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Racial differences in lung cancer

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Abstract

Although race, in and of itself, is not a relevant biologic variable, racial differences in disease characteristics and outcomes have been reported in many malignancies, including lung cancer. The lung cancer incidence rate in blacks has been consistently higher than that in whites for many years. This racial disparity is seen primarily in men and is significantly greater in younger age groups. The reason for higher lung cancer incidence rates in blacks remains unclear, but racial differences in smoking habits, socioeconomic variables, and the metabolism of tobacco carcinogens may all play an important role. Blacks are also more likely than whites to present with squamous cell carcinoma and with advanced-stage disease. A significant racial difference in survival rates has developed over the past 30 years, with a poorer prognosis noted in black patients, particularly those with local- and regional-stage disease. This disparity appears to be due to a lack of improvement in the survival of black patients with lung cancer, but the biological and/or societal basis for racial variations in survival have not been determined. In summary, significant racial differences exist in lung cancer incidence and survival rates. Further research is required to determine the factors responsible for these differences and to develop effective preventative and therapeutic interventions that will impact favorably on the incidence and prognosis of this disease.

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References

  1. Jemal A, Thomas A, Murray T, Thun M: Cancer statistics, 2002. CA Cancer J Clin 52: 23-47, 2002

    Google Scholar 

  2. Freeman HP: The meaning of race in science-considerations for cancer research: Concerns of special populations in the National Cancer Program. Cancer 18: 219-225, 1998

    Google Scholar 

  3. Brawley OW, Freeman HP: Race and outcomes: Is this the end of the beginning for minority health research? J Natl Cancer Inst 91: 1908-1909, 1999

    Google Scholar 

  4. Wingo PA, Ries LA, Giovino GA, Miller DS, Rosenberg HM, Shopland DR, Thun MJ, Edwards BK: Annual report to the nation on the status of cancer, 1973-1996, with a special section on lung cancer and tobacco smoking. J Natl Cancer Inst 91: 675-690, 1999

    Google Scholar 

  5. Wu LY, Semenya KA, Hardy RE, Hargreaves MK, Robinson SB, Pederson L, Sung JF, Haynes MA: Cancer rate differentials between blacks and whites in three metropolitan areas: A 10-year comparison. J Natl Med Assoc 90: 410-416, 1998

    Google Scholar 

  6. Cooley ME, Jennings-Dozier K: Lung cancer in African-Americans-a call for action. Cancer Pract 6: 99-106, 1998

    Google Scholar 

  7. Stewart JH: Lung carcinoma in African Americans-a review of the current literature. Cancer 91: 2476-2482, 2001

    Google Scholar 

  8. Gadgeel SM, Severson RK, Kau Y, Graff J, Weiss LK, Kalemkerian GP: Impact of race in lung cancer-analysis of temporal trends from a surveillance, epidemiology, and end results database. Chest 120: 55-63, 2001

    Google Scholar 

  9. Blot WJ, Fraumeni JF: Changing patterns of lung cancer in the United States. Am J Epidemiol 115: 664-673, 1982

    Google Scholar 

  10. Howe HL, Wingo PA, Thun MJ, Ries LA, Rosenberg HM, Feigal EG, Edwards BK: Annual report to the nation on the status of cancer featuring cancers with recent increasing trends. J Natl Cancer Inst 93: 824-842, 2001

    Google Scholar 

  11. Satariano WA, Swanson GM: Racial differences in cancer incidence: The significance of age-specific patterns. Cancer 62: 2640-2653, 1988

    Google Scholar 

  12. Fiore MC: Trends in cigarette smoking in the United States. The epidemiology of tobacco use. Med Clin North Am 76: 289-303, 1992

    Google Scholar 

  13. Cigarette smoking among adults-United States, 1998. MMWR 49: 881-884, 2000

    Google Scholar 

  14. Kabat GC, Morabia A, Wynder EL: Comparison of smoking habits of blacks and whites in a case-control study. Am J PublicHealth 81: 1483-1486, 1991

    Google Scholar 

  15. Cummings KM, Giovino G, Mendicino AJ: Cigarette advertising and black-white differences in brand preference. PublicHealth Rep 102: 698-701, 1987

    Google Scholar 

  16. Richardson TL: African-American smokers and cancers of the lung and of the upper respiratory and digestive tracts. Is menthol part of the puzzle? West J Med 166: 189-194, 1997

