Review
Radon and Lung Cancer : Current Trends and Future Perspectives
Mariona Riudavets 1 ,† , Marta Garcia de Herreros 2 ,† , Benjamin Besse 1 , * and Laura Mezquita 2 , 3 , 4
1 Medical Oncology Department , Gustave Roussy Cancer Campus , University Paris-Saclay , F-94800 Villejuif , France ;
mariona . riudavets @ gustaveroussy . fr
2 Medical Oncology Department Hospital Clínic i Provincial de Barcelona , IDIBAPS , 08036 Barcelona , Spain ;
garciadehe @ clinic . cat ( M . G . d . H .); lmezquita @ clinic . cat ( L . M .)
3 Laboratory of Translational Genomics and Targeted Therapies in Solid Tumors , IDIBAPS , 08036 Barcelona , Spain
4 Department of Medicine , University of Barcelona , 08007 Barcelona , Spain
* Correspondence : benjamin . besse @ gustaveroussy . fr † These authors contributed equally to this work .
Simple Summary : Radon represents the main risk factor of lung cancer in non-smokers and the second one in smoking patients . In Europe , there are several radon-prone areas , but regulatory policies may vary between countries . Radon causes DNA damage and high genomic tumor instability , but its exact carcinogenesis mechanism in lung cancer remains unknown . Molecular drivers in NSCLC are more often described in non-smoker patients and a potential association between radon exposure and oncogenic-driven NSCLC has been postulated . This is an updated review on indoor radon exposure and its role in lung cancer carcinogenesis , especially focusing on its potential relation with NSCLC with driver genomic alterations . We want to contribute to rising knowledge and awareness on this still silent but preventable lung cancer risk factor .
Citation : Riudavets , M .; Garcia de Herreros , M .; Besse , B .; Mezquita , L . Radon and Lung Cancer : Current Trends and Future Perspectives . Cancers 2022 , 14 , 3142 .
https :// doi . org / 10.3390 / cancers14133142
Academic Editors : Paul Hofman , Sendurai A . Mani , George A Calin , Ignacio I . Wistuba and Fabrizio Bianchi
Received : 25 April 2022 Accepted : 24 June 2022 Published : 27 June 2022
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Copyright : © 2022 by the authors . Licensee MDPI , Basel , Switzerland . This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution ( CC BY ) license (
https :// creativecommons . org / licenses / by / 4.0 /).
Abstract : Lung cancer is a public health problem and the first cause of cancer death worldwide . Radon is a radioactive gas that tends to accumulate inside homes , and it is the second lung cancer risk factor after smoking , and the first one in non-smokers . In Europe , there are several radon-prone areas , and although the 2013 / 59 EURATOM directive is aimed to regulate indoor radon exposition , regulating measures can vary between countries . Radon emits alpha-ionizing radiation that has been linked to a wide variety of cytotoxic and genotoxic effects ; however , the link between lung cancer and radon from the genomic point of view remains poorly described . Driver molecular alterations have been recently identified in non-small lung cancer ( NSCLC ), such as somatic mutations ( EGFR , BRAF , HER2 , MET ) or chromosomal rearrangements ( ALK , ROS1 , RET , NTRK ), mainly in the non-smoking population , where no risk factor has been identified yet . An association between radon exposure and oncogenic NSCLC in non-smokers has been hypothesised . This paper provides a practical , concise and updated review on the implications of indoor radon in lung cancer carcinogenesis , and especially of its potential relation with NSCLC with driver genomic alterations .
Keywords : lung cancer ; radon ; carcinogenesis ; driver genomic alterations ; non-smokers
Lung cancer is the second most common type of tumor in the world . According to the Global Cancer Observatory , a project developed by the International Agency for Research on Cancer ( IARC , part of the World Health Organization – WHO ), during 2020 a total of 19,292,789 new cases of cancer were documented , led by breast cancer ( 11.7 %) and followed by lung cancer ( 11.4 %), which is the most common type of tumor in men ( 14.3 %) [ 1 ].
In terms of mortality , lung cancer is the leading cause of death by cancer in the world , with 1,796,144 deaths registered in 2020 [ 1 ]. These data are a reflection of the serious health problem posed by this disease .
The main risk factor for developing lung cancer is tobacco smoking , which is related to 80 – 90 % of cases , and responsible of most of the deaths [ 2 – 4 ].