Lung cancer in nonsmokers

Among 2668 patients with newly diagnosed lung cancer interviewed between 1971 and 1980, 134 cases occurred in "validated" nonsmokers. The proportion of nonsmokers among all cases was 1.9% (37 of 1919) for men and 13.0% (97 of 749) for women, giving a sex ratio of 1:2.6. Kreyberg Type II (mainly adenocarcinoma) was more common among nonsmoking cases, especially women, than among all lung cancer cases. Comparison of cases with equal numbers of age-, sex-, race-, and hospital-matched nonsmoking controls showed no differences by religion, proportion of foreign-born, marital status, residence (urban/rural), alcohol consumption or Quetelet's index. Male cases tended to have higher proportions of professionals and to be more educated than controls. No differences in occupation or occupational exposure were seen in men. Among women, cases were more likely than controls to have worked in a textile-related job (relative risk = 3.10, 95% confidence interval 1.11-8.64), but the significance of this finding is not clear. Preliminary data on exposure to passive inhalation of tobacco smoke, available for a subset of cases and controls, showed no differences except for more frequent exposure among male cases than controls to sidestream tobacco smoke at work. The need for more complete information on exposure to secondhand tobacco smoke is discussed.