Lung cancer is the leading cause of death from malignant neoplasms in the United States. Reduction in the mortality from this lethal malignancy will require reduction in the prevalence of risk factors and/or improved diagnosis and therapy. While relative survival rates for localized disease are dramatically better than for nonlocalized disease, most patients are not diagnosed early enough for present therapies to be effective. Advances in our understanding of the biology of lung cancer in recent years indicate that research to identify early markers of lung cancer may hold great promise for the reduction of lung cancer mortality. Numerous potential candidates for the early detection of lung cancer in sputum exist. The tin miners at the Yunnan Tin Corporation (YTC) in China have an extremely high rate of lung cancer. Among high risk miners, defined as 40+ years old with 10+ years of underground mining and/or smelting experience, lung cancer rates exceed 1% per year. These extraordinary lung cancer rates result from combined exposure to radon, arsenic, and tobacco smoking in the form of cigarettes and/or bamboo water pipe. The primary objective of this study is to establish a biologic specimen bank and data bank that can be used for the validation and refinement of potential early markers of lung cancer. Biologic specimens to be collected include sputum, blood, urine, and toenails. A secondary objective includes the establishment of a cohort for the study of environmental (including dietary) and genetic risk factors for lung cancer.
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