OBJECTIVE: To analyze the association between exposure to second-hand smoke (SHS) and 23 diseases, categorized into four classifications, among the Chinese population. METHODS: We searched the literature up to June 30, 2021, and eligible studies were identified according to the PECOS format: Participants and Competitors (Chinese population), Exposure (SHS), Outcomes (Disease or Death), and Study design (Case-control or Cohort). RESULTS: In total, 53 studies were selected. The odds ratio (OR) for all types of cancer was 1.79 (1.56-2.05), and for individual cancers was 1.92 (1.42-2.59) for lung cancer, 1.57 (1.40-1.76) for breast cancer, 1.52 (1.12-2.05) for bladder cancer, and 1.37 (1.08-1.73) for liver cancer. The OR for circulatory system diseases was 1.92 (1.29-2.85), with a value of 2.29 (1.26-4.159) for stroke. The OR of respiratory system diseases was 1.76 (1.13-2.74), with a value of 1.82 (1.07-3.11) for childhood asthma. The original ORs were also shown for other diseases. Subgroup analyses were performed for lung and breast cancer. The ORs varied according to time period and were significant during exposure in the household; For lung cancer, the OR was significant in women. CONCLUSION The effect of SHS exposure in China was similar to that in Western countries, but its definition and characterization require further clarification. Studies on the association between SHS exposure and certain diseases with high incidence rates are insufficient.
Child ; Female ; Humans ; Asthma/epidemiology* ; Breast Neoplasms ; East Asian People ; Lung Neoplasms/etiology* ; Tobacco Smoke Pollution/adverse effects* ; China

OBJECTIVE: No consensus exists on the relative risk ( RR) of lung cancer (LC) attributable to active smoking in China. This study aimed to evaluate the unified RR of LC attributable to active smoking among the Chinese population. METHODS: A systematic literature search of seven databases was conducted to identify studies reporting active smoking among smokers versus nonsmokers in China. Primary articles on LC providing risk estimates with their 95% confidence intervals ( CIs) for "ever" "former" or "current" smokers from China were selected. Meta-analysis was used to estimate the pooled RR of active smoking. RESULTS: Forty-four unique studies were included. Compared with that of nonsmokers, the pooled RR (95% CI) for "ever" "former" and "current" smokers were 3.26 (2.79-3.82), 2.95 (1.71-5.08), and 5.16 (2.58-10.34) among men, 3.18 (2.78-3.63), 2.70 (2.08-3.51), and 4.27 (3.61-5.06) among women, and 2.71 (2.12-3.46), 2.66 (2.45-2.88), and 4.21 (3.25-5.45) in both sexes combined, respectively. CONCLUSION The RR of LC has remained relatively stable (range, 2-6) over the past four decades in China. Early quitting of smoking could reduce the RR to some extent; however, completely refraining from smoking is the best way to avoid its adverse effects.
Male ; Humans ; Female ; Smoking/epidemiology* ; Smoking Cessation ; Smokers ; Risk ; Lung Neoplasms/etiology* ; Risk Factors

BACKGROUND: Through the comparative analysis of the acute and chronic pain postoperative between the single port and triple port video-assisted thoracic surgery to seek the better method which can reduce the incidence of acute and chronic pain in patients with lung cancer. METHODS: Data of 232 patients who underwent single port -VATS (n=131) or triple port VATS (n=101) for non-small cell lung cancer (NSCLC) on January 1, 2016 to June 30, 2017 in our hospital were analyzed. The clinical and operative data were assessed, numeric rating scale (NRS) was used to evaluate the mean pain score on the 1th, 2th, 3th, 7th, 14th days, 3th months and 6th months postoperative. RESULTS: Both groups were similar in clinical characteristics, there were no perioperative death in two groups. In the 1th, 2th, 7th, 14th days and 3th, 6th months postoperative, the NRS score of the single port group was superior, and the difference was significant compared with the triple port (P<0.05). There was no statistically significant difference between the two groups in operative time, blood loss, postoperative hospitalization time, duration of chest tube, the NRS scores in the 3 d (P>0.05). Univariate and multivariate analysis of the occurrence on the chronic pain showed that the operation time, surgical procedure and the 14th NRS score were risk factors for chronic pain (P<0.05). CONCLUSIONS The single port thoracoscopic surgery has an advantage in the incidence of acute and chronic pain in patients with non-small cell lung cancer. Shorter operative time can reduce the occurrence of chronic pain. The 14th day NRS score is a risk factor for chronic pain postoperative.
Acute Pain ; epidemiology ; etiology ; Aged ; China ; Chronic Pain ; epidemiology ; etiology ; Female ; Humans ; Lung Neoplasms ; complications ; surgery ; Male ; Middle Aged ; Pain, Postoperative ; epidemiology ; etiology ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; methods

OBJECTIVETo understand the smoking-attributed mortality by inclusion of smoking information into all causes of death surveillance.

