Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Respirology. 2022 Nov;27(11):951-958. doi: 10.1111/resp.14316. Epub 2022 Jun 24.
The prevalence of smoking among women in Taiwan is <5%, but the incidence of lung cancer remains high. This study determined the association between PM (fine particulate matter with an aerodynamic diameter of ≤2.5 μm) exposure and lung cancer among women in Taiwan.
In total, 21,301 female lung cancer cases nationwide were newly diagnosed between 2012 and 2017. Each case was age-, sex- and calendar year-matched with four controls randomly selected from the general population. Allowing a latent period of 5 years, we estimated the PM and nitrogen dioxide (NO ) exposures for each individual according to the residential changes from 2000. We adopted self-reported smoking statuses for the cases, while those of controls were estimated using annual surveys in each residential county. We performed multiple logistic regression analyses to examine the associations between PM and NO exposures and incident lung cancer cases.
The ORs of lung adenocarcinoma for the third (30.5-35.1 μg/m ), fourth (35.1-39.3 μg/m ) and fifth PM exposure quintiles (39.3-48.1 μg/m ) relative to the first quintile were 1.10 (95% CI: 1.04-1.16), 1.12 (95% CI: 1.06-1.19) and 1.10 (95% CI: 1.04-1.16), respectively, after adjusting for smoking, residence and comorbidities. A dose-response relationship (p = 0.004) was found. The associations persisted with a 10-year latency and were not detected for small-cell and squamous cell carcinoma after control for smoking. We did not observe a similar effect for NO exposure.
Residential PM exposure higher than 30 μg/m was associated with an increased risk of lung adenocarcinoma in women of Taiwan.
台湾地区女性吸烟率<5%，但肺癌发病率仍然很高。本研究旨在探讨台湾地区女性细颗粒物（PM ，空气动力学直径≤2.5μm 的颗粒物质）暴露与肺癌之间的关系。
本研究共纳入了 2012 年至 2017 年间全国范围内新诊断的 21301 例女性肺癌病例。每个病例按年龄、性别和日历年份与从一般人群中随机选择的 4 名对照进行匹配。考虑到 5 年潜伏期，我们根据 2000 年以来的居住变化，估算了每个个体的 PM 和二氧化氮（NO ）暴露情况。病例的吸烟状况为自我报告，而对照的吸烟状况则通过每个居住县的年度调查进行估算。我们采用多因素逻辑回归分析来探讨 PM 和 NO 暴露与新发肺癌病例之间的关系。
与第一五分位组相比，第三（30.5-35.1μg/m ）、第四（35.1-39.3μg/m ）和第五 PM 暴露五分位组（39.3-48.1μg/m ）患肺腺癌的 OR 值分别为 1.10（95% CI：1.04-1.16）、1.12（95% CI：1.06-1.19）和 1.10（95% CI：1.04-1.16），调整了吸烟、居住地和合并症因素后。我们发现了一个剂量-反应关系（p=0.004）。这种关联在潜伏期为 10 年时仍然存在，且在控制吸烟因素后，对于小细胞癌和鳞状细胞癌没有发现类似的关联。我们没有观察到 NO 暴露有类似的影响。
高于 30μg/m 的居住 PM 暴露与台湾女性患肺腺癌的风险增加有关。
