Please wait a minute...
Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med    0, Vol. Issue () : 388-394    https://doi.org/10.1007/s11684-012-0233-3
REVIEW
The epidemic status and risk factors of lung cancer in Xuanwei City, Yunnan Province, China
Yize Xiao1(), Ying Shao1, Xianjun Yu2, Guangbiao Zhou2()
1. Yunnan Center for Disease Control and Prevention, Kunming 650022, China; 2. Division of Molecular Carcinogenesis and Targeted Therapy for Cancer, State Key Laboratory of Biomembrane and Membrane Biotechnology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
 Download: PDF(424 KB)   HTML
 Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks
Abstract

Xuanwei City (formerly known as Xuanwei County) locates in the northeastern of Yunnan Province and is rich in coal, iron, copper and other mines, especially the smoky (bituminous) coal. Unfortunately, the lung cancer morbidity and mortality rates in this region are among China’s highest, with a clear upward trend from the mid-1970s to mid-2000s. In 2004–2005, the crude death rate of lung cancer was 91.3 per 100 000 in the whole Xuanwei City, while that for Laibin Town in this city was 241.14 per 100 000. The epidemiologic distribution (clustering patterns by population, time, and space) of lung cancer in Xuanwei has some special features, e.g., high incidence in rural areas, high incidence in females, and an early age peak in lung cancer deaths. The main factor that associates with a high rate of lung cancer incidence was found to be indoor air pollution caused by the indoor burning of smoky coal. To a certain extent, genetic defects are also associated with the high incidence of lung cancer in Xuanwei. Taken together, lung cancer in this smoky coal combustion region is a unique model for environmental factor-related human cancer, and the current studies indicate that abandoning the use of smoky coal is the key to diminish lung cancer morbidity and mortality.

Keywords lung cancer      Xuanwei      smoky coal combustion      polycyclic aromatic hydrocarbons      epidemiology     
Corresponding Author(s): Xiao Yize,Email:xyz6292@sina.com; Zhou Guangbiao,Email:gbzhou@ioz.ac.cn   
Issue Date: 05 December 2012
 Cite this article:   
Yize Xiao,Ying Shao,Xianjun Yu, et al. The epidemic status and risk factors of lung cancer in Xuanwei City, Yunnan Province, China[J]. Front Med, 0, (): 388-394.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-012-0233-3
https://academic.hep.com.cn/fmd/EN/Y0/V/I/388
Fig.1  Smoky coal stored by local residents for domestic use.
Fig.2  The mortality rates of lung cancer in Xuanwei City.
Fig.3  The regional distribution of lung cancer in Xuanwei. (A) Retrospective data of a 1990-1992 survey of causes of death. (B) Retrospective data of a 2004-2005 survey of causes of death.
Fig.4  Comparison of the gender composition of lung cancer mortality in Xuanwei and other regions or countries.
Fig.5  The relationship between mortality rate and age.
Fig.6  Comparison of hearth cooking stoves, blast furnaces, and improved stoves. (A) Fireplace; (B) Blast furnace; (C) New stove.
