Abstract
B5
Background: Lung cancer risk-prediction models can identify high-risk smokers who can be targeted for intensive interventions such as smoking-cessation programs, chemoprevention trials, or specialized screening programs. Current models have focused primarily on white heavy smokers; therefore, the construction of risk models based on data from lung cancer studies involving minority participants is clearly warranted. The purpose of this analysis was to identify lung cancer risk factors for African Americans and Mexican Americans and to construct risk models for these two groups, respectively. Methods: We constructed risk models for African Americans and Mexican Americans, separately, and calculated absolute 5-year risks of lung cancer on the basis of data from 703 patients with lung cancer (491 African Americans and 212 Mexican Americans) and 825 controls. Data included smoking history, environmental and occupational exposures, medical history and family history of cancer. Results: The risk models included participants’ age at smoking cessation (former smokers), pack-years smoked (current smokers), current body mass index, and whether participants had prior chronic obstructive pulmonary disease or hay fever or had been exposed to asbestos (African Americans), wood dust (African Americans), or pesticides (Mexican Americans). The discriminatory powers for our ethnic-specific lung models were 0.79 (95% confidence interval [CI] = 0.77-0.82) for African Americans and 0.74 (95% CI = 0.69-0.79) for Mexican Americans; these discriminatory powers were higher than those obtained using a lung cancer risk model based white subjects to predict lung cancer among our Mexican American and African American smokers. Conclusions: Our lung cancer risk models showed that minority populations may share lung cancer exposures with whites but also exhibit differing levels of risks and unique risks specifically related to occupational exposures. Validation of these risk models in independent populations is warranted.
First AACR International Conference on the Science of Cancer Health Disparities-- Nov 27-30, 2007; Atlanta, GA