1594P - Cancer mortality in young population and estimated radon areas in Spain

Background

Radon (Rn) gas is a significant cause of lung cancer in non-smokers, yet its involvement in other solid tumors remains uncertain. Here, we explore the link between cancer mortality across various tumor types and estimated Rn risk areas in Spain.

Methods

Retrospective analysis of mortality cases recorded in the National Mortality Registry (INE) between 1999-2021. We analyzed age-standardized rates, considering age and sex, using the ICD-10 classification, in municipalities with >10,000 inhabitants (overall, and the P25 of municipalities with higher rates). Spain was categorized into three risk groups: high (≥301 Bq/m3), intermediate (201 to 300 Bq/m3), and low (≤200 Bq/m3), based on the Rn Map from the Nuclear Safety Council.

Results

Out of 9,140,258 deaths, 2,351,989 (26.7%) were due to cancer; 61.7% in males and 38.3% in females; 147,324 (6.3%) in patients ≤50 y.o., with a median (m) age of 45 (15-50); 78,515 were in males (m. of 46) and 68,809 in females (m. of 45). Regarding municipalities: 87 (10.7%) were in high-Rn areas, 153 (19.7%) in intermediate, and 527 (69.5%) in low-Rn areas. No association was observed in age-standardized death rates by Rn area in the overall cohort. However, significant correlations were observed between Rn and certain solid tumors in young females, including pyriform sinus tumor (C12), with a higher mortality rate in high-risk areas (Pearson correlation coefficient (PCC): 0.95, P <0.0001), similar to malignant tumors of undefined (intrathoracic) sites of the respiratory system (C39) (PCC: 0.91, P =0.013) and renal pelvis tumors (C65) (PCC: 0.99, P <0.0001). In intermediate areas, correlations were observed in ureter (C66) (PCC: 0.99, P =0.002) and trachea tumors (C33) (considering the P25; PCC: 0.86, P =0.013). No correlation was observed in young males or between low-Rn areas and mortality rates.

Conclusions

This ecological study showed correlations between age-standardized death rates for certain solid tumors and Rn areas in Spain, notably in oropharyngeal and urothelial tumors in young females. Also, a correlation was found between Rn areas and thoracic malignancies in young females, a population typically associated with lower cumulative smoking exposure. Further prospective studies are needed to explore Rn's role in the young population.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Hospital Clínic i Provincial de Barcelona.

Funding

Has not received any funding.

Disclosure

A.F. Navarro Mendivil: Financial Interests, Personal, Advisory Board: Boehringer Ingelheim, Oryzon Genomics, Amgen, Hengenix Biotech, MedSIR, BMS; Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca, Pfizer, Takeda, Tecnofarma; Non-Financial Interests, Principal Investigator: BMS, PharmaMar, MSD, Amgen, Novartis, Debiopharm, Daiichi Sankyo, Roche, AstraZeneca. N. Reguart Aransay: Financial Interests, Personal, Advisory Board: Roche, MSD, Takeda, Bayer, Boehringer Ingelheim Pfizer, Novartis, Sanofi, Janssen, AstraZeneca, Amgen, Novartis, Merck, Janssen, AbbVie; Financial Interests, Personal, Invited Speaker: AstraZeneca, MSD, BMS, Amgen, Novartis, Sanofy, Merck; Non-Financial Interests, Principal Investigator, PI of Investigator Initiated Trial (PEERS) sponsored by MSD: MSD. C. Teixido: Financial Interests, Personal, Invited Speaker: AstraZeneca, Merck Sharp & Dohme, Roche Farma, Diaceutics, Pfizer; Financial Interests, Personal, Advisory Board: AstraZeneca, Novartis; Financial Interests, Institutional, Research Grant: Novartis, AstraZeneca. R. López Castro: Financial Interests, Personal, Advisory Board: AstraZeneca, Roche, Novartis, Amgen, Pierre Fabre. L. Mezquita: Financial Interests, Personal, Advisory Board: Takeda, Roche, AstraZeneca, MSD, Janssen; Financial Interests, Personal, Invited Speaker: Takeda, Roche, BMS, AstraZeneca, Janssen; Financial Interests, Personal, Research Grant, SEOM Beca Retorno 2019: BI; Financial Interests, Personal, Research Grant, ESMO TR Research Fellowship 2019: BMS; Financial Interests, Institutional, Research Grant, COVID research Grant: AMGEN; Financial Interests, Institutional, Coordinating PI, Cover cost of molecular test.: INIVATA; Financial Interests, Institutional, Coordinating PI: GILEAD; Financial Interests, Institutional, Coordinating PI, Beca SEOM Grupo Emergente 2022: AstraZeneca. All other authors have declared no conflicts of interest.