    Google Scholar 

  17. Schmeltz I, Schlotzhaur WS: Benzo(a)pyrene, phenols, and other products from pyrolysis of the cigarette additive, (dl)-menthol. Nature 219: 370-371, 1968

    Google Scholar 

  18. Clark PI, Gautam S, Gerson LW: Effect of menthol cigarettes on biochemical markers of smoke exposure among black and white smokers. Chest 110: 1194-1198, 1996

    Google Scholar 

  19. McBride B, Whitelaw WA. A physiological stimulus to upper airway receptors in humans. J Appl Physiol 51: 1189-1197, 1981

    Google Scholar 

  20. Orani GP, Anderson JW, Sant'Ambrogio G, Sant'Ambrogio FB: Upper airway cooling and l-menthol reduce ventilation in the guinea pig. J Appl Physiol 70: 2080-2086, 1991

    Google Scholar 

  21. Carpenter CL, Jarvik ME, Morgenstern H, McCarthy WJ, London SJ: Mentholated cigarette smoking and lungcancer risk. Ann Epidemiol 9: 114-120, 1999

    Google Scholar 

  22. Kabat GC, Hebert JR: Use of mentholated cigarettes and lung cancer risk. Cancer Res 51: 6510-6513, 1991

    Google Scholar 

  23. Sidney S, Tekawa IS, Freidman GD, Sadler MC, Tashkin DP: Mentholated cigarette use and lung cancer. Arch Int Med 155: 727-732, 1995

    Google Scholar 

  24. McGrady GA, Ahluwalia JS, Pederson LL: Smoking initiation and cessation in African-Americans attending an inner-city walk-in clinic. Am J Prev Med 14: 130-137, 1998

    Google Scholar 

  25. Wynder EL, Covey LS, Mabuchi K: Current smoking habits by selected background variables: Their effect on future disease trends. Am J Epidemiol 100: 168-177, 1974

    Google Scholar 

  26. Jenkins CD: Social environment and cancer mortality in men. N Engl J Med 308: 395-398, 1983

    Google Scholar 

  27. Baquet CR, Horm JW, Gibbs T, Greenwald P: Socioeconomic factors and cancer incidence among blacks and whites. J Natl Cancer Inst 83: 551-557, 1991

    Google Scholar 

  28. Novotny TE, Warner KE, Kendrick JS, Remington PL: Smoking by blacks and whites: Socioeconomic and demographicdifferenc es. Am J PublicHealth 78: 1187-1189, 1988

    Google Scholar 

  29. Devesa SS, Diamond EL: Socioeconomic and racial differences in lung cancer incidence. Am J Epidemiol 118: 818-831, 1983

    Google Scholar 

  30. Bang KM, Perlin E, Sampson CC: Increased cancer risks in blacks-a look at the factors. J Natl Med Assoc 79: 383-388, 1987

    Google Scholar 

  31. Mettlin C: Nutritional habits of blacks and whites. Prev Med 9: 601-606, 1980

    Google Scholar 

  32. LeMarchand L, Yoshizawa CN, Kolonel LN, Hankin JH, Goodman MT: Vegetable consumption and lung cancer risk: A population-based case-control study in Hawaii. J Natl Cancer Inst 81: 1158-1164, 1989

    Google Scholar 

  33. Dorgan JF, Ziegler RG, Schoenberg JB, Hartge P, McAdams MJ, Falk RT, Wilcox HB, Shaw GL: Race and sex differences in associations of vegetables, fruits, and carotenoids with lung cancer risk in New Jersey. Cancer Causes Control 4: 273-281, 1993

    Google Scholar 

  34. Swanson CA, Gridley G, Greenberg RS, Schoenberg JB, Swanson GM, Brown LM, Hayes R, Silverman D, Pottern L: A comparison of diets of blacks and whites in three areas of the United States. Nutr Cancer 20: 153-165, 1993

    Google Scholar 

  35. Muscat JE, Stellman SD, Richie JP Jr, Wynder EL: Lung cancer risk and workplace exposures in black men and women. Environ Res 76: 78-84, 1998

    Google Scholar 

  36. Swanson GM, Lin CS, Burns PB: Diversity in the association between occupation and lung cancer among black and white men. Cancer Epidemiol Biomarker Prev 2: 313-320, 1993

