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Background: Lung cancer is a public health problem worldwide. Small-cell lung cancer (SCLC) is the most aggressive histologic type, with a 5-year survival <10%. SCLC is closely associated with tobacco consumption and infrequent in never-smokers. We aim to describe SCLC characteristics in never-smokers recruited in a radon-prone area., Patients and Methods: We designed a multicentric case series where SCLC cases were recruited consecutively following histologic confirmation. Detailed information was obtained for indoor radon exposure, occupation and environmental tobacco smoke. We also collected different clinical characteristics such as extended or limited disease at diagnosis., Results: We recruited 32 never-smoking SCLC cases. Median age was 75 years and 87.5% were women; 47% had extended disease. Median radon concentration was 182 Bq/m 3 . There were no statistically significant differences in residential radon concentration neither regarding age at diagnosis nor regarding sex. The most frequent symptoms were constitutional syndrome (23.1%) and coughing (23.1%). As much as 63% of cases had an Eastern Cooperative Oncology Group Study (ECOG) status of 0-2. The 1- and 2-year survival rates were 34.4% and 21.9%, respectively. The 2-year survival rate with a localized tumor was 26.7%, compared with 18.8% for extended disease., Conclusions: These results show, for the first time, that indoor radon might not be associated with SCLC characteristics at diagnosis in never-smokers, and also confirms the low survival of this aggressive type of lung cancer also for never-smokers., Competing Interests: Disclosure The authors has declared no conflict of interest., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction and Objectives: Chronic obstructive pulmonary disease (COPD) is a major public health problem. The aim of this study was to ascertain the prevalence of COPD and whether such prevalence was positively or negatively associated with COPD admissions, using all the data of a regional health care system., Materials and Methods: We designed a descriptive cross-sectional study which included all subjects aged over 45 years, diagnosed with COPD in primary care in 2013. We also calculated the number of such patients who had a record of hospital admissions due to this disease. COPD prevalence and incidence of admissions were calculated. Poisson regression models were then used to analyse the association between cases with diagnosis of COPD and admissions due to COPD, by sex, adjusting for socio-demographic variables and distance to hospital. Sensitivity subanalyses were performed by reference to the respective municipal rurality indices., Results: Median municipal prevalence of COPD was 5.29% in men and 2.19% in women. Among patients with COPD, 28.22% of men and 16.00% of women had at least one hospital admission. The relative risk of admission per unit of the standardised prevalence ratio was 0.37 (95% CI 0.34-0.41) for men and 0.39 (95% CI 0.34-0.45) for women., Conclusions: There is a significant negative association between COPD prevalence and hospital admissions due to this disease. The proportion of admissions is lower in municipalities lying furthest from hospitals. There is considerable municipal variability in terms of COPD prevalence and proportion of admissions. In-depth attention should be given to disease-management training programmes., (Copyright © 2018 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Environmental tobacco smoke (ETS) is currently the main indoor pollutant and causes a high morbility and mortality. A partial restriction came into force in Portugal, in 2008, law 37/2007, trying to control, define and regulate smoke-free environments., Objective: To assess exposure and perceived impact of the law 37/2007 on exposure to ETS among adults attending to the two health care facilities of Chaves (Portugal)., Method: A cross-sectional survey on tobacco consumption and exposure to ETS was undertaken in Chaves (Northern Portugal) between November 2009 and February 2010. All the patients, over 17, attending to any of the Chaves Primary Care Facilities were interviewed. Patient enrolment was done on a rolling basis covering all days of the week. A face to face interview was carried out and a carbon monoxide was measured. Prevalence and means are shown with 95% confidence intervals., Results: 287 patients participated in the survey, 56% were males and the mean age was 54 years. Smoking prevalence was 23,6%, significantly higher in males (31% vs 17%). 46,2% reported exposure tobacco smoke elsewhere (53% in males vs. 40% in females). Smokers declared to be more exposed to ETS than non-smokers. 16.2% of the population declared to be exposed at home, 14% at work and 33% at leisure places. The highest decrease in perception of passive exposure was found for restaurants (95%). In nightclubs 68% of the participants stated that exposure has remained unchanged., Conclusion: The tobacco control law offered protection against tobacco smoke in several closed public spaces. However, a significant proportion of the population remains exposed. This study highlights the ineffectiveness of a partial ban. A comprehensive law is, therefore, required in Portugal., (Copyright © 2012 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.)

The incidence of oral and pharyngeal cancer in Spain is among the highest in Europe. A hospital-based case-control study was carried out in NW Spain to investigate the role of tobacco. The study included 92 incident male cases and 230 male controls. Tobacco smoking was strongly associated with oral and pharyngeal cancer (OR(ever smokers)=27.7). The risk for black tobacco (OR=33.1) was approximately double that of blond tobacco (OR=15.4). Alcohol drinking increased the risk posed by tobacco consumption. Risks were significantly lower for subjects that started smoking later and was significantly reduced after 10 years of leaving the habit., (Copyright 2009 Elsevier Ireland Ltd. All rights reserved.)

As reported in previous studies, Galicia (NW Spain) is an area of high radon concentrations. This study was sought to analyze the correlation between short-term (activated carbon) and long-term (alpha particle track) detectors in this geographic area, and ascertain whether there were differences in their readings that might be influenced by other variables. A comparison study, as part of a case-control study was designed in which two detectors, one of each type, were placed in the selected homes. A total of 391 homes yielded readings with both detectors. The results indicated that there was a relatively good correlation between both types of monitors (correlation coefficient 0.608; p<0.001). The highest correlations between both detectors were observed for unventilated homes, coastal sites, and the oldest buildings. Short-term and long-term detectors do not show a similar performance in all settings or situations. It is advisable to use long-term detectors whenever possible.

