Cancer mortality risk, fine particulate air pollution, and smoking in a large, representative cohort of US adults

Abstract

Purpose

Air pollution and smoking are associated with various types of mortality, including cancer. The current study utilizes a publicly accessible, nationally representative cohort to explore relationships between fine particulate matter (PM2.5) exposure, smoking, and cancer mortality.

Methods

National Health Interview Survey and mortality follow-up data were combined to create a study population of 635,539 individuals surveyed from 1987 to 2014. A sub-cohort of 341,665 never-smokers from the full cohort was also created. Individuals were assigned modeled PM2.5 exposure based on average exposure from 1999 to 2015 at residential census tract. Cox Proportional Hazard models were utilized to estimate hazard ratios for cancer-specific mortality controlling for age, sex, race, smoking status, body mass, income, education, marital status, rural versus urban, region, and survey year.

Results

The risk of all cancer mortality was adversely associated with PM2.5 (per 10 µg/m3 increase) in the full cohort (hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.08–1.22) and the never-smokers’ cohort (HR 1.19, 95% CI 1.06–1.33). PM2.5-morality associations were observed specifically for lung, stomach, colorectal, liver, breast, cervix, and bladder, as well as Hodgkin lymphoma, non-Hodgkin lymphoma, and leukemia. The PM2.5-morality association with lung cancer in never-smokers was statistically significant adjusting for multiple comparisons. Cigarette smoking was statistically associated with mortality for many cancer types.

Conclusions

Exposure to PM2.5 air pollution contributes to lung cancer mortality and may be a risk factor for other cancer types. Cigarette smoking has a larger impact on cancer mortality than PM2.5 , but is associated with similar cancer types.

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Acknowledgments

M.E. reports a charitable grant from AstraZeneca Young Health Programme, and personal fees from Prudential, Scor and Third Bridge, all outside the submitted work.

Funding

This publication was developed as part of the Center for Air, Climate, and Energy Solutions (CACES), which was supported under Assistance Agreement No. R835873 awarded by the US Environmental Protection Agency. It has not been formally reviewed by EPA. The views expressed in this document are solely those of authors and do not necessarily reflect those of the Agency. EPA does not endorse any products or commercial services mentioned in this publication.

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Correspondence to C. Arden Pope III.

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Coleman, N.C., Burnett, R.T., Higbee, J.D. et al. Cancer mortality risk, fine particulate air pollution, and smoking in a large, representative cohort of US adults. Cancer Causes Control 31, 767–776 (2020). https://doi.org/10.1007/s10552-020-01317-w

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Keywords

  • PM2.5
  • Cancer
  • Mortality
  • Air pollution
  • Smoking