Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Sci Rep. 2020 Mar 25;10(1):5392. doi: 10.1038/s41598-020-62200-x.
Breast cancer is one of the major female health problems worldwide. Although there is growing evidence indicating that air pollution increases the risk of breast cancer, there is still inconsistency among previous studies. Unlike the previous studies those had case-control or cohort study designs, we performed a nationwide, whole-population census study. In all 252 administrative districts in South Korea, the associations between ambient NO and particulate matter 10 (PM) concentration, and age-adjusted breast cancer mortality rate in females (from 2005 to 2016, N = 23,565), and incidence rate (from 2004 to 2013, N = 133,373) were investigated via multivariable beta regression. Population density, altitude, rate of higher education, smoking rate, obesity rate, parity, unemployment rate, breastfeeding rate, oral contraceptive usage rate, and Gross Regional Domestic Product per capita were considered as potential confounders. Ambient air pollutant concentrations were positively and significantly associated with the breast cancer incidence rate: per 100 ppb CO increase, Odds Ratio OR = 1.08 (95% Confidence Interval CI = 1.06-1.10), per 10 ppb NO, OR = 1.14 (95% CI = 1.12-1.16), per 1 ppb SO, OR = 1.04 (95% CI = 1.02-1.05), per 10 µg/m PM, OR = 1.13 (95% CI = 1.09-1.17). However, no significant association between the air pollutants and the breast cancer mortality rate was observed except for PM: per 10 µg/m PM, OR = 1.05 (95% CI = 1.01-1.09).
乳腺癌是全球女性主要健康问题之一。尽管越来越多的证据表明空气污染会增加乳腺癌的风险，但之前的研究仍存在不一致。与之前采用病例对照或队列研究设计的研究不同，我们进行了一项全国性的全人群普查研究。在韩国的 252 个行政区域中，通过多变量β回归调查了环境 NO 和 PM10 浓度与女性年龄调整乳腺癌死亡率（2005 年至 2016 年，N=23565）和发病率（2004 年至 2013 年，N=133373）之间的关联。人口密度、海拔高度、高等教育率、吸烟率、肥胖率、生育次数、失业率、母乳喂养率、口服避孕药使用率和人均国内生产总值被认为是潜在的混杂因素。环境空气污染物浓度与乳腺癌发病率呈正相关且显著：每增加 100ppb CO，比值比 OR=1.08（95%置信区间 CI=1.06-1.10），每增加 10ppb NO，OR=1.14（95%CI=1.12-1.16），每增加 1ppb SO，OR=1.04（95%CI=1.02-1.05），每增加 10μg/m PM，OR=1.13（95%CI=1.09-1.17）。然而，除了 PM 之外，没有观察到空气污染物与乳腺癌死亡率之间存在显著关联：每增加 10μg/m PM，OR=1.05（95%CI=1.01-1.09）。
