Lung cancer risk in white and black Americans

Steven D. Stellman, Yu Chen, Joshua Muscat, Mirjana V. Djordjevic, John Richie, Philip Lazarus, Seth Thompson, Nasser Altorki, Marianne Berwick, Marc L. Citron, Susan Harlap, Tajinder B. Kaur, Alfred I. Neugut, Sara Olson, John M. Travaline, Philip Witorsch, Zuo Feng Zhang

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Abstract

PURPOSE: To test whether differences in smoking-related lung cancer risks in blacks and whites can explain why lung cancer incidence is greater in black males than in white males but about equal in black and white females, given that a greater proportion of blacks are smokers, but smoke far fewer cigarettes per day than do whites. METHODS: A hospital-based case-control study was conducted between 1984 and 1998 that included interviews with 1,710 white male and 1,321 white female cases of histologically confirmed lung cancer, 254 black male and 163 black female cases, and 8,151 controls. Relative risks were estimated via odds ratios using logistic regression, adjusted for age, education, and body mass index. RESULTS. We confirmed prior reports that smoking prevalence is higher but overall dosage is lower among blacks. Overall ORs were similar for blacks and whites, except among the heaviest smoking males (21+ cigarettes per day or 37.5 pack-years), in whom ORs for blacks were considerably greater than for whites. Long-term benefits of cessation were similar for white and black ex-smokers. Smokers of menthol flavored cigarettes were at no greater risk for lung cancer than were smokers of unflavored brands. CONCLUSIONS. Lung cancer risks were similar for whites and blacks with similar smoking habits, except possibly for blacks who were very heavy smokers; this sub-group is unusual in the general population of African American smokers. Explanations of racial disparities in lung cancer risk may need to account for modifying factors including type of cigarette (yield, mentholation), diet, occupation, and host factors such as ability to metabolize mainstream smoke carcinogens.

Original languageEnglish (US)
Pages (from-to)294-302
Number of pages9
JournalAnnals of Epidemiology
Volume13
Issue number4
DOIs
StatePublished - Apr 1 2003

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Lung Neoplasms
Tobacco Products
Smoking
Smoke
Menthol
Aptitude
Occupations
African Americans
Carcinogens
Habits
hydroquinone
Case-Control Studies
Body Mass Index
Logistic Models
Odds Ratio
Interviews
Diet
Education
Incidence
Population

All Science Journal Classification (ASJC) codes

  • Epidemiology

Cite this

Stellman, S. D., Chen, Y., Muscat, J., Djordjevic, M. V., Richie, J., Lazarus, P., ... Zhang, Z. F. (2003). Lung cancer risk in white and black Americans. Annals of Epidemiology, 13(4), 294-302. https://doi.org/10.1016/S1047-2797(02)00420-9
Stellman, Steven D. ; Chen, Yu ; Muscat, Joshua ; Djordjevic, Mirjana V. ; Richie, John ; Lazarus, Philip ; Thompson, Seth ; Altorki, Nasser ; Berwick, Marianne ; Citron, Marc L. ; Harlap, Susan ; Kaur, Tajinder B. ; Neugut, Alfred I. ; Olson, Sara ; Travaline, John M. ; Witorsch, Philip ; Zhang, Zuo Feng. / Lung cancer risk in white and black Americans. In: Annals of Epidemiology. 2003 ; Vol. 13, No. 4. pp. 294-302.
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abstract = "PURPOSE: To test whether differences in smoking-related lung cancer risks in blacks and whites can explain why lung cancer incidence is greater in black males than in white males but about equal in black and white females, given that a greater proportion of blacks are smokers, but smoke far fewer cigarettes per day than do whites. METHODS: A hospital-based case-control study was conducted between 1984 and 1998 that included interviews with 1,710 white male and 1,321 white female cases of histologically confirmed lung cancer, 254 black male and 163 black female cases, and 8,151 controls. Relative risks were estimated via odds ratios using logistic regression, adjusted for age, education, and body mass index. RESULTS. We confirmed prior reports that smoking prevalence is higher but overall dosage is lower among blacks. Overall ORs were similar for blacks and whites, except among the heaviest smoking males (21+ cigarettes per day or 37.5 pack-years), in whom ORs for blacks were considerably greater than for whites. Long-term benefits of cessation were similar for white and black ex-smokers. Smokers of menthol flavored cigarettes were at no greater risk for lung cancer than were smokers of unflavored brands. CONCLUSIONS. Lung cancer risks were similar for whites and blacks with similar smoking habits, except possibly for blacks who were very heavy smokers; this sub-group is unusual in the general population of African American smokers. Explanations of racial disparities in lung cancer risk may need to account for modifying factors including type of cigarette (yield, mentholation), diet, occupation, and host factors such as ability to metabolize mainstream smoke carcinogens.",
author = "Stellman, {Steven D.} and Yu Chen and Joshua Muscat and Djordjevic, {Mirjana V.} and John Richie and Philip Lazarus and Seth Thompson and Nasser Altorki and Marianne Berwick and Citron, {Marc L.} and Susan Harlap and Kaur, {Tajinder B.} and Neugut, {Alfred I.} and Sara Olson and Travaline, {John M.} and Philip Witorsch and Zhang, {Zuo Feng}",
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Stellman, SD, Chen, Y, Muscat, J, Djordjevic, MV, Richie, J, Lazarus, P, Thompson, S, Altorki, N, Berwick, M, Citron, ML, Harlap, S, Kaur, TB, Neugut, AI, Olson, S, Travaline, JM, Witorsch, P & Zhang, ZF 2003, 'Lung cancer risk in white and black Americans', Annals of Epidemiology, vol. 13, no. 4, pp. 294-302. https://doi.org/10.1016/S1047-2797(02)00420-9

