Chest
Volume 130, Issue 4, October 2006, Pages 968-975
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Original Research
Association Between Lung Cancer Incidence and Family History of Lung Cancer: Data From a Large-Scale Population-Based Cohort Study, the JPHC Study

https://doi.org/10.1378/chest.130.4.968Get rights and content

Study objectives

To clarify the possibility of a hereditary predisposition to lung cancer, we investigated the association between a family history of lung cancer and subsequent risk of lung cancer in a large-scale, population-based cohort study.

Design

We investigated 102,255 middle-aged and older Japanese subjects (48,834 men and 53,421 women) with 13-year follow-up. A total of 791 cases of lung cancer were newly diagnosed during the follow-up period.

Results

A family history of lung cancer in a first-degree relative was associated with a significantly increased risk of lung cancer (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.31 to 2.88). The association was stronger in women than in men (HR, 2.65; 95% CI, 1.40 to 5.01 and HR, 1.69; 95% CI, 1.03 to 2.78, respectively), and in never-smokers than in current smokers (HR, 2.48; 95% CI, 1.27 to 4.84 and HR, 1.73; 95% CI, 0.99 to 3.00, respectively). In addition, family history was more strongly associated with the risk of squamous cell carcinoma than with other histologic types (HR, 2.79; 95% CI, 1.37 to 5.68), while no clear increase in risk was observed in adenocarcinoma and small cell carcinoma. A family history of overall cancer was not associated with an increased risk of lung cancer.

Conclusions

These results suggest that those with a family history of lung cancer are more likely to acquire lung cancer themselves.

Section snippets

Study Population

The Japan Public Health Center-based prospective study was launched in 1990 for cohort I and in 1993 for cohort II. Cohort I comprised five prefectural public health center (PHC) areas, and cohort II comprised six PHC areas. The details of the study design have been described elsewhere.28, 29 The study protocol was approved by the Institutional Review Board of the National Cancer Center, Japan. In the present analysis, one PHC area was excluded because data on cancer incidence were not

Results

During the 1,116,731 person-years of follow-up (average follow-up period, 10.9 years) for the 102,255 subjects (48,834 men, 53,421 women), a total of 791 cases of newly diagnosed lung cancer (584 men, 207 women) were documented. At baseline, the mean age of the study subjects was 51.7 years (range, 40 to 69 years) [Table 1]. Male and female subjects were of almost same age (mean age, 51.6 years and 51.9 years, respectively).

Table 2 shows HRs and their 95% CI of lung cancer according to family

Discussion

The purpose of the present study was to determine the association between a family history of lung cancer and subsequent risk of lung cancer in a Japanese population. To our knowledge, this is the first prospective study of this association in Japan.

The familial risk of lung cancer documented in previous studies23, 24, 25 may have been due to shared environmental as well as hereditary predisposition. Study8, 18, 33 findings suggest that the long-held belief that lung cancer is not hereditary

Conclusions

In conclusion, our long-term follow-up of a large-scale, population-based cohort identified a significant increase in the risk of lung cancer associated with a family history of lung cancer in a first-degree relative in a Japanese population. Our results suggest that those with a family history of lung cancer are more likely to acquire lung cancer themselves, although further studies are needed to clarify if there is an effect modification between family history of lung cancer and smoking.

Appendix

Members of the Japan Public Health Center-based prospective study group are as follows: S. Tsugane, M. Inoue, T. Sobue, T. Hanaoka, National Cancer Center, Tokyo; J. Ogata, S. Baba, T. Mannami, A. Okayama, National Cardiovascular Center, Suita; K. Miyakawa, F. Saito, A. Koizumi, Y. Sano, I. Hashimoto, Iwate Prefectural Ninohe Public Health Center, Ninohe; Y. Miyajima, N. Suzuki, S. Nagasawa, Y. Furusugi, N. Nagai, Akita Prefectural Yokote Public Health Center, Yokote; H. Sanada, Y. Hatayama, F.

Acknowledgment

The authors thank all staff members in each study area for their efforts with baseline and follow-up surveys. We also thank the Iwate, Aomori, Ibaraki, Niigata, Osaka, Kochi, Nagasaki, and Okinawa Cancer Registries for providing the incidence data.

References (53)

  • U.S. Department of Health and Human Service

    The health consequences of smoking: cancer; a report of Surgeon General, 1982

    (1982)
  • SobueT et al.

    Case control study for lung cancer and cigarette smoking in Osaka, Japan: comparison with the results from Western Europe

    Jpn J Cancer Res

    (1994)
  • TokuhataGK et al.

    Familial aggregation of lung cancer in humans

    J Natl Cancer Inst

    (1963)
  • OoiWL et al.

    Increased familial risk for lung cancer

    J Natl Cancer Inst

    (1986)
  • SellersTA et al.

    Increased familial risk for non-lung cancer among relatives of lung cancer patients

    Am J Epidemiol

    (1987)
  • LynchHT et al.

    Genetics and smoking-associated cancers: a study of 485 families

    Cancer

    (1986)
  • SametJM et al.

    Personal and family history of respiratory disease and lung cancer risk

    Am Rev Respir Dis

    (1986)
  • WuAH et al.

    Personal and family history of lung disease as risk factors for adenocarcinoma of the lung

    Cancer Res

    (1988)
  • HorwitzRI et al.

    An ecogenetic hypothesis for lung cancer in women

    Arch Intern Med

    (1988)
  • OsannKE

    Lung cancer in women: the importance of smoking, family history of cancer, and medical history of respiratory disease

    Cancer Res

    (1991)
  • WuAH et al.

    Family history of cancer and risk of lung cancer among lifetime nonsmoking women in the United States

    Am J Epidemiol

    (1996)
  • KreuzerM et al.

    Risk factors for lung cancer in young adults

    Am J Epidemiol

    (1998)
  • BromenK et al.

    Aggregation of lung cancer in families: results from a population-based case-control study in Germany

    Am J Epidemiol

    (2000)
  • SchwartzAG et al.

    Familial risk of lung cancer among nonsmokers and their relatives

    Am J Epidemiol

    (1996)
  • MatakidouA et al.

    Case-control study of familial lung cancer risks in UK women

    Int J Cancer

    (2005)
  • PooleCA et al.

    Influence of a family history of cancer within and across multiple sites on patterns of cancer mortality risk for women

    Am J Epidemiol

    (1999)
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    This work was supported by a Grant-in-Aid for Cancer Research and for the Third Term Comprehensive 10-Year-Strategy for Cancer Control from the Ministry of Health, Labor and Welfare of Japan.

    The authors have no conflicts of interest to disclose.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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