Residential Radon Exposure and Lung Cancer Among Nonsmoking Women

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Abstract
Background: Radon at sufficiently high concentrations is known to cause lung cancer among underground miners and in experimental laboratory animals. Purpose: Our aim was to determine whether indoor levels of radon are associated with a detectable increase in lung cancer. Nonsmoking women were selected because they offer the best opportunity to detect radon-related risk while minimizing the potentially confounding influences of cigarette smoking and occupation. Methods: A population-based, case-control study of incident lung cancer was conducted in Missouri. A total of 538 non-smoking white women diagnosed with lung cancer between 1986 and 1992 and 1183 age-matched control subjects were identified from the Missouri Cancer Registry and from driver's license and Medicare listings, respectively. Information on lung cancer risk factors was obtained by telephone interview. Year-long radon measurements were sought in every dwelling occupied for the previous 5–30 years. Results: Radon measurements covered 78% of the relevant residential period, and women reported being indoors for 84% of this time. The time-weighted average radon concentrations were exactly the same for case subjects and control subjects (1.82 pCi/L of air [pCi L −1 ]). Radon levels greater than 4 pCi L −1 were experienced by 6.5% of the case subjects and 6.8% of the control subjects. For all data combined, there was little evidence for a trend of lung cancer with increasing radon concentrations (two-tailed trend test, P = .99 continuous data analysis; P = .19 categorical data analysis). A positive dose-response trend was suggested for the adenocarcinoma cell type and among directly interviewed women (two-tailed trend test; P = .31 continuous data analysis; P = .04 categorical data analysis), but not for other histologies or among those who had surrogate interviews. Conclusions: The possibility of detecting a risk from indoor radon in this study was maximized by ( a ) including a large number of nonsmoking women with high indoor occupancy, ( b ) conducting a large number of radon measurements near the time of the diagnosis of cancer, and ( c ) controlling for known causes of lung cancer. However, an association between lung cancer and the exposure to domestic levels of radon was not convincingly demonstrated. Implications: The magnitude of the lung cancer risk from radon levels commonly found in U.S. dwellings appears low. [J Natl Cancer Inst 86:1829–1837, 1994]

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