A test of the linear-no threshold theory of radiation carcinogenesis.

It has been pointed out that, while an ecological study cannot determine whether radon causes lung cancer, it can test the validity of a linear-no threshold relationship between them. The linear-no threshold theory predicts a substantial positive correlation between the average radon exposure in various counties and their lung cancer mortality rates. Data on living areas of houses in 411 counties from all parts of the United States exhibit, rather, a substantial negative correlation with the slopes of the lines of regression differing from zero by 10 and 7 standard deviations for males and females, respectively, and from the positive slope predicted by the theory by at least 16 and 12 standard deviations. When the data are segmented into 23 groups of states or into 7 regions of the country, the predominantly negative slopes and correlations persist, applying to 18 of the 23 state groups and 6 of the 7 regions. Five state-sponsored studies are analyzed, and four of these give a strong negative slope (the other gives a weak positive slope, in agreement with our data for that state). A strong negative slope is also obtained in our data on basements in 253 counties. A random selection-no charge study of 39 high and low lung cancer counties (+4 low population states) gives a much stronger negative correlation. When nine potential confounding factors are included in a multiple linear regression analysis, the discrepancy with theory is reduced only to 12 and 8.5 standard deviations for males and females, respectively. When the data are segmented into four groups by population, the multiple regression vs radon level gives a strong negative slope for each of the four groups. Other considerations are introduced to reduce the discrepancy, but it remains very substantial. Since cigarette sales data are available only on a statewide basis, mean radon data for states are analyzed. The linear regression for lung cancer rates vs radon levels is also negative and has a much steeper slope than that for the county data. When cigarette sales per capita is introduced into the regression, the negative slope for dependence on radon level is essentially unchanged.