Occupation, gender, race, and lung cancer.

Lung cancer cases in the United States have decreased among men but continue to increase among women, and specifically black women.1–3 The former trend is attributed to the reduction in cigarette smoking, a well-established risk factor for lung cancer. Nevertheless, the latter trend remains unexplained because new cases are being diagnosed in women who have never smoked. Among other causes of lung cancer are occupational and/or environmental exposures to carcinogens,4–12 including residential radon13,14 and environmental tobacco smoke (ETS).15 Associations between exposures to cooking oil vapors and coal fumes at home and high levels of lung cancer have been reported in nonsmoking women.16,17 The combination of exposure to environmental risk factors and genetic differences has also been hypothesized to account for higher risks of lung cancer in women.18–21 There is a growing body of literature that addresses lung cancer and gender differences in susceptibility to tobacco-induced carcinogenesis.18–24 We used the multicenter case-control Maryland Lung Cancer Study to determine whether gender and race differences existed when the associations between lung cancer and occupations were examined.