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Poster-discussion: Lung Cancer
SYNERGY epidemiological database and some results on smoking by major histological subtypes of lung cancer
  1. Beate Pesch1,
  2. Benjamin Kendzia1,
  3. Per Gustavsson2,
  4. Karl-Heinz Jöckel3,
  5. Georg Johnen1,
  6. Hermann Pohlabeln4,
  7. Ann Olsson5,
  8. Wolfgang Ahrens4,
  9. Irene Brüske6,
  10. Heinz-Erich Wichmann6,
  11. Franco Merletti7,
  12. Lorenzo Richiardi7,
  13. Lorenzo Simonato8,
  14. Cristina Fortes9,
  15. Jack Siemiatycki10,
  16. Javier Pintos10,
  17. Dario Consonni11,
  18. Maria Teresa Landi12,
  19. Neil Caporaso12,
  20. David Zaridze13,
  21. Adrian Cassidy14,
  22. Neonila Szeszenia-Dabrowska15,
  23. Peter Rudnai16,
  24. Jolanta Lissowska17,
  25. Isabelle Stücker18,
  26. Eleonora Fabianova19,
  27. Rodica Stanescu Dumitru20,
  28. Vladimir Bencko21,
  29. Lenka Foretova22,
  30. Vladimir Janout23,
  31. John McLaughlin24,
  32. Paul Demers24,
  33. Susan Peters25,
  34. Roel Vermeulen25,
  35. Hans Kromhout25,
  36. Bas Bueno-de-Mesquita26,
  37. Paul Brennan5,
  38. Paolo Boffetta27,
  39. Kurt Straif5,
  40. Thomas Brüning1
  1. 1IPA, Bochum, Germany
  2. 2Karolinska Institutet, Stockholm, Sweden
  3. 3University of Duisberg-Essen, Essen, Germany
  4. 4University of Bremen, Bremen, Germany
  5. 5IARC, Lyon, France
  6. 6Institute of Epidemiology, Muenchen, Germany
  7. 7University of Turin, Turin, Italy
  8. 8University of Padova, Padova, Italy
  9. 9IDI-IRCCS, Rome, Italy
  10. 10University of Montreal, Montreal, Canada
  11. 11Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Milan, Italy
  12. 12NCI, Bethesda, USA
  13. 13Russian Cancer Research Centre, Moscow, Russia
  14. 14University of Liverpool, Liverpool, UK
  15. 15Nofer Institute, Lodz, Poland
  16. 16National Institute of Environment Health, Budapest, Hungary
  17. 17Cancer Center and Institute of Oncology, Warsaw, Poland
  18. 18INSERM U 754 - IFR69, Villejuif, France
  19. 19Regional Authority of Public Health, Banska Bystrica, Slovakia
  20. 20National Institute of Public Health, Bucharest, Romania
  21. 21Charles University, Prague, Czech Republic
  22. 22Masaryk Memorial Cancer Institute, Brno, Czech Republic
  23. 23Palacky University, Olomouc, Czech Republic
  24. 24Cancer Care Ontario, Toronto, Canada
  25. 25Utrect University, Utrecht, The Netherlands
  26. 26RIVM, Bilthoven, The Netherlands
  27. 27Mount Sinai School of Medicine, New York, USA


Objectives SYNERGY's primary scope is the investigation of joint effects of occupational lung carcinogens. Smoking will be explored as potential confounder and effect modifier.

Methods The SYNERGY database has been developed as platform for pooling studies with detailed occupational and smoking information. Occupations and industries were coded according to international classifications. Smoking-status definitions were harmonised. We present lung cancer risk estimates for smoking for 13 169 cases and 16 010 controls.

Results The database comprises 16 830 cases (13 397 men, 3 433 women) and 20 975 controls (16 309 men, 4666 women) from 13 studies (54 centres, 13 countries, recruitment 1985–2007). Among cases, 2% of men and 24% of women were never smokers. Adenocarcinoma (AdCa) was the most prevalent subtype in never smokers and women but squamous cell carcinoma (SqCC) in male smokers. Current smoking was associated with an OR of 23.6 (95% CI 20.4 to 27.2) in men and 7.8 (95% CI 6.8 to 9.0) in women. ORs increased by intensity or duration of cigarette smoking more pronounced for SqCC and small cell lung cancer (SCLC) than for AdCa. Smoking cessation reduced the risks already shortly after quitting but risk in heavy smokers did not fully return to the baseline risk of never smokers.

Conclusions The SYNERGY project is the largest collection of cases and controls with detailed occupational and smoking information. This database allows precise risk estimates for pulmonary carcinogens and in-depth analyses, for example, in never smokers or for the subtypes of lung cancer. Smoking exerted a steeper risk gradient on SqCC and SCLC than on AdCa.

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