Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Opposing Effects of Emphysema, Hay Fever, and Select Genetic Variants on Lung Cancer Risk
1 Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
2 Southwest Center for Occupational and Environmental Health, The University of Texas School of Public Health, Houston, TX.
3 Kelsey-Seybold Clinic and Kelsey Research Foundation, Houston, TX.
4 St. Luke’s Lung Institute, Houston, TX.
5 Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
The authors compared histories of nonmalignant respiratory diseases (asthma, bronchitis, emphysema, hay fever, and pneumonia) in 1,553 lung cancer patients and 1,375 healthy controls enrolled in a Texas case-control study from 1995 to 2003. They incorporated data on two biologically relevant polymorphic genes, matrix metalloproteinase-1 and myeloperoxidase. Emphysema was associated with a statistically significant increased lung cancer risk (odds ratio (OR) = 2.87, 95% confidence interval (CI): 2.20, 3.76), while hay fever had a significant protective effect (OR = 0.58, 95% CI: 0.48, 0.70). Odds ratios were consistent after exclusion of respiratory disease diagnoses made up to 10 years before interview. There was little association between other respiratory diseases and lung cancer risk. Among carriers of "protective" genotypes, emphysema was associated with a 1.7-fold increased risk (95% CI: 0.84, 3.50), as compared with the substantially higher risk for persons possessing one (OR = 4.98, 95% CI: 2.94, 8.44) or two (OR = 4.23, 95% CI: 1.84, 9.73) "adverse" genotypes. For hay fever, significantly decreased risks were evident with one (OR = 0.32, 95% CI: 0.21, 0.50) or two (OR = 0.35, 95% CI: 0.19, 0.66) protective genotypes as compared with none (OR = 0.69, 95% CI: 0.30, 1.59). The biologic role of respiratory disease in lung cancer is unclear. Further study may yield new insights for identification of susceptible subgroups.
case-control studies; epidemiology, molecular; genetic predisposition to disease; lung neoplasms; polymorphism, genetic; respiratory tract diseases; smoking; tobacco
Abbreviations: CI, confidence interval; MMP-1, matrix metalloproteinase-1; MPO, myeloperoxidase; OR, odds ratio.
Correspondence to Dr. Margaret R. Spitz, Department of Epidemiology, Unit 189, M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 (e-mail: mspitz{at}mdanderson.org).
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