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Research Article

Lung Cancer Occurrence in Never-Smokers: An Analysis of 13 Cohorts and 22 Cancer Registry Studies

  • Michael J Thun mail,

    To whom correspondence should be addressed. E-mail: mthun@cancer.org

    Affiliation: American Cancer Society, Atlanta, Georgia, United States of America

    X
  • Lindsay M Hannan,

    Affiliation: American Cancer Society, Atlanta, Georgia, United States of America

    X
  • Lucile L Adams-Campbell,

    Affiliation: Howard University Cancer Center, Washington, D. C., United States of America

    X
  • Paolo Boffetta,

    Affiliation: International Agency for Research on Cancer (IARC), Lyon, France

    X
  • Julie E Buring,

    Affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America

    X
  • Diane Feskanich,

    Affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America

    X
  • W. Dana Flanders,

    Affiliations: American Cancer Society, Atlanta, Georgia, United States of America, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America

    X
  • Sun Ha Jee,

    Affiliation: Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea

    X
  • Kota Katanoda,

    Affiliation: Cancer Information Services and Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan

    X
  • Laurence N Kolonel,

    Affiliation: Cancer Research Center of Hawaii, University of Hawaii, Honolulu, Hawaii, United States of America

    X
  • I-Min Lee,

    Affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America

    X
  • Tomomi Marugame,

    Affiliation: Cancer Information Services and Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan

    X
  • Julie R Palmer,

    Affiliation: Slone Epidemiology Center, Boston University, Boston, Massachusetts, United States of America

    X
  • Elio Riboli,

    Affiliation: International Agency for Research on Cancer (IARC), Lyon, France

    X
  • Tomotaka Sobue,

    Affiliation: Cancer Information Services and Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan

    X
  • Erika Avila-Tang,

    Affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Lynne R Wilkens,

    Affiliation: Cancer Research Center of Hawaii, University of Hawaii, Honolulu, Hawaii, United States of America

    X
  • Jon M Samet

    Affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America

    X
  • Published: September 09, 2008
  • DOI: 10.1371/journal.pmed.0050185

Reader Comments (6)

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A Lung Cancer Virus?

Posted by plosmedicine on 31 Mar 2009 at 00:30 GMT

Author: Sidney Sullivan
Position: Aerospace Engineer, Retired
E-mail: jsidneysullivan@cox.net
Submitted Date: September 15, 2008
Published Date: September 19, 2008
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Dr. Thun and his co-authors should be commended for the integrity and courage they show in publishing this report.

The finding that lung cancer incidence and death rates among never-smokers have not changed appreciatively over the past 70 years is striking.

A constant level despite the fluctuating levels of secondhand smoke due to fluctuations in active smoking, and despite the increase in environmental pollution from vehicles, pesticides, industrial chemicals and plastics over that 70 years indicates that it is time to look outside the environmental box for the causes of lung cancers.

Dr. Safirsein made a logical suggestion. The association of human papilloma virus with cancers of the cervix and oral cavity may extend to an association with cancer of the lung.

Another suggestion in regard to the association of lung cancer with active smoking. The tobacco mosaic virus is not destroyed by the strenuous processing tobacco undergoes before being manufactured into cigarettes. Cigarette ends tossed into a compost pile will result in tobacco mosaic disease in your tomato plants. Could tobacco be the vector for a lung cancer virus, carried by smoke into the nurturing environment of the lungs? In the same vein, do vehicle emissions, tobacco smoke, etc. rather than initiate a cancer simply change the lungs into a more nurturing environment for a lung cancer virus?

Competing interests declared: Pro-Tobacco Activist