1 Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61(2): 69-90
doi: 10.3322/caac.20107 pmid:21296855
2 Zhou YS. Lung Cancer. Beijing: People’s Medical Publishing House.1980
3 Chen Z. The Third Chinese National Retrospective Surveys for the Causes of Death. Beijing: Peking Union Medical College Press. 2008
4 Pavlish JH, Sondreal EA, Mann MD, Olson ES, Galbreath KC, Laudal DL, Benson SA. Status review of mercury control options for coal-fired power plants. Fuel Process Technol 2003; 82(2-3): 89-165
doi: 10.1016/S0378-3820(03)00059-6
5 Marzec A. Towards an understanding of the coal structure: a review. Fuel Process Technol 2002; 77-78: 25-32
doi: 10.1016/S0378-3820(02)00045-0
6 Page K. Blood on the coal: the effect of organizational size and differentiation on coal mine accidents. J Safety Res 2009; 40(2): 85-95
doi: 10.1016/j.jsr.2008.12.007 pmid:19433200
7 Attfield MD, Seixas NS. Prevalence of pneumoconiosis and its relationship to dust exposure in a cohort of U.S. bituminous coal miners and ex-miners. Am J Ind Med 1995; 27(1): 137-151
doi: 10.1002/ajim.4700270113 pmid:7900731
8 McCunney RJ, Morfeld P, Payne S. What component of coal causes coal workers’ pneumoconiosis? J Occup Environ Med 2009; 51(4): 462-471
doi: 10.1097/JOM.0b013e3181a01ada pmid:19333134
9 Santo Tomas LH. Emphysema and chronic obstructive pulmonary disease in coal miners. Curr Opin Pulm Med 2011; 17(2): 123-125
doi: 10.1097/MCP.0b013e3283431674 pmid:21178627
10 Cao Y, Gao H. Prevalence and causes of air pollution and lung cancer in Xuanwei City and Fuyuan County, Yunnan Province, China. Front Med 2012; 6(2): 217-220
doi: 10.1007/s11684-012-0192-8 pmid:22573219
11 Mumford JL, He XZ, Chapman RS, Cao SR, Harris DB, Li XM, Xian YL, Jiang WZ, Xu CW, Chuang JC, .Lung cancer and indoor air pollution in Xuan Wei, China. Science 1987; 235(4785): 217-220
doi: 3798109" target="_blank">10.1126/science. pmid:3798109 pmid:3798109
12 Liang CK, Quan NY, Cao SR, He XZ, Ma F. Natural inhalation exposure to coal smoke and wood smoke induces lung cancer in mice and rats. Biomed Environ Sci 1988; 1(1): 42-50
pmid:3268107
13 Mumford JL, Helmes CT, Lee XM, Seidenberg J, Nesnow S. Mouse skin tumorigenicity studies of indoor coal and wood combustion emissions from homes of residents in Xuan Wei, China with high lung cancer mortality. Carcinogenesis 1990; 11(3): 397-403
doi: 10.1093/carcin/11.3.397 pmid:2311182
14 He XZ, Chen W, Liu ZY, Chapman RS. An epidemiological study of lung cancer in Xuan Wei County, China: current progress. Case-control study on lung cancer and cooking fuel. Environ Health Perspect 1991; 94(8): 9-13
doi: 10.2307/3431286 pmid:1954946
15 Lan Q, Chapman RS, Schreinemachers DM, Tian L, He X. Household stove improvement and risk of lung cancer in Xuanwei, China. J Natl Cancer Inst 2002; 94(11): 826-835
doi: 10.1093/jnci/94.11.826 pmid:12048270
16 Dong ZW, Qiao YL, Li LD, Wang GQ, Zhang SW, Meng XZ, Li JB. A report of cancer high incidence scene in China. China Cancer (Zhongguo Zhong Liu) 2009; 18(1): 4-5 (in Chinese)
17 Luo RQ, Zhao TD. An analysis on the trend of mortality with lung cancer in 9 counties of Yunnan Province. China Cancer (Zhongguo Zhong Liu) 2002; 11: 700-701 (in Chinese)
18 Yang L, Li LD, Chen YD, Parkin DM. Cancer incidence and mortality estimates and prediction for year 2000 and 2005 in China. Chin J Health Stat (Zhongguo Wei Sheng Tong Ji) 2005; 22: 218-219 (in Chinese)
19 Hao JH, Huang YC, Ren HX, Chen Y, Hao X, Shi QP, Xiao YZ. Trend analysis of lung cancer mortality in areas with high incidence from 1973 to 2005. Chinese Gen Pract (Zhongguo Quan Ke Yi Xue) 2009; 12(24):2279-2282 (in Chinese)
