Abstract:
Introduction. Lung cancer is currently the leading cause of cancer-related death worldwide and tobacco smoking is the most important risk factor for its occurrence. Recent research suggests that lung cancer in never-smokers could be a different disease than lung
cancer in smokers, since different molecular pathways are present in never-smokers' lung
cancer. Residential radon exposure is the second risk factor of lung cancer after tobacco
smoking and the first risk factor for never-smokers. The problem of assessing the relationship between residential radon and lung cancer is the low variability in radon concentrations, as well as its weak linear relationship with smoking, hence being difficult to estimate
possible dose–response patterns. Some studies, performed in Europe and North America,
include risk communication/questionnaire and case–control studies on that issue. A review and a synthetic analysis of specialized literature served as the basis for a methodology
design aimed to study the synergism of radon and smoking in the occurrence of lung cancer
in the Republic of Moldova.
Material and methods. The study of the international experience on the methodology of
the synergism between radon and smoking was carried out by searching 30 different current publications, published over the last 10 years on ResearchGate, Pubmed, BioMedCentral, RSCI, European Commission Webgate, WHO publications, etc. A descriptive synthesis
of current approaches to the development and implementation of research methods for the
synergistic impact of radon and smoking on lung cancer was performed.
Results. To date, a few research have focused on the study of the effect of synergistic exposure to smoke and radon on lung cancer incidence. A review of the specialized literature
showed that the main methods for studying this phenomenon are case-control studies and
sociological methods by raising public awareness, free testing and subsequent interviewing the risk groups. A combination of the approaches based on the successful experience of
Spanish researchers, allowed to develop a questionnaire for the case-control study of patients with lung cancer. It includes 15 questions (related to sociodemographic, shelter,
smoking, measuring radon, and diagnosis issues), hence suggesting being used within a
long-term study along with the Institute of Oncology, followed by the subsequent database
creation and the statistical processing of the obtained materials. The reliable statistical
data on the relationship of the synergism of exposure to radon and smoking will allow to
quantify and qualify the combination of these risk factors for the lung cancer incidence
across our country.
Conclusions. The methodological approach designed to study the synergism of radon and
smoking on the lung cancer incidence, based on the international experience and its application in Moldova will contribute significantly to this little-studied research area, as well
as allow the public health system to develop the appropriate preventive means. There is a
need to provide strategic guidance on what the synergistic approach to radon and tobacco
control entails.
