Racial, ethnic and gender trends in lung cancer mortality rates in the United States-Mexico border and non-border areas.

BACKGROUND: Geographic patterns of lung cancer mortality rate differ in the region bordering Mexico in contrast to the US. This study compares lung cancer mortality between border and non-border counties by race/ethnicity and gender. METHODS: This study utilized population-level death certificate data from US Centers for Disease Control and Prevention Public Internet Wide-Ranging Online Data for Epidemiologic Research dataset between 1999 and 2020. Established algorithms were implemented to examine lung cancer deaths among US residents. We analyzed the age-adjusted data by year, race/ethnicity, gender, and geographic region. Joinpoint regression was used to determine mortality trends across time. RESULTS: Lung cancer mortality rates were lower in border counties compared to non-border counties across time (p < 0.05). Hispanic lung cancer mortality rates were not different in border counties compared to non-border counties during the same period (p > 0.05). Lung cancer mortality among non-Hispanic White living in border counties was lower than non-Hispanic White residing in non-border counties (p < 0.01), and non-Hispanic Black living in border counties had lower lung cancer mortality than non-Hispanic Black in non-border counties in all but three years (p < 0.05). Both female and male mortality rates were lower in border counties compared to non-border counties (p < 0.05). CONCLUSION: Differences in lung cancer mortality between border counties and non-border counties reflect lower mortality in Hispanics overall and a decline for non-Hispanic White and non-Hispanic Black living in border counties experiencing lower lung cancer mortality rates than non-border counties. Further studies are needed to identify specific causes for lower mortality rates in border counties.

Indoor radon exposure and excess of lung cancer mortality: the case of Mexico-an ecological study.

Radon is a radioactive gas that can migrate from soils and rocks and accumulate in indoor areas such as dwellings and buildings. Many studies have shown a strong association between the exposure to radon, and its decay products, and lung cancer (LC), particularly in miners. In Mexico, according to published surveys, there is evidence of radon exposure in large groups of the population, nevertheless, only few attention has been paid to its association as a risk factor for LC. The aim of this ecological study is to evaluate the excess risk of lung cancer mortality in Mexico due to indoor radon exposure. Mean radon levels per state of the Country were obtained from different publications and lung cancer mortality was obtained from the National Institute of Statistics, Geography and Informatics for the period 2001-2013. A model proposed by the International Commission on Radiological Protection to estimate the annual excess risk of LC mortality (per 105 inhabitants) per dose unit of radon was used. The average indoor radon concentrations found rank from 51 to 1863 Bq m-3, the higher average dose exposure found was 3.13 mSv year-1 in the north of the country (Chihuahua) and the mortality excess of LC cases found in the country was 10 ± 1.5 (range 1-235 deaths) per 105 inhabitants. The highest values were found mainly in the Northern part of the country, where numerous uranium deposits are found, followed by Mexico City, the most crowded and most air polluted area in the country. A positive correlation (r = 0.98 p < 0.0001) was found between the excess of LC cases and the dose of radon exposure. Although the excess risk of LC mortality associated with indoor radon found in this study was relatively low, further studies are needed in order to accurately establish its magnitude in the country.

Role of gender in the survival of surgical patients with nonsmall cell lung cancer.

PURPOSE: There are reports of greater survival rates in nonsmall cell lung cancer (NSCLC) patients of female gender. The objective of this study was to evaluate the role of gender in survival of NSCLC patients treated surgically with curative intent (stage I/II). METHODS: In a retrospective cohort design, we screened 498 NSCLC patients submitted to thoracotomies at the hospital Sγo Lucas, in Porto Alegre, Brazil from 1990 to 2009. After exclusion of patients that did not fit to all the inclusion criteria, we analyzed survival rates of 385 subjects. Survival was analyzed using the Kaplan-Meier method. The Cox regression model was used to evaluate potential confounding factors. RESULTS: Survival rates at 5 and 10 years were 65.3% and 49.5% for women and 46.5% and 33.2% for men, respectively (P = 0.006). Considering only stage I patients, the survival rates at 5 and 10 years were 76.2% and 55.1% for women and 50.7% and 35.4% for men, respectively (P = 0.011). No significant differences in survival rates were found among stage II patients. CONCLUSIONS: Our results show female gender as a possible protective factor for better survival of stage I NSCLC patients, but not among stage II patients. This study adds data to the knowledge that combined both genders survival rates for NSCLC is not an adequate prognosis.

Diferenças de gênero na tendência de mortalidade por câncer de pulmão nas macrorregiões brasileiras / Gender differences in lung cancer mortality trends in Brazilian macro regions

O câncer de pulmão é a primeira causa de óbito por câncer entre homens e a segunda entre mulheres no Brasil. Em países desenvolvidos, a mortalidade por este tipo de câncer vem declinando entre homens, mas não entre as mulheres. Este estudo analisou as tendências de mortalidade por câncer de pulmão no Brasil para homens e mulheres durante o período de 1979 a 2003 em todo o país e nas cinco macrorregiões. Foram calculadas taxas de mortalidade padronizadas por idade e específicas para os grupos etários de 40-59 e 60 anos e mais. As variações percentuais anuais estimadas (Estimated Annual Percent Change - EAPC) foram avaliadas para os períodos: 1979-1987, 1988-1995, 1996-2003. A mortalidade por câncer de pulmão em todo o período (1979-2003) aumentou em 29 por cento entre homens e em 86 por cento entre mulheres. Desagregando-se os dados, observou-se uma tendência inversa evidente na região Sudeste entre 1996 e 2003 para o grupo etário mais jovem com diminuição para homens (EAPC = - 2,1) e aumento para mulheres (EAPC = 3,2). Merece destaque a grande variação positiva nas tendências para mulheres na região Norte e Nordeste a partir de 1988 nos dois grupos etários estudados. Os resultados reforçam a necessidade de dar continuidade às ações de controle do tabagismo para os homens e de aperfeiçoar as estratégias voltadas para as mulheres.