Yufeng Chen1, Ellen T Chang2, Zhiwei Liu1, Qing Liu3, Yonglin Cai4, Zhe Zhang5, Guomin Chen6, Qi-Hong Huang7, Shang-Hang Xie3, Su-Mei Cao3, Wei-Hua Jia8, Yuming Zheng4, Yancheng Li9, Longde Lin10, Ingemar Ernberg11, Hongwei Zhao12, Ruimei Feng13, Guangwu Huang5, Yi Zeng6, Yi-Xin Zeng14, Hans-Olov Adami15, Weimin Ye16. 1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 2. Exponent, Inc., Center for Health Sciences, Menlo Park, CA, USA; Stanford Cancer Institute, Stanford, CA, USA. 3. Department of Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China; State Key Laboratory of Oncology in South China & Collaborative Innovation Center for Cancer Medicine & Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China. 4. Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou, China; Wuzhou Health System Key Laboratory for Nasopharyngeal Carcinoma Etiology and Molecular Mechanism, Wuzhou, China. 5. Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China. 6. State Key Laboratory for Infectious Diseases Prevention and Control, Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. 7. Sihui Cancer Institute, Sihui, China. 8. State Key Laboratory of Oncology in South China & Collaborative Innovation Center for Cancer Medicine & Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China. 9. Cangwu Institute for Nasopharyngeal Carcinoma Control and Prevention, Wuzhou, China. 10. Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Nanning, China. 11. Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden. 12. Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA. 13. Department of Epidemiology and Health Statistics & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. 14. State Key Laboratory of Oncology in South China & Collaborative Innovation Center for Cancer Medicine & Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China; Beijing Hospital, Beijing, China. 15. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway. 16. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Health Statistics & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. Electronic address: weimin.ye@ki.se.
Abstract
OBJECTIVES: Given the role of exposures related to residence in the development of nasopharyngeal carcinoma (NPC) has not been well explored, present study aims to investigate the magnitude and pattern of associations for NPC with lifelong residential exposures. MATERIALS AND METHODS: We carried out a multi-center, population-based case-control study with 2533 incident NPC cases and 2597 randomly selected population controls in southern China between 2010 and 2014. We performed multivariate logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the risk of NPC associated with residential exposures. RESULTS: Compared with those living in a building over lifetime, risk of NPC was higher for individuals living in a cottage (OR: 1.56; 95% CI: 1.34-1.81) or in a boat (3.87; 2.07-7.21). NPC risk was also increased in individuals using wood (1.34; 1.03-1.75), coal (1.70; 1.17-2.47), or kerosene (3.58; 1.75-7.36) vs. using gas/electricity as cooking fuel; using well water (1.57; 1.34-1.83), river water (1.80; 1.47-2.21), or spring/pond/stream water (2.03; 1.70-2.41) vs. tap water for source of drinking water; living in houses with smaller-sized vs. larger windows in the bedroom (3.08; 2.46-3.86), hall (1.89; 1.55-2.31) or kitchen (1.67; 1.34-2.08); and increasing exposure to cooking smoke [(1.53; 1.20-1.94) for high exposure)] or burned incense [(1.59; 1.31-1.95) for daily use)]. Weighted Cox regression analysis corroborated these results. CONCLUSION: Poorer residential conditions and household air pollution are associated with an increased risk of NPC. Large-scale studies in other populations or longitudinal studies are warranted to further corroborate these findings.
OBJECTIVES: Given the role of exposures related to residence in the development of nasopharyngeal carcinoma (NPC) has not been well explored, present study aims to investigate the magnitude and pattern of associations for NPC with lifelong residential exposures. MATERIALS AND METHODS: We carried out a multi-center, population-based case-control study with 2533 incident NPC cases and 2597 randomly selected population controls in southern China between 2010 and 2014. We performed multivariate logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the risk of NPC associated with residential exposures. RESULTS: Compared with those living in a building over lifetime, risk of NPC was higher for individuals living in a cottage (OR: 1.56; 95% CI: 1.34-1.81) or in a boat (3.87; 2.07-7.21). NPC risk was also increased in individuals using wood (1.34; 1.03-1.75), coal (1.70; 1.17-2.47), or kerosene (3.58; 1.75-7.36) vs. using gas/electricity as cooking fuel; using well water (1.57; 1.34-1.83), river water (1.80; 1.47-2.21), or spring/pond/stream water (2.03; 1.70-2.41) vs. tap water for source of drinking water; living in houses with smaller-sized vs. larger windows in the bedroom (3.08; 2.46-3.86), hall (1.89; 1.55-2.31) or kitchen (1.67; 1.34-2.08); and increasing exposure to cooking smoke [(1.53; 1.20-1.94) for high exposure)] or burned incense [(1.59; 1.31-1.95) for daily use)]. Weighted Cox regression analysis corroborated these results. CONCLUSION: Poorer residential conditions and household air pollution are associated with an increased risk of NPC. Large-scale studies in other populations or longitudinal studies are warranted to further corroborate these findings.