    Google Scholar 

  37. Taioli E, Ford J, Trachman J, Demopoulos R, Garte S: Lung cancer risk and CYP1A1 genotype in African-Americans. Carcinogenesis 19: 813-817, 1998

    Google Scholar 

  38. Wu X, Amos CI, Kemp BL, Shi H, Jiang H, Wan Y, Spitz MR: Cytochrome P450-2E1 DraI polymorphisms in lung cancer in minority populations. Cancer Epidemiol Biomarker Prev 7: 13-18, 1998

    Google Scholar 

  39. Kelsey KT, Wiencke JK, Spitz MR: A race-specific genetic polymorphism in the CYP1A1 gene is not associated with lung cancer in African-Americans. Carcinogenesis 15: 1121-1124, 1994

    Google Scholar 

  40. London SJ, Daly AK, Leathart JBS, Navidi WC, Idle JR: Lung cancer risk in relation to the CYP2C9*1/CYP2C9*2 genetic polymorphism among African-Americans and Caucasians in Los Angeles County, California. Pharmacogenetics 6: 527-533, 1996

    Google Scholar 

  41. Perez-Stable EJ, Herrera B, Jacob P, Benowitz NL: Nicotine metabolism and intake in black and white smokers. JAMA 280: 152-156, 1998

    Google Scholar 

  42. Caraballo RS, Giovino GA, Pechacek TF, Mowery PD, Richter PA, Strauss WJ, Sharp DJ, Eriksen MP, Pirkle JL, Maurer KR: Racial and ethnic differences in serum cotinine levels of cigarette smokers: Third National Health and Nutrition Examination Survey, 1988-1991. JAMA 280: 135-139, 1998

    Google Scholar 

  43. Wynder EL, Hoffmann D: Smoking and lung cancer: Scientific challenges and opportunities. Cancer Res 54: 5284-5295, 1994

    Google Scholar 

  44. Sterling TD, Weinkam JJ: Comparison of smoking-related risk factors among black and white males. Am J Ind Med 15: 319-333, 1989

    Google Scholar 

  45. Fry WA, Menck HR, Winchester DP: The national cancer data base report on lung cancer. Cancer 77: 1947-1955, 1996

    Google Scholar 

  46. Graham MV, Geitz LM, Byhardt R, Asbell S, Roach M, Urtasun RC, Curran WJ, Lattin P, Russell AH, Cox JD: Comparison of prognosticfac tors and survival among black patients and white patients treated with irradiation for non-small-cell lung cancer. J Natl Cancer Inst 84: 1731-1735, 1992

    Google Scholar 

  47. Bach PB, Cramer LD, Warren JL, Begg CB: Racial differences in the treatment of early-stage lung cancer. N Engl J Med 341: 1198-1205, 1999

    Google Scholar 

  48. EVAXX: Black American attitudes toward cancer and cancer tests: Highlights of a study. CA Cancer J Clin 31: 212-218, 1981

    Google Scholar 

  49. Horm JW, Devesa SS, Burhansstipanov L: ancer inci-dence, mortality, and survival among racial and ethnic minority groups in the United States. In: Schottenfeld D, Fraumeni JF (eds) Cancer Epidemiology and Prevention. Oxford University, New York, 1996, pp 192-235

    Google Scholar 

  50. Freeman HP: Cancer in the socioeconomically disadvantaged. CA Cancer J Clin 39: 266-288, 1989

    Google Scholar 

  51. Akerley WL, Moritz TE, Ryan LS, Henderson WG, Zacharski LR: Racial comparison of outcomes of male Department of Veterans Affairs patients with lung and colon cancer. Arch Intern Med 153: 1681-1688, 1993

    Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Wayne State University, Karmanos Cancer Institute, Detroit, MI

    Shirish M. Gadgeel

  2. Department of Medicine, University of Michigan, Ann Arbor, MI

    Gregory P. Kalemkerian

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  1. Shirish M. Gadgeel
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  2. Gregory P. Kalemkerian
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Correspondence to Gregory P. Kalemkerian.

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Gadgeel, S.M., Kalemkerian, G.P. Racial differences in lung cancer. Cancer Metastasis Rev 22, 39–46 (2003). https://doi.org/10.1023/A:1022207917249

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