually increasing trend in men, but a increasing trend in women, seen in England and Wales and Denmark; a relatively steady trend in both sexes, seen only in Israel; a sharply decreasing trend in men, but a sharply increasing trend in women, seen in Netherlands, Poland and Switzerland. The period effects（SCC） for males and females from the APC model applied to the data from the 19 countries: an increasing trend in both sexes, seen in Taiwan and Estonia; an decreasing trend in both sexes, seen in Singapore, USA, England and Wales, Netherland, Switzerland, Japan, India, Israel, France, Denmark, Italy and Australia; a sharply increasing trend in both sex, seen only in Spain; a sharply decreasing trend in women, but a increasing trend in men, seen only in Iceland; a relatively steady trend in men, but a gradually increasing trend in women seen in Slovakia and Poland.
Conclusions: The sex ratio of the ASIR for adenocarcinoma（AC） was lower than sex ratio of the ASIR for squamous cell carcinoma（SCC） in 19 countries. These trends may reflect that SCC related with sex difference more than AC. A period effect（AC） was increasing in both sex seen in most countries, especially in Taiwan and Asia countries. But a period effect（SCC） decreasing in both sex seen in most countries（Singapore, North America and Europe countries）. A period effect（SCC） was increasing in both sex seen in Taiwan.
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Abstract
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Objective: The ecological study was to investigate the relationship between lung cancer incidence by histologic types and air pollution indexes in Taiwan.
Methods: Air pollution index data was from 70 air quality monitoring stations in different municipalities. We calculated the average air quality values (SO2, CO, O3, NOx, NO, and NO2) from the Taiwan environmental protection association (EPA) between 1994 and 1998. Patients with lung cancer were identified through the National Cancer Registration Program operated by the Taiwanese government. Two major pathological types were adenocarcinoma (AC) and squamous cell cancer (SCC). The Spearman’s correlation coefficients were to calculate the relationship between the air quality index and age-standardized incidence rate (ASR) of AC and SCC in both genders. We conducted 4 levels of analyses based on different NO concentrations (i.e., ≤ 5.590 ppb, 5.590-8.554 ppb, 8.554-13.536 ppb, > 13.536 ppb) when adjusting for NO2, CO, SO2, and O3, used Poisson Regression to estimate the relative risk of lung cancer.
Results: The traffic-related NOx and NO showed significantly positive correlations with males (0.424 v.s. 0.434) and female (0.277 v.s. 0.369) AC type incidence rates. Using NO concentration ≤5.59 ppb as the baseline, the risk for AC among males at 5.59 < NO ≤ 8.554 ppb was 1.324 times of that at the baseline level (95% CI: 1.105-1.587), 1.332 times at 8.554 < NO ≤13.536 level (95% CI: 1.106- 1.606), 1.655 times when13.536 < NO (95% CI: 1.361-2.014). The test for trend was statistically significant at p < 0.0001. Similar results were observed among females with increasing NO concentration, the risk for AC went up 1.308, 1.273, and 1.535 times of the baseline level. The test for trend was highly significant at p < 0.0001. On the contrary, the results didn't find any relationship between NO and SCC in both males and females.
Conclusions: The results showed that a dose-response relationship between NO and lung AC incidence in both genders.
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