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Race and risk of lung cancer
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     Specialist Registrar, East Kent Hospitals NHS Trust, UK

    Cote ML, Kardia SLR, Wenzlaff AS, et al. Risk of lung cancer among white and black relatives of individuals with early-onset lung cancer. JAMA 2005;293:3036–42

    The investigators collected interview data on 692 patients with early onset lung cancer, 773 matched controls, and 7576 first degree relatives of cases and controls. Patients were diagnosed between 1990 and 2003 in Detroit, USA and all were aged less than 50 years at diagnosis. One third of the study population was black. Age, sex, race, history of COPD, pneumonia, and smoking pack years were included in the analysis.

    The study found that smokers with a family history of early lung cancer had a higher risk of developing lung cancer with increasing age than smokers without a family history. The increase in risk occurred after the age of 60 and, by the age of 70, 17.1% (SE 2.4%) of white relatives and 25.1% (SE 5.8%) of black relatives had a diagnosis of lung cancer. Relatives of black cases were at a statistically increased risk of lung cancer than white relatives, even after adjusting for other factors (OR 2.07, 95% CI 1.29 to 3.32).

    The results from this paper could be used to discuss risk with relatives of patients with early onset lung cancer. Smoking habits and a family history of lung cancer should be recorded for adults presenting with respiratory symptoms.(K Ward)