Format

Send to

Choose Destination
Int J Cancer. 2018 Apr 26. doi: 10.1002/ijc.31564. [Epub ahead of print]

Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE).

Author information

1
Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
2
Agency for Preventive and Social Medicine, Bregenz (aks), Austria.
3
Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy.
4
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
5
Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
6
The Danish Cancer Society Research Ce, nter, Copenhagen, Denmark.
7
Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy.
8
Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden.
9
Norwegian Institute of Public Health, Oslo, Norway.
10
Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway.
11
Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
12
Department of Medical Epidemiology and Biostatistics, University Medical Center Utrecht, Utrecht, The Netherlands.
13
Department of Molecular Medicine and Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
14
Aging Research Center, Department of Neurobiology Care Science and Society, University Medical Center Utrecht, Utrecht, The Netherlands.
15
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
16
MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom.
17
Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
18
Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
19
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
20
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
21
Swiss Tropical and Public Health Institute, Basel, Switzerland.
22
University of Basel, Basel, Switzerland.
23
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
24
Vorarlberg cancer registry; Agency for Preventive and Social Medicine, Bregenz (aks), Austria.
25
Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington.
26
Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
27
Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
28
Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy.
29
Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy.
30
ISGlobal Institute de Salut Global Barcelona, Barcelona, Spain.
31
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
32
Universitat Pompeu Fabra, Barcelona, Spain.
33
Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
34
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
35
Molecular end Epidemiology Unit, HuGeF, Human Genetics Foundation, Torino, Italy.
36
Department of Environmental Science, Aarhus University, Roskilde, Denmark.

Abstract

Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancers of the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient air pollution with incidence of gastric and UADT cancer in 11 European cohorts. Air pollution exposure was assigned by land-use regression models for particulate matter (PM) below 10 µm (PM10 ), below 2.5 µm (PM2.5 ), between 2.5 and 10 µm (PMcoarse ), PM2.5 absorbance and nitrogen oxides (NO2 and NOX ) as well as approximated by traffic indicators. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. During average follow-up of 14.1 years of 305,551 individuals, 744 incident cases of gastric cancer and 933 of UADT cancer occurred. The hazard ratio for an increase of 5 µg/m3 of PM2.5 was 1.38 (95% CI 0.99; 1.92) for gastric and 1.05 (95% CI 0.62; 1.77) for UADT cancers. No associations were found for any of the other exposures considered. Adjustment for additional confounders and restriction to study participants with stable addresses did not influence markedly the effect estimate for PM2.5 and gastric cancer. Higher estimated risks of gastric cancer associated with PM2.5 was found in men (HR 1.98 [1.30; 3.01]) as compared to women (HR 0.85 [0.5; 1.45]). This large multicentre cohort study shows an association between long-term exposure to PM2.5 and gastric cancer, but not UADT cancers, suggesting that air pollution may contribute to gastric cancer risk.

KEYWORDS:

ESCAPE; air pollution; epidemiology; gastric cancer; upper aerodigestive tract cancer

PMID:
29696642
DOI:
10.1002/ijc.31564

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center