Lung cancer is the most common malignancy associated with occupational exposures. After cigarette smoking, radon exposure is the second leading cause of lung cancer in the United States. Other occupational causes of lung cancer include arsenic, chromates, chloromethyl ethers, nickel, and aromatic hydrocarbons, among others.3 Asbestos exposure alone is associated with an increased risk of lung cancer, and the effect is magnified in the presence of cigarette smoking.3 A substantial amount of evidence supports an association between COPD and lung cancer. Although exposure to cigarette smoke (either by smoking cigarettes or secondhand exposure) can be a confounding variable in determining whether COPD has a direct association with lung cancer, evidence suggests that COPD is associated with a two- to fourfold increased frequency in primary lung cancer.3–5 Cigar smoking is another known cause of lung cancer, but the risk it poses for the development of lung cancer is lower in comparison with the effect of cigarette smoking.3,6 This is most likely due to variations in smoking frequency and depth of inhalation from smoking cigarettes as opposed to cigars and pipes.3,7
- Occupational exposure to radon is associated with an increased risk of lung cancer.
3. Alberg A, Ford J, Samet J. Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007;132(3 Suppl):29S–55S.
4. Turner MC, Chen Y, Krewski D, et al. Chronic obstructive pulmonary disease is associated with lung cancer mortality in a prospective study of never smokers. Am J Respir Crit Care Med 2007;176:285–90.
5. Loganathan RS, Stover DE, Shi W, Venkatraman E. Prevalence of COPD in women compared to men around the time of diagnosis of primary lung cancer. Chest 2006;129:1305–12.
6. Smoking and tobacco control monograph 9. Cigars: health effects and trends. Bethesda (MD): US Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 1998. Pub no. 98–4302.
7. Boffetta P, Pershagen G, Jockel KH, et al. Cigar and pipe smoking and lung cancer risk: a multicenter study from Europe. J Natl Cancer Inst 1999;91:697–701.
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