Jianxin Li1,2, Xiangfeng Lu1,2, Fangchao Liu1, Fengchao Liang1, Keyong Huang1, Xueli Yang1, Qingyang Xiao3, Jichun Chen1, Xiaoqing Liu4, Jie Cao1, Shufeng Chen1, Chong Shen5, Ling Yu6, Fanghong Lu7, Xianping Wu8, Liancheng Zhao1, Xigui Wu1, Ying Li1, Dongsheng Hu9,10, Jianfeng Huang1, Meng Zhu5,11, Yang Liu12, Hongbing Shen5,11, Dongfeng Gu1,2,13. 1. Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 2. Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China. 3. School of Environment, Tsinghua University, Beijing, China. 4. Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China. 5. Department of Epidemiology, Center for Global Health, School of Public Health, and. 6. Department of Cardiology, Fujian Provincial Hospital, Fuzhou, China. 7. Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China. 8. Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, China. 9. Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China. 10. Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China. 11. Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China. 12. Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia; and. 13. School of Medicine, Southern University of Science and Technology, Shenzhen, China.
Abstract
Rationale: Limited cohort studies have evaluated chronic effects of high fine particulate matter (particulate matter with an aerodynamic diameter ≤2.5 μm [PM2.5]) exposure on lung cancer. Objectives: To investigate the response pattern of lung cancer associated with high PM2.5 exposure. Methods: A Chinese cohort of 118,551 participants was followed up from 1992 to 2015. By incorporating PM2.5 exposure at 1 km spatial resolution generated using the satellite-based model during 2000-2015, we estimated the association between lung cancer and time-weighted average PM2.5 concentration using Cox proportional hazard models.Measurements and Main Results: A total of 844 incident lung cancer cases were identified during 915,053 person-years of follow-up. Among them, 701 lung cancer deaths occurred later. The exposure-response curves for lung cancer associated with PM2.5 exposure were nonlinear, with steeper slopes at the higher concentrations. Adjusted for age, sex, geographical region, urbanization, education level, smoking status, alcohol consumption, work-related physical activity, and body mass index, participants exposed to the second-fifth quintiles of PM2.5 had higher risk for lung cancer incidence than those exposed to the first quintile, with hazard ratios of 1.44 (95% confidence interval [CI], 1.10-1.88), 1.49 (95% CI, 1.12-1.99), 2.08 (95% CI, 1.42-3.04), and 2.45 (95% CI, 1.83-3.29), respectively. The corresponding hazard ratios for lung cancer mortality were 1.83 (95% CI, 1.33-2.50), 1.80 (95% CI, 1.29-2.53), 2.50 (95% CI, 1.62-3.86), and 2.95 (95% CI, 2.09-4.17), respectively.Conclusions: We provide strong evidence that high PM2.5 exposure leads to an elevated risk of lung cancer incidence and mortality, highlighting that remarkable public health benefits could be obtained from the improvement of air quality in highly polluted regions.
Rationale: Limited cohort studies have evaluated chronic effects of high fine particulate matter (particulate matter with an aerodynamic diameter ≤2.5 μm [PM2.5]) exposure on lung cancer. Objectives: To investigate the response pattern of lung cancer associated with high PM2.5 exposure. Methods: A Chinese cohort of 118,551 participants was followed up from 1992 to 2015. By incorporating PM2.5 exposure at 1 km spatial resolution generated using the satellite-based model during 2000-2015, we estimated the association between lung cancer and time-weighted average PM2.5 concentration using Cox proportional hazard models.Measurements and Main Results: A total of 844 incident lung cancer cases were identified during 915,053 person-years of follow-up. Among them, 701 lung cancer deaths occurred later. The exposure-response curves for lung cancer associated with PM2.5 exposure were nonlinear, with steeper slopes at the higher concentrations. Adjusted for age, sex, geographical region, urbanization, education level, smoking status, alcohol consumption, work-related physical activity, and body mass index, participants exposed to the second-fifth quintiles of PM2.5 had higher risk for lung cancer incidence than those exposed to the first quintile, with hazard ratios of 1.44 (95% confidence interval [CI], 1.10-1.88), 1.49 (95% CI, 1.12-1.99), 2.08 (95% CI, 1.42-3.04), and 2.45 (95% CI, 1.83-3.29), respectively. The corresponding hazard ratios for lung cancermortality were 1.83 (95% CI, 1.33-2.50), 1.80 (95% CI, 1.29-2.53), 2.50 (95% CI, 1.62-3.86), and 2.95 (95% CI, 2.09-4.17), respectively.Conclusions: We provide strong evidence that high PM2.5 exposure leads to an elevated risk of lung cancer incidence and mortality, highlighting that remarkable public health benefits could be obtained from the improvement of air quality in highly polluted regions.
Entities:
Keywords:
chronic effect; cohort; fine particulate matter; lung cancer
Authors: Michelle C Turner; Daniel Krewski; C Arden Pope; Yue Chen; Susan M Gapstur; Michael J Thun Journal: Am J Respir Crit Care Med Date: 2011-10-06 Impact factor: 21.405
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