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Gregory J. Riely, MD, PhD


WCLC 2022: Radon Exposure and Prevalence of Molecular Alterations in NSCLC Across Europe

By: Kayci Reyer
Posted: Thursday, September 1, 2022

According to research presented at the International Association for the Study of Lung Cancer (IASLC) World Conference on Lung Cancer (WCLC) 2022 (Abstract OA13.04), there may be an association between environmental radon levels and the prevalence of ALK fusion in non–small cell lung cancer (NSCLC). The study sought to determine whether an association could be found between estimated indoor radon exposure and the frequency of driver alterations in some European countries.

“Radon is the leading cause of lung cancer in nonsmokers, in whom molecular driver alterations occur most commonly,” noted Laura Mezquita, MD, of the Hospital Clinic Barcelona, and colleagues.

The retrospective study included data from 21 European countries. The estimated mean indoor radon level was 78.5 Bq/m3. Albania, the Czech Republic, Finland, Serbia, and Sweden had mean levels higher than 100 Bq/m3. Radon concentrations topped 400 Bq/m3 in more than 1% of dwellings in six countries, including Austria (> 3%), Finland (> 3%), and the Czech Republic (> 3%). A positive correlation was noted between the prevalence of ALK alterations and the percentage of dwellings with levels higher than 200 Bq/m3 and those with levels higher than 400 Bq/m3. However, no correlation was observed between the prevalence of EGFR alterations and indoor radon levels.

Median prevalence of EGFR and ALK alterations across all observed countries was 10% and 4%, respectively. Across countries with a mean radon exposure of at least 101 Bq/m3 versus those with a mean radon exposure of up to 100 Bq/m3, the prevalence of EGFR alterations was 10% versus 11%, whereas the prevalence of ALK alterations was 5% versus 4%. Demographic data were sourced from the World Health Organization’s Global Cancer Observatory, and radon exposure data were collected from the European Commission Report 2005. Published articles with a sample size of at least 101 patients provided country-specific data on the prevalence of molecular alterations.

Disclosure: For full disclosures of the study authors, visit

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