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Residential Radon Exposure and Cigarette Smoking in Association with Lung Cancer: A Matched Case-Control Study in Korea

1
Department of Precision Medicine & Biostatistics, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
2
Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
3
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
4
Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
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Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul 03722, Korea
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Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon 16499, Korea
7
Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
8
Department of Preventive Medicine, School of Medicine, Gyeongsang National University, Jinju 52828, Korea
9
Department of Preventive Medicine, Ajou University School of Medicine, Suwon 16499, Korea
10
Department of Chemical and Biological Engineering, Seokyeong University, Seoul 02713, Korea
*
Author to whom correspondence should be addressed.
Eung Joo Park and Hokyou Lee contributed equally to this work as first authors.
Int. J. Environ. Res. Public Health 2020, 17(8), 2946; https://doi.org/10.3390/ijerph17082946
Received: 17 March 2020 / Revised: 21 April 2020 / Accepted: 22 April 2020 / Published: 24 April 2020
Residential radon exposure and cigarette smoking are the two most important risk factors for lung cancer. The combined effects thereof were evaluated in a multi-center matched case-control study in South Korea. A total of 1038 participants were included, comprising 519 non-small cell lung cancer cases and 519 age- and sex- matched community-based controls. Residential radon levels were measured for all participants. Multivariate logistic regression was used to calculate odds ratios (OR) for lung cancer according to radon exposure (high ≥ 100 Bq/m3 vs. low < 100 Bq/m3), smoking status, and combinations of the two after adjusting for age, sex, indoor hours, and other housing information. The median age of the participants was 64 years, and 51.3% were women. The adjusted ORs (95% confidence intervals [CIs]) for high radon and cigarette smoking were 1.56 (1.03–2.37) and 2.53 (1.60–3.99), respectively. When stratified according to combinations of radon exposure and smoking status, the adjusted ORs (95% CIs) for lung cancer in high-radon non-smokers, low-radon smokers, and high-radon smokers were 1.40 (0.81–2.43), 2.42 (1.49–3.92), and 4.27 (2.14–8.52), respectively, with reference to low-radon non-smokers. Both residential radon and cigarette smoking were associated with increased odds for lung cancer, and the difference in ORs according to radon exposure was much greater in smokers than in non-smokers. View Full-Text
Keywords: radon; cigarette smoking; lung cancer radon; cigarette smoking; lung cancer
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Park, E.J.; Lee, H.; Kim, H.C.; Sheen, S.S.; Koh, S.B.; Park, K.S.; Cho, N.H.; Lee, C.-M.; Kang, D.R. Residential Radon Exposure and Cigarette Smoking in Association with Lung Cancer: A Matched Case-Control Study in Korea. Int. J. Environ. Res. Public Health 2020, 17, 2946.

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