State of the science on outdoor air pollution exposure and liver cancer risk.
State of the science on outdoor air pollution exposure and liver cancer risk.
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DOI：
10.1016/j.envadv.2023.100354
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发表时间：
2023-04
影响因子：
--
通讯作者：
T. VoPham;Rena R. Jones
中科院分区：
文献类型：
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作者：
T. VoPham;Rena R. Jones
背景有新的证据表明，暴露于空气污染会增加患肝癌的风险。迄今为止，在美国、台湾和欧洲进行的四项流行病学研究显示，环境暴露于空气污染物（包括空气动力学直径<2.5 µm的颗粒物（PM2.5）和二氧化氮（NO2））与肝癌风险之间存在普遍一致的正相关。有几个研究空白，因此有宝贵的机会，未来的工作，继续建立在这个不断扩大的文学机构。本文的目的是综合现有的关于空气污染暴露与肝癌发病率之间关系的流行病学文献，并描述未来的研究方向，以促进对空气污染暴露在肝癌发展中作用的科学理解。未来的研究方向包括：1）解释主要组织学亚型的既定危险因素的潜在混杂，肝细胞癌（HCC）; 2）考虑到根据组织学的潜在差异相关性，检查偶发原发性肝癌结果; 3）考虑到早期生活和/或历史暴露、居住史、来自其他空气污染源的残留混杂（例如，吸烟），以及地理空间环境暴露建模与新的生物标志物技术的整合; 4）检查在环境中经历的空气污染混合物; 5）考虑由于气候变化而增加的暴露于室外空气污染的机会（例如，野火）;以及6）考虑空气污染暴露的修正因素，如社会经济地位，这可能有助于肝癌发病率的差异。结论根据越来越多的证据表明，较高水平的空气污染暴露增加了患肝癌的风险，方法学上的考虑主要是关于残余混杂和改进的暴露评估，这是有必要的，以有力地证明以下因素的独立相关性：空气污染是一种致癌物质。
BackgroundThere is emerging evidence that air pollution exposure increases the risk of developing liver cancer. To date, there have been four epidemiologic studies conducted in the United States, Taiwan, and Europe showing generally consistent positive associations between ambient exposure to air pollutants, including particulate matter <2.5 µm in aerodynamic diameter (PM2.5) and nitrogen dioxide (NO2), and liver cancer risk. There are several research gaps and thus valuable opportunities for future work to continue building on this expanding body of literature. The objectives of this paper are to narratively synthesize existing epidemiologic literature on the association between air pollution exposure and liver cancer incidence and describe future research directions to advance the science of understanding the role of air pollution exposure in liver cancer development.Future research directionsinclude 1) accounting for potential confounding by established risk factors for the predominant histological subtype, hepatocellular carcinoma (HCC); 2) examination of incident primary liver cancer outcomes with consideration of potential differential associations according to histology; 3) air pollution exposure assessments considering early-life and/or historical exposures, residential histories, residual confounding from other sources of air pollution (e.g., tobacco smoking), and integration of geospatial ambient exposure modeling with novel biomarker technologies; 4) examination of air pollution mixtures experienced in the exposome; 5) consideration of increased opportunities for exposure to outdoor air pollution due to climate change (e.g., wildfires); and 6) consideration of modifying factors for air pollution exposure, such as socioeconomic status, that may contribute to disparities in liver cancer incidence.ConclusionsIn light of mounting evidence demonstrating that higher levels of air pollution exposure increase the risk for developing liver cancer, methodological considerations primarily concerning residual confounding and improved exposure assessment are warranted to robustly demonstrate an independent association for air pollution as a hepatocarcinogen.