Cancer Res Treat.  2022 Oct;54(4):1030-1037. 10.4143/crt.2021.1030.

Long-term Exposure to PM₁₀ Increases Lung Cancer Risks: A Cohort Analysis

• Lee HW
• Kang SC
• Kim SY
• Cho YJ
• Hwang S

• KMID: 2534182
• DOI: http://doi.org/10.4143/crt.2021.1030

Abstract

Purpose
Although lung cancer incidences in female never-smokers have increased, few studies focus on explicit investigation. We aimed to investigate the relationship between long-term exposure to ambient particulate matter sized 10 μm or less in diameter (PM₁₀) and the incidence of lung cancer within different genders and smoking status populations.
Materials and Methods
We included Seoul metropolitan residents, aged between 20 and 65 years, who underwent a national health screening examination from 2005-2007 and were followed up until 2015. Individual-level long-term exposure to PM₁₀ was assessed based on subject home addresses. To assess the relationship between PM₁₀ and lung cancer, we estimated hazard ratios (HRs) for increased lung cancer incidence from a 10 µg/m³ increase in PM₁₀.
Results
Among 5,831,039 individuals, 36,225 (0.6%) developed lung cancer within the 7 years observed. In females, the majority (94.4%) of lung cancer development was found in never-smokers. In adjusted analyses, a significant relationship between lung cancer development and PM₁₀ was observed in males, regardless of smoking status (never-smoker: HR, 1.14 [95% confidence interval (CI), 1.13 to 1.15]; ex-smoker: HR, 1.16 [95% CI, 1.14 to 1.17]; current smoker: HR, 1.18 [95% CI, 1.17 to 1.19]). We also found significant associations in female never- or ex-smokers with smaller HRs (never-smoker: HR, 1.06 [95% CI, 1.05 to 1.07]; ex-smoker: HR, 1.13 [95% CI, 1.02 to 1.23]; current smoker: HR, 1.04 [95% CI, 0.99 to 1.10]).
Conclusion
Our findings suggest that long-term exposure to PM₁₀ is associated with lung cancer development. A novel approach to lung cancer screening needs to be considered depending on the exposed PM₁₀ level.

Keyword

Particulate matter; Lung neoplasms; Incidence; Women; Men; Non-smokers; Smokers

Figure

• 

  Fig. 1 Maps of mean PM10 concentrations in the Seoul metropolitan area of South Korea. PM10, particulate matter 10 μm or less in diameter.

Reference

References

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015; 65:5–29.

2. Malhotra J, Malvezzi M, Negri E, La Vecchia C, Boffetta P. Risk factors for lung cancer worldwide. Eur Respir J. 2016; 48:889–902.

3. Alberg AJ, Brock MV, Ford JG, Samet JM, Spivack SD. Epidemiology of lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013; 143(5 Suppl):e1S–e29S.

4. Tindle HA, Stevenson Duncan M, Greevy RA, Vasan RS, Kundu S, Massion PP, et al. Lifetime smoking history and risk of lung cancer: results from the Framingham Heart Study. J Natl Cancer Inst. 2018; 110:1201–7.

5. Patel MI, McKinley M, Cheng I, Haile R, Wakelee H, Gomez SL. Lung cancer incidence trends in California by race/ethnicity, histology, sex, and neighborhood socioeconomic status: an analysis spanning 28 years. Lung Cancer. 2017; 108:140–9.

6. Hecht SS. Lung carcinogenesis by tobacco smoke. Int J Cancer. 2012; 131:2724–32.

7. Park JY, Jang SH. Epidemiology of lung cancer in Korea: recent trends. Tuberc Respir Dis. 2016; 79:58–69.

8. Consonni D, Carugno M, De Matteis S, Nordio F, Randi G, Bazzano M, et al. Outdoor particulate matter (PM10) exposure and lung cancer risk in the EAGLE study. PLoS One. 2018; 13:e0203539.

9. Hamra GB, Guha N, Cohen A, Laden F, Raaschou-Nielsen O, Samet JM, et al. Outdoor particulate matter exposure and lung cancer: a systematic review and meta-analysis. Environ Health Perspect. 2014; 122:906–11.