20 Ning BF. Epidemioiogical analysis of lung cancer in Xuanwei from 1990-1992. China J Cancer Prev Treat (Zhong Liu Fang Zhi Za Zhi) 2001; 8(4): 178-190 (in Chinese)
21 He XZ, Lan Q, Yang RD, Li RF, Huang CF. An overview of studies on risk factors for lung cancer in Xuanwei, China (1979-1993). J Hyg Res(Wei Sheng Yan Jiu) 1995; 24(4): 203-206 (in Chinese)
22 Li JH, Zhang YS, Li Y, Yin G, Li Y, Ning B, Guo J. Descriptive study on the epidemiology of lung cancer in coal-producing area in eastern Yunnan, China. Chinese J Lung Cancer (Zhongguo Fei Ai Za Zhi) 2011; 14(2): 107-119
pmid:21342640 (in Chinese)
23 Wang ZJ. Epidemiology of Lung Cancer. China J Cancer Prev Treat (Zhong Liu Fang Zhi Za Zhi) 2002; 9(1): 1-5 (in Chinese)
24 Howlader N, Noone AM, Krapcho M, .SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations). National Cancer Institute. Bethesda, MD , http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER web site, April 2012
25 He XZ, Yang RD. Lung cancer and indoor air pollution from coal burning. Kunming: Yunnan Science and Technology Press. 1994
26 Blot WJ, Fryzek JP, Henderson BE, Sadler CJ, McLaughlin JK. A cohort mortality study among gas generator utility workers. J Occup Environ Med 2000; 42(2): 194-199
doi: 10.1097/00043764-200002000-00018 pmid:10693081
27 Cohen BL. Testing a BEIR-VI suggestion for explaining the lung cancer vs. radon relationship for U.S. counties. Health Phys 2000; 78(5): 522-527
doi: 10.1097/00004032-200005000-00009 pmid:10772025
28 Gerken M, Kreienbrock L, Wellmann J, Kreuzer M, Wichmann HE. Models for retrospective quantification of indoor radon exposure in case-control studies. Health Phys 2000; 78(3): 268-278
doi: 10.1097/00004032-200003000-00004 pmid:10688449
29 Gilliland FD, Hunt WC, Pardilla M, Key CR. Uranium mining and lung cancer among Navajo men in New Mexico and Arizona, 1969 to 1993. J Occup Environ Med 2000; 42(3): 278-283
doi: 10.1097/00043764-200003000-00008 pmid:10738707
30 Danielsen TE, Lang?rd S, Andersen A. Incidence of cancer among welders and other shipyard workers with information on previous work history. J Occup Environ Med 2000; 42(1): 101-109
doi: 10.1097/00043764-200001000-00023 pmid:10652696
31 Brüske-Hohlfeld I, M?hner M, Pohlabeln H, Ahrens W, Bolm-Audorff U, Kreienbrock L, Kreuzer M, Jahn I, Wichmann HE, J?ckel KH. Occupational lung cancer risk for men in Germany: results from a pooled case-control study. Am J Epidemiol 2000; 151(4): 384-395
doi: 10.1093/oxfordjournals.aje.a010218 pmid:10695597
32 Sun SQ. Etiology of lung cancer at the Gejiu tin mine, China. Princess Takamatsu Symp 1987; 18: 103-115
pmid:3506537
33 Lin HP, Xie MT, Wu XY, Liu ZQ, Wang JJ, Jiang RY, Gao ZL. Health risk assessment of polycyclic aromatic hydrocarbons (PAHs) pollution in air in Xuanwei, China. J Environ Health (Huan Jing Yu Jian Kang Za Zhi) 2010; 27(6): 511-513 (in Chinese)
34 He XZ. Correlation of indoor air pollution caused by indoor burning of smoky coal to genetic susceptibility of lung cancer- Advance in etiology of lung cancer for 22 years in Xuanwei. J Pract Oncol (Shi Yong Zhong Liu Za Zhi) 2001; 16(6): 369-370 (in Chinese)
35 Lan Q, Tian LW, He XZ, Yang RD, Li RF, Huang ZF. Primary Prevention Strategy and Reduction of Lang Cancer Risk: Intervention Effect Assessment of the Stove Improvement in Xuanwei County. Chin J Publ Health (Zhongguo Gong Gong Wei Sheng) 1999; 15(2): 116-119 (in Chinese)