Lung cancer risk in white and black Americans. / Stellman, Steven D.; Chen, Yu; Muscat, Joshua; Djordjevic, Mirjana V.; Richie, John; Lazarus, Philip; Thompson, Seth; Altorki, Nasser; Berwick, Marianne; Citron, Marc L.; Harlap, Susan; Kaur, Tajinder B.; Neugut, Alfred I.; Olson, Sara; Travaline, John M.; Witorsch, Philip; Zhang, Zuo Feng.

In: Annals of Epidemiology, Vol. 13, No. 4, 01.04.2003, p. 294-302.

Research output: Contribution to journalArticle

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T1 - Lung cancer risk in white and black Americans

AU - Stellman, Steven D.

AU - Chen, Yu

AU - Muscat, Joshua

AU - Djordjevic, Mirjana V.

AU - Richie, John

AU - Lazarus, Philip

AU - Thompson, Seth

AU - Altorki, Nasser

AU - Berwick, Marianne

AU - Citron, Marc L.

AU - Harlap, Susan

AU - Kaur, Tajinder B.

AU - Neugut, Alfred I.

AU - Olson, Sara

AU - Travaline, John M.

AU - Witorsch, Philip

AU - Zhang, Zuo Feng

PY - 2003/4/1

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N2 - PURPOSE: To test whether differences in smoking-related lung cancer risks in blacks and whites can explain why lung cancer incidence is greater in black males than in white males but about equal in black and white females, given that a greater proportion of blacks are smokers, but smoke far fewer cigarettes per day than do whites. METHODS: A hospital-based case-control study was conducted between 1984 and 1998 that included interviews with 1,710 white male and 1,321 white female cases of histologically confirmed lung cancer, 254 black male and 163 black female cases, and 8,151 controls. Relative risks were estimated via odds ratios using logistic regression, adjusted for age, education, and body mass index. RESULTS. We confirmed prior reports that smoking prevalence is higher but overall dosage is lower among blacks. Overall ORs were similar for blacks and whites, except among the heaviest smoking males (21+ cigarettes per day or 37.5 pack-years), in whom ORs for blacks were considerably greater than for whites. Long-term benefits of cessation were similar for white and black ex-smokers. Smokers of menthol flavored cigarettes were at no greater risk for lung cancer than were smokers of unflavored brands. CONCLUSIONS. Lung cancer risks were similar for whites and blacks with similar smoking habits, except possibly for blacks who were very heavy smokers; this sub-group is unusual in the general population of African American smokers. Explanations of racial disparities in lung cancer risk may need to account for modifying factors including type of cigarette (yield, mentholation), diet, occupation, and host factors such as ability to metabolize mainstream smoke carcinogens.

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