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Lung cancer has high mortality and incidence rates. The leading causes of lung cancer are smoking and radon exposure. Indeed, the World Health Organization (WHO) has categorized radon as a carcinogenic substance causing lung cancer. Radon is a natural, radioactive substance; it is an inert gas that mainly exists in soil or rock. The gas decays into radioactive particles called radon progeny that can enter the human body through breathing. Upon entering the body, these radioactive elements release α-rays that affect lung tissue, causing lung cancer upon long-term exposure thereto. Epidemiological studies first outlined a high correlation between the incidence rate of lung cancer and exposure to radon progeny among miners in Europe. Thereafter, data and research on radon exposure and lung cancer incidence in homes have continued to accumulate. Many international studies have reported increases in the risk ratio of lung cancer when indoor radon concentrations inside the home are high.

Although research into indoor radon concentrations and lung cancer incidence is actively conducted throughout North America and Europe, similar research is lacking in Korea. Recently, however, studies have begun to accumulate and report important data on indoor radon concentrations across the nation. In this study, we aimed to review domestic and foreign research into indoor radon concentrations and to outline correlations between indoor radon concentrations in homes and lung cancer incidence, as reported in ecological studies thereof.

Herein, we noted large differences in radon concentrations between and within individual countries. For Korea, we observed tremendous differences in indoor radon concentrations according to region and year of study, even within the same region. In correlation analysis, lung cancer incidence was not found to be higher in areas with high indoor radon concentrations in Korea.

Through our review, we identified a need to implement a greater variety of statistical analyses in research on indoor radon concentrations and lung cancer incidence. Also, we suggest that cohort research or patient-control group research into radon exposure and lung cancer incidence that considers smoking and other factors is warranted.

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Although the incidence and mortality for most cancers such as lung and colon are decreasing in several countries, they are increasing in several developed countries because of an unhealthy western lifestyles including smoking, physical inactivity and consumption of calorie-dense food. The incidences for lung and colon cancers in a few of these countries have already exceeded those in the United States and other western countries. Among them, lung cancer is the main cause of cancer death in worldwide. The cumulative survival rate at five years differs between 13 and 21 % in several countries. Although the most important risk factors are smoking for lung cancer, however, the increased incidence of lung cancer in never smokers(LCINS) is necessary to improve knowledge concerning other risk factors. Environmental factors and genetic susceptibility are also thought to contribute to lung cancer risk. Patients with lung adenocarcinoma who have never smoking frequently contain mutation within tyrosine kinase domain of the epidermal growth factor receptor(EGFR) gene. Also, K-ras mutations are more common in individuals with a history of smoking use and are related with resistance to EFGR-tyrosine kinase inhibitors. Recently, radon(Rn), natural and noble gas, has been recognized as second common reason of lung cancer. In this review, we aim to know whether residential radon is associated with an increased risk for developing lung cancer and regulated by several genetic polymorphisms.

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Lung cancer is a leading cause of cancer-related death in the world. Smoking is definitely the most important risk factor for lung cancer. Radon (²²²Rn) is a natural gas produced from radium (²²⁶Ra) in the decay series of uranium (²³⁸U). Radon exposure is the second most common cause of lung cancer and the first risk factor for lung cancer in never-smokers.

Case–control studies have provided epidemiological evidence of the causative relationship between indoor radon exposure and lung cancer. Twenty-four case–control study papers were found by our search strategy from the PubMed database. Among them, seven studies showed that indoor radon has a statistically significant association with lung cancer. The studies performed in radon-prone areas showed a more positive association between radon and lung cancer. Reviewed papers had inconsistent results on the dose–response relationship between indoor radon and lung cancer risk.

Further refined case–control studies will be required to evaluate the relationship between radon and lung cancer. Sufficient study sample size, proper interview methods, valid and precise indoor radon measurement, wide range of indoor radon, and appropriate control of confounders such as smoking status should be considered in further case–control studies.

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Exposure to radon gas is the second most common cause of lung cancer after smoking. A large number of studies have reported that exposure to indoor radon, even at low concentrations, is associated with lung cancer in the general population. This paper reviewed studies from several countries to assess the attributable risk (AR) of lung cancer death due to indoor radon exposure and the effect of radon mitigation thereon. Worldwide, 3–20 % of all lung cancer deaths are likely caused by indoor radon exposure. These values tend to be higher in countries reporting high radon concentrations, which can depend on the estimation method. The estimated number of lung cancer deaths due to radon exposure in several countries varied from 150 to 40,477 annually. In general, the percent ARs were higher among never-smokers than among ever-smokers, whereas much more lung cancer deaths attributable to radon occurred among ever-smokers because of the higher rate of lung cancers among smokers. Regardless of smoking status, the proportion of lung cancer deaths induced by radon was slightly higher among females than males. However, after stratifying populations according to smoking status, the percent ARs were similar between genders. If all homes with radon above 100 Bq/m³ were effectively remediated, studies in Germany and Canada found that 302 and 1704 lung cancer deaths could be prevented each year, respectively. These estimates, however, are subject to varying degrees of uncertainty related to the weakness of the models used and a number of factors influencing indoor radon concentrations.

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Radiation from natural sources is one of causes of the environmental diseases. Radon is the leading environmental cause of lung cancer next to smoking. To investigate the relationship between indoor radon concentrations and lung cancer, researchers must be able to estimate an individual’s cumulative level of indoor radon exposure and to do so, one must first be able to assess indoor radon concentrations. In this article, we outline factors affecting indoor radon concentrations and review related mathematical models based on the mass balance equation and the differential equations. Furthermore, we suggest the necessities of applying time-dependent functions for indoor radon concentrations and developing stochastic models.

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