METHODSSince 2010, the information about smoking status, smoking history and the number of cigarettes smoked daily had been added in death surveillance system. The measures of training, supervision, check, sampling survey and telephone verifying were taken to increase death reporting rate and reduce data missing rate and underreporting rate. Multivariate logistic regression analysis was conducted to identify risk factors for smoking-attributed mortality.

RESULTSDuring the study period (2010-2014), the annual death reporting rates ranged from 6.5‰ to 7.0‰. The reporting rates of smoking status, smoking history and the number of cigarettes smoked daily were 95.53%, 98.63% and 98.58%, respectively. Compared with the nonsmokers, the RR of males was 1.38 (1.33-1.43) for all causes of death and 3.07 (2.91-3.24) for lung cancer due to smoking, the RR of females was 1.46 (1.39-1.54) for all causes of death and 4.07 (3.81-4.35) for lung cancer due to smoking, respectively.

CONCLUSIONThe study of smoking attributed mortality can be developed with less investment by using the stable and effective all causes of death surveillance system in Tianjin.

Cause of Death ; China ; epidemiology ; Female ; Humans ; Logistic Models ; Lung Neoplasms ; etiology ; mortality ; Male ; Multivariate Analysis ; Population Surveillance ; methods ; Risk Factors ; Smoking ; adverse effects ; mortality

Recently, a series of lawsuits were filed in Korea claiming tort liability against tobacco companies. The Supreme Court has already issued decisions in some cases, while others are still pending. The primary issue in these cases is whether the epidemiological evidence submitted by the plaintiffs clearly proves the causal relationship between smoking and disease as required by civil law. Proving causation is difficult in tobacco lawsuits because factors other than smoking are involved in the development of a disease, and also because of the lapse of time between smoking and the manifestation of the disease. The Supreme Court (Supreme Court Decision, 2011Da22092, April 10, 2014) has imposed some limitations on using epidemiological evidence to prove causation in tobacco lawsuits filed by smokers and their family members, but these limitations should be reconsidered. First, the Court stated that a disease can be categorized as specific or non-specific, and for each disease type, causation can be proven by different types of evidence. However, the concept of specific diseases is not compatible with multifactor theory, which is generally accepted in the field of public health. Second, when the epidemiological association between the disease and the risk factor is proven to be significant, imposing additional burdens of proof on the plaintiff may considerably limit the plaintiff's right to recovery, but the Court required the plaintiffs to provide additional information such as health condition and lifestyle. Third, the Supreme Court is not giving greater weight to the evidential value of epidemiological study results because the Court focuses on the fact that these studies were group-level, not individual-level. However, group-level studies could still offer valuable information about individual members of the group, e.g., probability of causation.
Chloracne/epidemiology/etiology ; Humans ; *Liability, Legal ; Life Style ; Lung Neoplasms/epidemiology/etiology ; Public Health ; Republic of Korea ; Risk Factors ; *Smoking/adverse effects

Radon is likely the second most common cause of lung cancer after smoking. We estimated the lung cancer risk due to radon using common risk models. Based on national radon survey data, we estimated the population-attributable fraction (PAF) and the number of lung cancer deaths attributable to radon. The exposure-age duration (EAD) and exposure-age concentration (EAC) models were used. The regional average indoor radon concentration was 37.5 95 Bq/m3. The PAF for lung cancer was 8.3% (European Pooling Study model), 13.5% in males and 20.4% in females by EAD model, and 19.5% in males and 28.2% in females by EAC model. Due to differences in smoking by gender, the PAF of radon-induced lung cancer deaths was higher in females. In the Republic of Korea, the risk of radon is not widely recognized. Thus, information about radon health risks is important and efforts are needed to decrease the associated health problems.
Adult ; Demography ; *Environmental Exposure ; Female ; Humans ; Lung Neoplasms/*epidemiology/etiology/mortality ; Male ; Models, Theoretical ; Neoplasms, Radiation-Induced/*epidemiology/etiology ; Radon/*toxicity ; Republic of Korea/epidemiology ; Risk Assessment ; Smoking ; Survival Analysis

OBJECTIVETo characterize the histological and epidemiological features of male lung cancer patients in China.

METHODSThe demographic and histological information about male lung cancer patients identified from 2000-01-01 to 2012-12-31, was collected from the Cancer Hospital of the Chinese Academy of Medical Sciences. Relative frequencies (RF) were estimated for major histological subtypes and compared according to the years of diagnosis and birth.

