Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, Salt Lake City, Utah.
Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
Cancer Epidemiol Biomarkers Prev. 2020 Oct;29(10):1929-1939. doi: 10.1158/1055-9965.EPI-19-1363. Epub 2020 May 13.
Air pollution is a carcinogen and causes pulmonary and cardiac complications. We examined the association of fine particulate matter pollution (PM) and mortality from cancer and all causes among pediatric, adolescent, and young adult (AYA) patients with cancer in Utah, a state with considerable variation in PM.
We followed 2,444 pediatric (diagnosed ages 0-14) and 13,459 AYA (diagnosed ages 15-39) patients diagnosed in 1986-2015 from diagnosis to 5 and 10 years postdiagnosis, death, or emigration. We measured average monthly PM by ZIP code during follow-up. Separate pediatric and AYA multivariable Cox models estimated the association of PM and mortality. Among AYAs, we examined effect modification of PM and mortality by stage while controlling for cancer type.
Increases in PM per 5 μg/m were associated with cancer mortality in pediatric lymphomas and central nervous system (CNS) tumors at both time points, and all cause mortality in lymphoid leukemias [HR = 1.32 (1.02-1.71)]. Among AYAs, PM per 5 μg/m was associated with cancer mortality in CNS tumors and carcinomas at both time points, and all cause mortality for all AYA cancer types [HR = 1.06 (1.01-1.13)]. PM ≥12 μg/m was associated with cancer mortality among breast [HR = 1.50 (1.29-1.74); HR = 1.30 (1.13-1.50)] and colorectal cancers [HR = 1.74 (1.29-2.35); HR = 1.67 (1.20-2.31)] at both time points. Effect modification by stage was significant, with local tumors at highest risk.
PM was associated with mortality in pediatric and AYA patients with specific cancers.
Limiting PM exposure may be important for young cancer patients with certain cancers.
空气污染是一种致癌物质，可导致肺部和心脏并发症。我们研究了细颗粒物污染（PM）与犹他州儿科、青少年和年轻成人（AYA）癌症患者癌症和所有原因死亡率之间的关联，该州 PM 变化较大。
我们随访了 1986 年至 2015 年间诊断为 0-14 岁的 2444 名儿科患者和诊断为 15-39 岁的 13459 名 AYA 患者，随访至诊断后 5 年和 10 年、死亡或移民。我们在随访期间按邮政编码测量平均每月 PM。单独的儿科和 AYA 多变量 Cox 模型估计了 PM 和死亡率之间的关联。在 AYAs 中，我们在控制癌症类型的同时，检查了 PM 和死亡率的阶段间效应修饰。
每增加 5μg/m 的 PM 与儿科淋巴瘤和中枢神经系统（CNS）肿瘤的癌症死亡率相关，与淋巴样白血病的所有原因死亡率相关[HR=1.32（1.02-1.71）]。在 AYAs 中，每增加 5μg/m 的 PM 与 CNS 肿瘤和癌在两个时间点的癌症死亡率以及所有 AYA 癌症类型的所有原因死亡率相关[HR=1.06（1.01-1.13）]。PM≥12μg/m 与两个时间点的乳腺癌[HR=1.50（1.29-1.74）；HR=1.30（1.13-1.50）]和结直肠癌[HR=1.74（1.29-2.35）；HR=1.67（1.20-2.31）]的癌症死亡率相关。阶段间的效应修饰是显著的，局部肿瘤的风险最高。
PM 与特定癌症的儿科和 AYA 患者的死亡率相关。
限制 PM 暴露可能对某些癌症的年轻癌症患者很重要。