36 Hosgood HD 3rd, Wei H, Sapkota A, Choudhury I, Bruce N, Smith KR, Rothman N, Lan Q. Household coal use and lung cancer: systematic review and meta-analysis of case-control studies, with an emphasis on geographic variation. Int J Epidemiol 2011; 40(3): 719-728
doi: 10.1093/ije/dyq259 pmid:21278196
37 Jin YT, He XZ, Zhou XT. Analysis of the familial risk factors on lung cancer. Chin J Lung Cancer (Zhongguo Fei Ai Za Zhi) 2002; 5(2): 83-86
pmid:21320394 (in Chinese)
38 Jin YT, Zhou XT, He XZ. The general measurement of genetic factors on lung cancer in Xuanwei, China. Chin J Lung Cancer (Zhongguo Fei Ai Za Zhi) 2001; 4(5): 354-356
pmid:21059316 (in Chinese)
39 Jin YT, Zhou XT, He XZ. Genetic epidemiology of lung cancer in Xuanwei. Chin J Publ Health (Zhongguo Gong Gong Wei Sheng) 1996; 12(12): 537-539 (in Chinese)
40 Jin YT, He XZ. Analysis on lung cancer in 370 core family members. J Hyg Res(Wei Sheng Yan Jiu) 1996; 25: 271-273 (in Chinese)
41 Jin YT, Zhou XT, He XZ. Genetic epidemiology study on lung cancer in women. Chin J Prev Control Chronic Non-Commun Dis (Zhongguo Man Xing Bing Yu Fang Yu Kong Zhi) 1998; 6: 5-7 (in Chinese)
42 Liu BQ, Peto R, Chen ZM, Boreham J, Wu YP, Li JY, Campbell TC, Chen JS. Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths. BMJ 1998; 317(7170): 1411-1422
doi: 10.1136/bmj.317.7170.1411 pmid:9822393
43 Shen Y, Shen Y. Occupational impact of pathology and age of onset of female lung cancer in Xuanwei and Yunxi, China. Clin Focus (Lin Chuang Hui Cui) 1999; 14(1): 12 (in Chinese)
44 Deng ZH, Huang ZH, Zeng QX, Yang DY, He XZ, Wang SW, Yin YW. Epidemiology of radon in indoor air pollution and gamma-radiation from surface on lung cancer. Chin J Radiol Med Prot (Zhonghua Fang She Yi Xue Yu Fang Hu Za Zhi) 2001; 21(5): 389-391 (in Chinese)
45 Bostr?m CE, Gerde P, Hanberg A, Jernstr?m B, Johansson C, Kyrklund T, Rannug A, T?rnqvist M, Victorin K, Westerholm R. Cancer risk assessment, indicators, and guidelines for polycyclic aromatic hydrocarbons in the ambient air. Environ Health Perspect 2002; 110(Suppl 3): 451-488
doi: 10.1289/ehp.02110s3451 pmid:12060843
46 Zhang Y, Tao S. Global atmospheric emission inventory of polycyclic aromatic hydrocarbons (PAHs) for 2004. Atmos Environ 2009; 43(4): 812-819
doi: 10.1016/j.atmosenv.2008.10.050
[1] Gang Lu, Yun Ling, Minghao Jiang, Yun Tan, Dong Wei, Lu Jiang, Shuting Yu, Fangying Jiang, Shuai Wang, Yao Dai, Jinzeng Wang, Geng Wu, Xinxin Zhang, Guoyu Meng, Shengyue Wang, Feng Liu, Xiaohong Fan, Saijuan Chen. Primary assessment of the diversity of Omicron sublineages and the epidemiologic features of autumn/winter 2022 COVID-19 wave in Chinese mainland[J]. Front. Med., 2023, 17(4): 758-767.
[2] Tianzhuo Wang, Huiying Guo, Lei Zhang, Miao Yu, Qianchen Li, Jing Zhang, Yan Tang, Hongquan Zhang, Jun Zhan. FERM domain-containing protein FRMD6 activates the mTOR signaling pathway and promotes lung cancer progression[J]. Front. Med., 2023, 17(4): 714-728.
[3] Mengmeng Yin, Hongsheng Wang, Xianmin Guan, Ju Gao, Minghua Yang, Ningling Wang, Tianfeng Liu, Jingyan Tang, Alex WK Leung, Fen Zhou, Xuedong Wu, Jie Huang, Hong Li, Shaoyan Hu, Xin Tian, Hua Jiang, Jiaoyang Cai, Xiaowen Zhai, Shuhong Shen, Qun Hu. Venous thromboembolism in children with acute lymphoblastic leukemia in China: a report from the Chinese Children’s Cancer Group-ALL-2015[J]. Front. Med., 2023, 17(3): 518-526.
[4] Xueqing Hu, Ujjwol Khatri, Tao Shen, Jie Wu. Progress and challenges in RET-targeted cancer therapy[J]. Front. Med., 2023, 17(2): 207-219.