RESULTSThe RF of adenocarcinoma (ADC) increased from 21.96% to 43.36% and the RF of squamous cell carcinoma (SCC) decreased from 39.11% to 32.23% from 2000 to 2012 in the 15 427 male lung cancer patients included in this study (Z=17.909, P<0.0001; Z=-6.117, P<0.0001). The RF of ADC increased from 28.72% in 2000-2004, 36.88% in 2005-2008 to 48.61% in 2009-2012 in patients born after 1960. The age-adjusted RF of ADC in 2007-2012 increased consistently in all the investigated areas.

CONCLUSIONThe increased RF of ADC in male lung cancer patients highlights the need for further investigation of the etiologic factors of these tumors. Smoke-free policies rather than modifying tobacco products should be enforced.

Adult ; Aged ; Aging ; Carcinoid Tumor ; epidemiology ; etiology ; Carcinoma, Adenosquamous ; epidemiology ; etiology ; China ; epidemiology ; Humans ; Lung Neoplasms ; classification ; epidemiology ; etiology ; Male ; Middle Aged ; Smoking ; adverse effects ; Time Factors

OBJECTIVETo review the studies investigating the increased risk of lung cancer in patients with idiopathic pulmonary fibrosis (IPF).

DATA SOURCESData cited in this review were obtained mainly from PubMed and Medline from 1999 to 2013 and highly regarded older publications were also included.

STUDY SELECTIONWe identified, retrieved and reviewed the information on the frequency, risk factors, anatomical features, histological types, clinical manifestations, computed tomography findings and underlying mechanisms of lung cancer in IPF patients.

RESULTSThe prevalence rates of lung cancer in patients with IPF (4.8% to 48%) are much higher than patients without IPF (2.0% to 6.4%). The risk factors for lung cancer in IPF include smoking, male gender, and age. Lung cancers often occur in the peripheral lung zones where fibrotic changes are predominant. Adenocarcinoma and squamous cell carcinoma are the most common types of lung cancer in patients with IPF. Radiologic features of these patients include peripherally located, ill-defined mass mimicking air-space disease. The underlying mechanisms of the development of lung cancer in patients with IPF have not been fully understood, but may include the inflammatory response, epithelial injury and/or abnormalities, aberrant fibroblast proliferation, epigenetic and genetic changes, reduced cell-to-cell communication, and activation of specific signaling pathways.

CONCLUSIONSThese findings suggest that IPF is associated with increased lung cancer risk. It is necessary to raise the awareness of lung cancer risk in IPF patients among physicians and patients.

Age Factors ; Female ; Humans ; Idiopathic Pulmonary Fibrosis ; complications ; epidemiology ; genetics ; Lung Neoplasms ; epidemiology ; etiology ; genetics ; Male ; Risk Factors ; Sex Factors

An understanding of the characteristics of occupational lung cancer is important to establish policies that prevent carcinogen exposure and to compensate workers exposed to lung carcinogens. This study analyzed the characteristics of occupational lung cancers in workers who were compensated under the Industrial Accident Compensation Insurance Law between 1994 and 2011. A total of 179 occupational lung cancers were compensated. The main carcinogenic exposure was asbestos, followed by crystalline silica and hexavalent chromium. The mean exposure duration and latency were 19.8 and 23.2 yr. The most common industry was manufacturing, followed by construction and transportation. The most common occupation was maintenance and repair, followed by foundry work, welding, painting, and spinning or weaving. Although asbestos was predominant carcinogen, the proportion of these cases was relatively low compared to other developed countries. Proper surveillance system is needed to monitor occupational lung cancer and improve prevention measures.
Adult ; Aged ; Asbestos/toxicity ; Chromium/toxicity ; Female ; Humans ; Insurance Benefits/legislation & jurisprudence ; Lung Neoplasms/economics/*epidemiology/etiology ; Male ; Middle Aged ; Occupational Diseases/economics/*epidemiology/etiology ; Occupational Exposure ; Republic of Korea/epidemiology ; Silicon Dioxide/toxicity ; Smoking ; Workers' Compensation/statistics & numerical data

Particulate matter (PM) plays an important role in air pollution, especially in China. European and American researchers conducted several cohort-based studies to examine the potential relationship between PM and lung cancer and found a positive association between PM and lung cancer mortality. In contrast, the results regarding PM and lung cancer risk remain inconsistent. Most of the previous studies had limitations such as misclassification of PM exposure and residual confounders, diminishing the impact of their findings. In addition, prospective studies on this topic are very limited in Chinese populations. This is an important problem because China has one of the highest concentrations of PM in the world and has had an increased mortality risk due to lung cancer. In this context, more prospective studies in Chinese populations are warranted to investigate the relationship between PM and lung cancer.
Air Pollutants ; toxicity ; Air Pollution ; adverse effects ; China ; Cohort Studies ; Epidemiologic Studies ; Humans ; Lung Neoplasms ; epidemiology ; etiology ; Particulate Matter ; toxicity ; Prospective Studies