10. Loomis D, Grosse Y, Lauby-Secretan B, El Ghissassi F, Bouvard V, Benbrahim-Tallaa L, et al. The carcinogenicity of outdoor air pollution. Lancet Oncol. 2013; 14:1262–3.

11. Samet JM, Avila-Tang E, Boffetta P, Hannan LM, Olivo-Marston S, Thun MJ, et al. Lung cancer in never smokers: clinical epidemiology and environmental risk factors. Clin Cancer Res. 2009; 15:5626–45.

12. Lee J, Lee JS, Park SH, Shin SA, Kim K. Cohort Profile: The National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea. Int J Epidemiol. 2017; 46:e15.

13. Kim SY, Song I. National-scale exposure prediction for long-term concentrations of particulate matter and nitrogen dioxide in South Korea. Environ Pollut. 2017; 226:21–9.

14. Couraud S, Souquet PJ, Paris C, Do P, Doubre H, Pichon E, et al. BioCAST/IFCT-1002: epidemiological and molecular features of lung cancer in never-smokers. Eur Respir J. 2015; 45:1403–14.

15. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005; 55:74–108.

16. Sun S, Schiller JH, Gazdar AF. Lung cancer in never smokers: a different disease. Nat Rev Cancer. 2007; 7:778–90.

17. Koo LC, Ho JH. Worldwide epidemiological patterns of lung cancer in nonsmokers. Int J Epidemiol. 1990; 19(Suppl 1):S14–23.

18. In KH, Kwon YS, Oh IJ, Kim KS, Jung MH, Lee KH, et al. Lung cancer patients who are asymptomatic at diagnosis show favorable prognosis: a Korean Lung Cancer Registry Study. Lung Cancer. 2009; 64:232–7.

19. Tseng CH, Tsuang BJ, Chiang CJ, Ku KC, Tseng JS, Yang TY, et al. The relationship between air pollution and lung cancer in nonsmokers in Taiwan. J Thorac Oncol. 2019; 14:784–92.

20. Planchard D, Besse B. Lung cancer in never-smokers. Eur Respir J. 2015; 45:1214–7.

21. Raaschou-Nielsen O, Andersen ZJ, Beelen R, Samoli E, Stafoggia M, Weinmayr G, et al. Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Lancet Oncol. 2013; 14:813–22.

22. Gallus S, Negri E, Boffetta P, McLaughlin JK, Bosetti C, La Vecchia C. European studies on long-term exposure to ambient particulate matter and lung cancer. Eur J Cancer Prev. 2008; 17:191–4.

23. Hvidtfeldt UA, Severi G, Andersen ZJ, Atkinson R, Bauwelinck M, Bellander T, et al. Long-term low-level ambient air pollution exposure and risk of lung cancer: a pooled analysis of 7 European cohorts. Environ Int. 2021; 146:106249.

24. Puett RC, Hart JE, Yanosky JD, Spiegelman D, Wang M, Fisher JA, et al. Particulate matter air pollution exposure, distance to road, and incident lung cancer in the nurses’ health study cohort. Environ Health Perspect. 2014; 122:926–32.

25. Yang S, Kim OJ, Shin M, Kim WJ, Kim SY. Association between long-term exposure to high levels of ambient air pollution and incidence of lung cancer in a population-based cohort. Environ Res. 2021; 198:111214.

26. Moon DH, Kwon SO, Kim SY, Kim WJ. Air pollution and incidence of lung cancer by histological type in Korean adults: a Korean National Health Insurance Service Health Examinee Cohort Study. Int J Environ Res Public Health. 2020; 17:915.

27. Brauer M. How much, how long, what, and where: air pollution exposure assessment for epidemiologic studies of respiratory disease. Proc Am Thorac Soc. 2010; 7:111–5.

28. Hoek G, Ranzi A, Alimehmeti I, Ardeleanu ER, Arrebola JP, Avila P, et al. A review of exposure assessment methods for epidemiological studies of health effects related to industrially contaminated sites. Epidemiol Prev. 2018; 42:21–36.

29. Janerich DT, Thompson WD, Varela LR, Greenwald P, Chorost S, Tucci C, et al. Lung cancer and exposure to tobacco smoke in the household. N Engl J Med. 1990; 323:632–6.