[5] Jia Zhong, Hua Bai, Zhijie Wang, Jianchun Duan, Wei Zhuang, Di Wang, Rui Wan, Jiachen Xu, Kailun Fei, Zixiao Ma, Xue Zhang, Jie Wang. Treatment of advanced non-small cell lung cancer with driver mutations: current applications and future directions[J]. Front. Med., 2023, 17(1): 18-42.
[6] Shi-Yong Sun. Targeting apoptosis to manage acquired resistance to third generation EGFR inhibitors[J]. Front. Med., 2022, 16(5): 701-713.
[7] Jianhua Shi, Ying Cheng, Qiming Wang, Kai Li, Lin Wu, Baohui Han, Gongyan Chen, Jianxing He, Jie Wang, Haifeng Qin, Xiaoling Li. Anlotinib as third- or further-line therapy for short-term relapsed small-cell lung cancer: subgroup analysis of a randomized phase 2 study (ALTER1202)[J]. Front. Med., 2022, 16(5): 766-772.
[8] Xiang Wang, Minghui Wang, Lin Feng, Jie Song, Xin Dong, Ting Xiao, Shujun Cheng. Four-protein model for predicting prognostic risk of lung cancer[J]. Front. Med., 2022, 16(4): 618-626.
[9] Yaru Tian, Hairong Tian, Xiaoyang Zhai, Hui Zhu, Jinming Yu. Bevacizumab in combination with pemetrexed and platinum for elderly patients with advanced non-squamous non-small-cell lung cancer: a retrospective analysis[J]. Front. Med., 2022, 16(4): 610-617.
[10] Chun Cai, Yuexing Liu, Yanyun Li, Yan Shi, Haidong Zou, Yuqian Bao, Yun Shen, Xin Cui, Chen Fu, Weiping Jia, the SIM Study Group. Effectiveness of quality of care for patients with type 2 diabetes in China: findings from the Shanghai Integration Model (SIM)[J]. Front. Med., 2022, 16(1): 126-138.
[11] Wenjing Zhou, Jing Zhang, Mingkun Yan, Jin Wu, Shuo Lian, Kang Sun, Baiqing Li, Jia Ma, Jun Xia, Chaoqun Lian. Orlistat induces ferroptosis-like cell death of lung cancer cells[J]. Front. Med., 2021, 15(6): 922-932.
[12] William J. Liu, Haixia Xiao, Lianpan Dai, Di Liu, Jianjun Chen, Xiaopeng Qi, Yuhai Bi, Yi Shi, George F. Gao, Yingxia Liu. Avian influenza A (H7N9) virus: from low pathogenic to highly pathogenic[J]. Front. Med., 2021, 15(4): 507-527.
[13] Na Qin, Yuancheng Li, Cheng Wang, Meng Zhu, Juncheng Dai, Tongtong Hong, Demetrius Albanes, Stephen Lam, Adonina Tardon, Chu Chen, Gary Goodman, Stig E. Bojesen, Maria Teresa Landi, Mattias Johansson, Angela Risch, H-Erich Wichmann, Heike Bickeboller, Gadi Rennert, Susanne Arnold, Paul Brennan, John K. Field, Sanjay Shete, Loic Le Marchand, Olle Melander, Hans Brunnstrom, Geoffrey Liu, Rayjean J. Hung, Angeline Andrew, Lambertus A. Kiemeney, Shan Zienolddiny, Kjell Grankvist, Mikael Johansson, Neil Caporaso, Penella Woll, Philip Lazarus, Matthew B. Schabath, Melinda C. Aldrich, Victoria L. Stevens, Guangfu Jin, David C. Christiani, Zhibin Hu, Christopher I. Amos, Hongxia Ma, Hongbing Shen. Comprehensive functional annotation of susceptibility variants identifies genetic heterogeneity between lung adenocarcinoma and squamous cell carcinoma[J]. Front. Med., 2021, 15(2): 275-291.
[14] Solmaz Ohadian Moghadam, Seyed Ali Momeni. Human microbiome and prostate cancer development: current insights into the prevention and treatment[J]. Front. Med., 2021, 15(1): 11-32.
[15] Min Zhou, Xinxin Zhang, Jieming Qu. Coronavirus disease 2019 (COVID-19): a clinical update[J]. Front. Med., 2020, 14(2): 126-135.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed