Fine Particulate Matter Exposure and Cancer Incidence: Analysis of SEER Cancer Registry Data from 1992-2016
Fine Particulate Matter Exposure and Cancer Incidence: Analysis of SEER Cancer Registry Data from 1992-2016
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DOI：
10.1289/ehip7246
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发表时间：
2020-10-01
影响因子：
10.4
通讯作者：
Pope, C. Arden, III
中科院分区：
文献类型：
--
作者：
Coleman, Nathan C.;Burnett, Richard T.;Pope, C. Arden, III
背景：先前的研究已经确定了细颗粒物（PM2.5）空气污染与肺癌之间的联系。然而，这种关联的大部分证据是基于肺癌死亡率的研究，而不是发病率。有关PM2.5与非肺癌发病率之间潜在关联的研究还很有限。目的：本研究的主要目的是利用美国登记的850万例癌症发病率来评估癌症发病率与暴露于PM2.5之间的关系。次要目标包括评估模型选择、空间控制和潜伏期的敏感性，以及估计几种癌症类型的暴露-反应关系。方法：监测、流行病学和最终结果（SEER）项目数据用于计算美国607个县各种癌症类型的发病率。采用综合实证地理回归模型估算县级PM2.5浓度。采用灵活的半非参数回归模型来估计PM2.5与选定癌症发病率之间的关联，同时控制重要的县级协变量。使用1992-2016年平均发病率和1988-2015年平均PM2.5的主要时间无关模型进行估算。此外，利用2002-2011年年发病率的时变模型和PM2.5年估计值的滞后移动平均值也进行了估算。结果：所有癌症和肺癌的发病率与PM2.5一致相关。PM2.5每增加10 μ g/m(3)，所有癌症和肺癌的发生率分别为1.09 （95% CI: 1.03, 1.14）和1.19 （95% CI: 1.09, 1.30）。与口腔癌、直肠癌、肝癌、皮肤癌、乳腺癌和肾癌的相关性较弱。讨论：暴露于PM2.5空气污染会增加肺癌发病率，并可能与非肺癌发病率相关。
BACKGROUND: Previous research has identified an association between fine particulate matter (PM2.5) air pollution and lung cancer. Most of the evidence for this association, however, is based on research using lung cancer mortality, not incidence. Research that examines potential associations between PM2.5 and incidence of non-lung cancers is limited.OBJECTIVES: The primary purpose of this study was to evaluate the association between the incidence of cancer and exposure to PM2.5 using >8.5 million cases of cancer incidences from U.S. registries. Secondary objectives include evaluating the sensitivity of the associations to model selection, spatial control, and latency period as well as estimating the exposure-response relationship for several cancer types.METHODS: Surveillance, Epidemiology, and End Results (SEER) program data were used to calculate incidence rates for various cancer types in 607 U.S. counties. County-level PM2.5 concentrations were estimated using integrated empirical geographic regression models. Flexible semi-nonparametric regression models were used to estimate associations between PM2.5 and cancer incidence for selected cancers while controlling for important county-level covariates. Primary time-independent models using average incidence rates from 1992-2016 and average PM2.5 from 1988-2015 were estimated. In addition, time-varying models using annual incidence rates from 2002-2011 and lagged moving averages of annual estimates for PM2.5 were also estimated.RESULTS: The incidences of all cancer and lung cancer were consistently associated with PM2.5. The incident rate ratios (IRRs), per 10-mu g/m(3) increase in PM2.5, for all and lung cancer were 1.09 (95% CI: 1.03, 1.14) and 1.19 (95% CI: 1.09, 1.30), respectively. Less robust associations were observed with oral, rectal, liver, skin, breast, and kidney cancers.DISCUSSION: Exposure to PM2.5 air pollution contributes to lung cancer incidence and is potentially associated with non-lung cancer incidence.