Long-term exposure to ambient air pollution and risk of lung cancer – A comparative analysis of incidence and mortality in four administrative cohorts in the ELAPSE study

作者：Jie Chen, Richard Atkinson, Zorana Jovanovic Andersen, Bente Oftedal, Massimo Stafoggia, Youn-Hee Lim, Terese Bekkevold, Norun Hjertager Krog, Matteo Renzi, Jiawei Zhang, Mariska Bauwelinck, Nicole Janssen, Maciej Strak, Francesco Forastiere, Kees de Hoogh, Sophia Rodopoulou, Klea Katsouyanni, Ole Raaschou‐Nielsen, Evangelia Samoli, Bert Brunekreef, Gerard Hoek, Danielle Vienneau · 发表于：Environmental Research · 年份：2024 · DOI：10.1016/j.envres.2024.120236 · 被引用次数：18 · 研究领域：Air Quality and Health Impacts、Occupational and environmental lung diseases、Health, Environment, Cognitive Aging

Studies have linked air pollution to lung cancer incidence and mortality, but few have compared these associations, which may differ due to cancer survival variations. We aimed to evaluate the association between long-term air pollution exposure and lung cancer incidence and compare findings with previous lung cancer mortality analyses within the same cohorts. We analyzed four population-based administrative cohorts in Denmark (2000–2015), England (2011–2017), Norway (2001–2016) and Rome (2001–2015). We assessed residential exposure to annual average fine particulate matter (PM 2.5 ), nitrogen dioxide (NO₂), black carbon (BC), and warm-season ozone (O 3 ) using Europe-wide land use regression models. We used Cox proportional hazard models to evaluate cohort-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for lung cancer incidence identified using hospital admission records (English and Roman cohorts) or cancer registries (Danish and Norwegian cohorts). We evaluated the associations at low exposure levels using subset analyses and natural cubic splines. Cohort-specific HRs were pooled using random-effects meta-analyses, separately for incidence and mortality. Over 93,733,929 person-years of follow-up, 111,949 incident lung cancer cases occurred. Incident lung cancer was positively associated with PM 2.5 , NO 2 and BC, and negatively associated with O 3 . The negative O 3 association became positive after adjustment for NO 2 . Associations were almost identical ...