Premium
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(s) -
Nagel Gabriele,
Stafoggia Massimo,
Pedersen Marie,
Andersen Zorana J,
Galassi Claudia,
Munkenast Jule,
Jaensch Andrea,
Sommar Johan,
Forsberg Bertil,
Olsson David,
Oftedal Bente,
Krog Norun H,
Aamodt Geir,
Pyko Andrei,
Pershagen Göran,
Korek Michal,
De Faire Ulf,
Pedersen Nancy L,
Östenson ClaesGöran,
Fratiglioni Laura,
Sørensen Mette,
Tjønneland Anne,
Peeters Petra H,
BuenodeMesquita Bas,
Vermeulen Roel,
Eeftens Marloes,
Plusquin Michelle,
Key Timothy J,
Concin Hans,
Lang Alois,
Wang Meng,
Tsai MingYi,
Grioni Sara,
Marcon Alessandro,
Krogh Vittorio,
Ricceri Fulvio,
Sacerdote Carlotta,
Ranzi Andrea,
Cesaroni Giulia,
Forastiere Francesco,
TamayoUria Ibon,
Amiano Pilar,
Dorronsoro Miren,
de Hoogh Kees,
Beelen Rob,
Vineis Paolo,
Brunekreef Bert,
Hoek Gerard,
RaaschouNielsen Ole,
Weinmayr Gudrun
Publication year - 2018
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.31564
Subject(s) - medicine , confounding , cancer , incidence (geometry) , hazard ratio , cohort , proportional hazards model , stomach cancer , air pollution , cancer incidence , logistic regression , cohort study , confidence interval , biology , mathematics , ecology , geometry
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 (PM 10 ), below 2.5 µm (PM 2.5 ), between 2.5 and 10 µm (PM coarse ), PM 2.5 absorbance and nitrogen oxides (NO 2 and NO X ) 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/m 3 of PM 2.5 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 PM 2.5 and gastric cancer. Higher estimated risks of gastric cancer associated with PM 2.5 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 PM 2.5 and gastric cancer, but not UADT cancers, suggesting that air pollution may contribute to gastric cancer risk.