Indoor cooking over stoves that burn solid fuel (wood, charcoal, crop residues, dung, and coal) increases the risk of lung cancer, according to a study conducted in Eastern and Central Europe and the United Kingdom, and published in the American Journal of Epidemiology.

Lung cancer is the leading cause of cancer death in the U.S. and Europe. In the U.S., an estimated 90,000 men and 73,000 women will die of lung cancer in 2005. Smoking is the leading cause of lung cancer, but air pollution may also play a role. Indoor air pollution can result from radon, chemicals, and smoke from cooking or heating stoves.

In order to evaluate the effect of indoor cooking or heating with solid fuels on the risk of lung cancer, researchers conducted a study in Central and Eastern Europe and the United Kingdom. These regions have high rates of lung cancer and a long history of burning coal and other solid fuels. Between 1998 and 2002, the researchers enrolled 2861 lung cancer patients and 3118 persons without lung cancer from the Czech Republic, Hungary, Poland, Romania, Russia, Slovakia, and the United Kingdom. Information about indoor use of solid fuels for cooking or heating was collected by interviewing study subjects about the fuel sources in each place they had lived.

Eighty-two percent of study subjects had used indoor solid fuel at some point in their lives. Coal was the most common. Compared to study subjects who had never lived in a home where solid fuels were used for cooking or heating, those with any exposure had a roughly 20% increased risk of lung cancer. Risk of lung cancer was more elevated after exposure to solid fuels for cooking than after exposure to solid fuels only for heat. Study subjects who had used solid fuel for cooking throughout their entire lives had an 80% increased risk of lung cancer compared to subjects who had never been exposed to indoor solid fuel. Among subjects who switched from using solid fuels to using modern fuels (such as gas, electricity, or kerosene), risk of lung cancer was less elevated (16% increased risk of lung cancer).

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The researchers conclude that indoor burning of solid fuels for cooking results in a modestly increased risk of lung cancer. This study built upon previous studies by separately considering the effects of cooking and heating with solid fuels. Indoor cooking with solid fuels appears to pose a greater lung cancer risk than indoor heating with solid fuels.

Reference: Lissowska J, Bardin-Mikolajczak A, Fletcher T et al. Lung cancer and indoor air pollution from heating and cooking with solid fuels. The IARC International Multicentre Case-Control Study in Eastern/Central Europe and the United Kingdom. American Journal of Epidemiology. 2005;162:326-333.

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