Department of Radiation Oncology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA.
Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA.
Neuro Oncol. 2023 Feb 14;25(2):407-417. doi: 10.1093/neuonc/noac163.
Global incidence for brain tumors varies substantially without explanation. Studies correlating radon exposure and incidence are inconclusive. Particulate pollution has been linked to increased tumor incidence. Particulates may disrupt the blood-brain barrier allowing intracranial exposure to oncogenic radon. We investigated the relationship between exposure to residential radon, particulate pollution, and brain tumor incidence in the United States (US).
County-level median radon testing results and annual air quality index values were obtained and divided into tertiles. Counties without both values were excluded. Four groups of counties were generated: high particulate/high radon (high/high), high/low, low/high, and low/low. Using incidence data from the Central Brain Tumor Registry of the US (provided by CDC's National Program of Cancer Registries and NCI's SEER), annual age-adjusted incidence rates (AAAIRs) by group were generated by behavior. Incidence rate ratios were calculated to examine for significant differences (α = .05). Poisson regression accounting for possible confounders was conducted.
Counties with available data included 83% of the US population. High/high exposure was significantly associated with increased AAAIR of all non-malignant tumors (up to 26% higher, including most meningiomas) even after accounting for potential confounders. An increased AAAIR was noted for all malignant tumors (up to 10% higher), including glioblastoma, but was negated after accounting for demographic/socioeconomic differences.
We present the first report suggesting increased non-malignant brain tumor incidence in regions with high particulate and radon exposure. These findings provide insight into unexplained variation in tumor incidence. Future studies are needed to validate these findings in other populations.
全球脑瘤发病率差异巨大,原因不明。相关研究表明氡暴露与发病率之间并无关联。颗粒污染与肿瘤发病率的增加有关。颗粒可能会破坏血脑屏障,使颅内接触致癌性氡。我们研究了美国(US)居民氡暴露、颗粒污染与脑瘤发病率之间的关系。
获得县级平均氡检测结果和年度空气质量指数值,并将其分为三分位数。排除没有这两个值的县。生成四组县:高颗粒/高氡(高/高)、高/低、低/高和低/低。利用美国中央脑肿瘤登记处(由 CDC 的国家癌症登记处和 NCI 的 SEER 提供)的发病数据,按行为生成各组的年度年龄调整发病率(AAAIR)。计算发病率比值以检查是否存在显著差异(α=0.05)。进行了考虑可能混杂因素的泊松回归分析。
有可用数据的县包括美国 83%的人口。高/高暴露与所有非恶性肿瘤的 AAAIR 显著相关(最高增加 26%,包括大多数脑膜瘤),即使在考虑潜在混杂因素后也是如此。所有恶性肿瘤(包括胶质母细胞瘤)的 AAAIR 均有所增加,但在考虑人口统计学/社会经济差异后被否定。
我们首次报告提示高颗粒和氡暴露地区非恶性脑瘤发病率增加。这些发现为肿瘤发病率的不明原因变化提供了一些见解。需要进一步的研究来验证这些发现是否适用于其他人群。