Diet is one of the elements that may influence the development of lung cancer. To ascertain the relationship between meat and fish consumption and the appearance of this disease, a case-control study was conducted on a population in Galicia (NW Spain), with a sample of 295 cases and 322 controls. All cases had histologic confirmation, and controls were individuals who were attending the hospital to undergo trivial surgery. All subjects were over 35, and sampling was based on sex frequency. Frequent consumption of meat seemed to have a protective effect, with an OR of 0.24 (95% CI 0.11-0.50), an effect that was maintained for pork consumption (OR 0.35; 95% CI 0.18-0.67). In contrast, consumption of fish showed an association with lung cancer, with an OR of 1.67 (95% CI 0.99-2.81), an association that extended to both white (OR 1.61 95% CI 0.93-2.79) and blue fish (OR 2.03 95% CI 1.23-3.34). Consumption of meat seems to reduce the risk of lung cancer, whereas consumption of fish could exert an influence by increasing the risk of this disease.

Tobacco use is the leading risk factor for lung cancer, yet in addition to smoking habit, diet may also play a role in the disease's appearance. While there are reports to indicate that antioxidant vitamins and carotenoids may decrease the risk of lung cancer, results to date have been somewhat ambiguous. This review aimed to describe the results yielded by different studies, which have addressed antioxidant vitamin intake and lung cancer, and to indicate the mechanisms whereby these nutrients might be exercising their activity. Antioxidant vitamins were observed to have no clear protective effect, though there was some evidence pointing to a protective role for vitamins C and E. Vitamin A, in contrast, evinced no clear effect. Insofar as provitamin A carotenoids were concerned, lutein/zeaxanthin, lycopene and alpha-carotene displayed a certain protective trend, yet beta-carotene exhibited no protective effect whatsoever; and indeed, there was speculation as to whether it might even be pernicious in smokers. Beta-criptoxanthin, on the other hand, showed a more consistent protective effect. The study highlighted the need to conduct further research on smokers and non-smokers alike, and in particular, to investigate the effect, if any, on lung cancer of carotenoids or vitamins when ingested in differing dosages.

Background: Only 15% of heavy smokers go on to develop lung cancer, indicating the existence of individual predisposition., Patients and Methods: Using a case-control study, we ascertained whether there were differences between cases and controls in the frequency of GSTM1 and GSTT1 gene polymorphisms, and whether their effect might be linked to smoking habit., Results: While a risk of lung cancer of 1.7 (1.0-3.0) was observed for GSTM1 gene deficiency, there appeared to be no such association for absence of the GSTT1 gene. The interaction observed with tobacco use indicated an excess risk of 24.5% (IC 95%-59.8-109.0) for the GSTM1 gene, with no such interaction in evidence for the GSTT1 gene. The highest risk for a combination of the different haplotypes was for subjects with the GSTT1 gene present and the GSTM1 gene deleted, with an Odds Ratio of 2.19 (1.18-4.07)., Conclusion: The absence of the GSTM1 gene is, while that of the GSTT1 gene is seemingly not, implicated in susceptibility to lung cancer.

At the present time, lung cancer is the leading cause of cancer-related death in males. Diagnostic difficulty makes detection complicated and this, in conjunction with the low survival rate, renders the disease a serious health problem. In-depth knowledge of associated risk factors is therefore called for, in order to prevent or at least reduce the appearance of lung cancer and to open new avenues of research. Although the disease has a multicausal aetiology, tobacco accounts for 85-90% of all cases. This paper reviews the current situation, dividing the risk factors, for study purposes, into two groups; intrinsic (non-modifiable) and extrinsic (modifiable).

Lung cancer is one of major public health problems facing the world today, owing to the high incidence of the disease and its poor prognosis. Although the principal cause of lung cancer is tobacco use, smokers find it extremely difficult to quit the habit. Hence, there is a need to take action targeted at other risk factors for this disease. One such factor is diet, which is known to be able to raise or lower the risk of lung cancer. This paper seeks to complement other reviews in the field and to shed more light both on the influence that dietary factors may have upon the occurrence of this neoplasm and on the causes of this possible effect.

We have studied mortality due to general causes and to eight groups of causes (CIE-WHO) in 28 Basic Areas or parishes of the province of A Coruña (Galicia, Spain). We have calculated the direct adjusted rates for men and women, in 1961-1970 and 1971-1980, and we have compared them with the respective provincial rates, thereby identifying areas with excess or infra-mortality. We have found a decrease of general mortality between the two decades, larger in the case of women (4.5%) than in the case of men (0.9%), as well as an increase in the cardiovascular mortality (12% in men and 6% in women) and in mortality due to accidents (41.77% and 45.11% respectively). The rate of neoplasias in men has increased (7.62%) but decreased in women (2.32%). We have examined the geographical distribution criteria for tumoral rates and for accidents in areas which are mainly urban (men and women) and for cardiovascular rates in rural areas (for women, especially).

Sex mortality differential is studied for all the causes of death, in La Coruña (Galicia, Spain), according to geographic area, zone (urban, semiurban and countryside) and decade (1961-1970 y 1971-1980). Two study methods are compared: a) Rate ratio (with direct age-adjusted rates); and b): Differential (Dj) between observed rate (M) and expected rate (M), for male mortality, according to female level (orthogonal regression model). t-Student-Fisher tests have been used to compare an observed mean and a theoretic one, and to compare two observed means, with independent data. An increase in male overmortality is found, from one to the other decade (112.9% to 117.0%), confirmed by orthogonal method: respectively 5.38 deaths every 100,000 and 16.81 deaths. This over-mortality is more frequent in the urban areas, while inframortality appears mainly in countryside areas. Furthermore, male overmortality increases in urban zones and decreases in semiurban and rural zones.