Manali I Patel1, Ange Wang2, Kristopher Kapphahn2, Manisha Desai2, Rowan T Chlebowski2, Michael S Simon2, Chloe E Bird2, Giselle Corbie-Smith2, Scarlett Lin Gomez2, Lucile L Adams-Campbell2, Michele L Cote2, Marcia L Stefanick2, Heather A Wakelee2. 1. Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC. manalip@stanford.edu. 2. Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC.
Abstract
PURPOSE: This study aimed to evaluate racial/ethnic differences in lung cancer incidence and mortality in the Women's Health Initiative Study, a longitudinal prospective cohort evaluation of postmenopausal women recruited from 40 clinical centers. METHODS: Lung cancer diagnoses were centrally adjudicated by pathology review. Baseline survey questionnaires collected sociodemographic and health information. Logistic regression models estimated incidence and mortality odds by race/ethnicity adjusted for age, education, calcium/vitamin D, body mass index, smoking (status, age at start, duration, and pack-years), alcohol, family history, oral contraceptive, hormones, physical activity, and diet. RESULTS: The cohort included 129,951 women--108,487 (83%) non-Hispanic white (NHW); 10,892 (8%) non-Hispanic black (NHB); 4,882 (4%) Hispanic; 3,696 (3%) Asian/Pacific Islander (API); 534 (< 1%) American Indian/Alaskan Native; and 1,994 (1%) other. In unadjusted models, Hispanics had 66% lower odds of lung cancer compared with NHW (odds ratio [OR], 0.34; 95% CI, 0.2 to 0.5), followed by API (OR, 0.45; 95% CI, 0.27 to 0.75) and NHB (OR, 0.75; 95% CI, 0.59 to 0.95). In fully adjusted multivariable models, the decreased lung cancer risk for Hispanic compared with NHW women attenuated to the null (OR, 0.59; 95% CI, 0.35 to 0.99). In unadjusted models Hispanic and API women had decreased risk of death compared with NHW women (OR, 0.30 [95% CI, 0.15 to 0.62] and 0.34 [95% CI, 0.16 to 0.75, respectively); however, no racial/ethnic differences were found in risk of lung cancer death in fully adjusted models. CONCLUSION: Differences in lung cancer incidence and mortality are associated with sociodemographic, clinical, and behavioral factors. These findings suggest modifiable exposures and behaviors may contribute to differences in incidence of and mortality by race/ethnicity for postmenopausal women. Interventions focused on these factors may reduce racial/ethnic differences in lung cancer incidence and mortality.
PURPOSE: This study aimed to evaluate racial/ethnic differences in lung cancer incidence and mortality in the Women's Health Initiative Study, a longitudinal prospective cohort evaluation of postmenopausal women recruited from 40 clinical centers. METHODS:Lung cancer diagnoses were centrally adjudicated by pathology review. Baseline survey questionnaires collected sociodemographic and health information. Logistic regression models estimated incidence and mortality odds by race/ethnicity adjusted for age, education, calcium/vitamin D, body mass index, smoking (status, age at start, duration, and pack-years), alcohol, family history, oral contraceptive, hormones, physical activity, and diet. RESULTS: The cohort included 129,951 women--108,487 (83%) non-Hispanic white (NHW); 10,892 (8%) non-Hispanic black (NHB); 4,882 (4%) Hispanic; 3,696 (3%) Asian/Pacific Islander (API); 534 (< 1%) American Indian/Alaskan Native; and 1,994 (1%) other. In unadjusted models, Hispanics had 66% lower odds of lung cancer compared with NHW (odds ratio [OR], 0.34; 95% CI, 0.2 to 0.5), followed by API (OR, 0.45; 95% CI, 0.27 to 0.75) and NHB (OR, 0.75; 95% CI, 0.59 to 0.95). In fully adjusted multivariable models, the decreased lung cancer risk for Hispanic compared with NHW women attenuated to the null (OR, 0.59; 95% CI, 0.35 to 0.99). In unadjusted models Hispanic and API women had decreased risk of death compared with NHW women (OR, 0.30 [95% CI, 0.15 to 0.62] and 0.34 [95% CI, 0.16 to 0.75, respectively); however, no racial/ethnic differences were found in risk of lung cancer death in fully adjusted models. CONCLUSION: Differences in lung cancer incidence and mortality are associated with sociodemographic, clinical, and behavioral factors. These findings suggest modifiable exposures and behaviors may contribute to differences in incidence of and mortality by race/ethnicity for postmenopausal women. Interventions focused on these factors may reduce racial/ethnic differences in lung cancer incidence and mortality.
Authors: Alice T Shaw; Sai-Hong I Ou; Yung-Jue Bang; D Ross Camidge; Benjamin J Solomon; Ravi Salgia; Gregory J Riely; Marileila Varella-Garcia; Geoffrey I Shapiro; Daniel B Costa; Robert C Doebele; Long Phi Le; Zongli Zheng; Weiwei Tan; Patricia Stephenson; S Martin Shreeve; Lesley M Tye; James G Christensen; Keith D Wilner; Jeffrey W Clark; A John Iafrate Journal: N Engl J Med Date: 2014-09-27 Impact factor: 91.245
Authors: Anna E Prizment; Hiroshi Yatsuya; Pamela L Lutsey; Jay H Lubin; Mark Woodward; Aaron R Folsom; Rachel R Huxley Journal: Am J Prev Med Date: 2014-06 Impact factor: 5.043
Authors: Manali I Patel; Clayton W Schupp; Scarlett L Gomez; Ellen T Chang; Heather A Wakelee Journal: J Clin Oncol Date: 2013-08-19 Impact factor: 50.717
Authors: Antoinette M Stroup; Kimberly A Herget; Heidi A Hanson; Diana Lane Reed; Jared T Butler; Kevin A Henry; C Janna Harrell; Carol Sweeney; Ken R Smith Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-09-21 Impact factor: 4.254
Authors: W Quinn O'Neill; Jay Wasman; Jason Thuener; Kate Chatfield-Reed; Lizabeth Lukesic; Ravi Kyasram; John Shanahan; Blake Szelesety; Brandon Vu; Pierre Lavertu; Rod Rezaee; Shawn Li; Nicole Fowler; Theodoros N Teknos; Quintin Pan Journal: JCO Oncol Pract Date: 2021-05
Authors: Misako Nagasaka; Amy Lehman; Rowan Chlebowski; Brittany M Haynes; Gloria Ho; Manali Patel; Lori C Sakoda; Ann G Schwartz; Michael S Simon; Michele L Cote Journal: Lung Cancer Date: 2020-01-07 Impact factor: 5.705