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Tupakoin), geenit ja keuhkosyöpä -­‐
NorTwinCan tutkimus JAAKKO KAPRIO LKT, akatemiaprofessori HJELT INSTITUTE, DEPT OF PUBLIC HEALTH, UNIVERSITY OF HELSINKI INSTITUTE FOR MOLECULAR MEDICINE (FIMM), UNIVERSITY OF HELSINKI NATIONAL INSTITUTE FOR HEALTH & WELFARE, HELSINKI, FINLAND CONFLICT OF INTEREST STATEMENT •  Dr. Kaprio has consulted for Pfizer in 2012 – 2014 CO-­‐AUTHORS Jacob Hjelmborg, Tellervo Korhonen, Klaus
Holst, Axel Skytthe, Eero Pukkala, Jennifer
R. Harris, Julia Kutschke, Lorelei A. Mucci,
Kamila Czene, Hans-Olov Adami, Thomas
Scheike.
This paper is currently under review SUPPORT Ellison Foundation (PI L.A. Mucci) and the
Nordic Union of Cancer (PI J. Kaprio). L.A.
Mucci is supported by the Prostate Cancer
Foundation. The Finnish Twin Cohort was
supported by the Academy of Finland
(grant numbers 213506, 129680, 265240,
263278) and Karolinska Institutet
Distinguished Professor Award to Prof. HO Adami (Dnr: 2368/10-221). The Ministry
for Higher Education financially supports
the Swedish Twin Registry. Adult per capita cigarette consumption, the United States, 1900–2006.
Warner K E , Mendez D Nicotine Tob Res 2010;12:876-887
© The Author 2010. Published by Oxford University Press on behalf of the Society for Research
on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail:
journals.permissions@oxfordjournals.org
Smoking prevalence 1950-2011 in Finland
80.0 70.0 60.0 50.0 40.0 Men Women 30.0 22,0
20.0 15,0
10.0 0.0 1950 1960 1970 1980 1990 2000 2010 Age-standardized incidence of lung cancer in working
age men in Finland (red), Denmark (green), Norway
(blue) and Sweden (yellow). 0.8 Es#mates of heritability for cancer, 2000 0.7 Heritability (95% CI) 0.6 0.5 0.4 0.3 0.2 0.1 0.0 Lichtenstein et al, 2000 Cancer Site or Type NorTwinCan • Popula)on-­‐based registries of twins and of cancer in Denmark, Finland, Norway and Sweden  36,508 incident cancers
Birth Cohort Alive at Mean follow-­‐up N Incident Cancers Denmark 1870-­‐2004 Jan 1943 35 years 11,840 Finland 1875-­‐1957 Feb 1974 29 years 4,487 Norway 1915-­‐1979 Jan 1964 40 years 3,368 Sweden 1886-­‐2008 Apr 1961 30 years 16,813 Country Country-­‐specific incidences of lung cancer in NorTwinCan Overall cancer risk 5.6% less in
men and 3.6% less in women in
the NorTwinCan cohorts than in the
population based on comparison
with cancer registry data for each
country.
The SIRs for lung cancer also
indicated less lung cancer among
twins than in the general population
(SIR for men = 0.88 and for women
0.95).
Incidences by zygosity very similar Smoking is major determinant of lung cancer based on 1356 cases among 102700 individual twins of known smoking status from Denmark, Finland and Sweden) Cumulative incidence of lung cancer adjusted for censoring, delayed entry to cancer registration, and
competing risk of death
Muut tulosdiat poisteeu Conclusions and context •  There is substan)al heritability of lung cancer and gene)c influences are condi)onal on exposure to tobacco and stable with increasing age. •  Earlier family (Czene K et al 2002) and twin (Braun M et al. 1995, Lichtenstein P et al. 2000) studies suggest that the contribu)on of gene)c factors is very modest. However, these studies have not taken the effect of smoking into account. •  GWAS studies indicate that some associated loci are found in both smokers and non-­‐smokers, while others (such as the CHRNA5 D398N variant) are found to be associated with lung cancer only in smokers. Genetic Influences on Lung Cancer: The Nordic Twin Study of Cancer
Hjelmborg J, Korhonen T et al, under review
Lorelei Mucci Hans-­‐Olov Adami Kathryn Penney David Havelick Harvard School of Public Health Axel SkyUhe Jacob Hjelmborg Thomas Scheike Niels Holm Danish Twin Registry The NorTwinCan Team Jennifer Harris Ingunn Brandt Thomas Nilsen Jaakko Kaprio Eero Pukkala Norwegian Twin Registry Swedish Twin Registry Tellervo Korhonen Kauko Heikkilä
Finnish Twin Cohort Study Mikael Hartman Kamila Czene Juni Palmgren Nancy Pedersen