Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Department of Earth System Science, Tsinghua University, Beijing, China, 100085.
Sci Total Environ. 2023 Feb 1;858(Pt 2):159857. doi: 10.1016/j.scitotenv.2022.159857. Epub 2022 Oct 31.
Long-term exposure to ambient fine particulate matter (PM) has been linked to increases in the incidence of lung cancer. However, more evidence is needed to conclude its effects on lung cancer survival.
The study aimed to explore the relationship between long-term PM exposure and lung cancer survival and evaluated the benefits of clean air actions in Beijing.
A whole-population cohort study was conducted on lung cancer patients diagnosed between 2001 and 2017. An atmospheric chemical transport model was used to estimate exposure under a counterfactual scenario without the policy and then quantified the effect of the policy. Cox regression models were used with the seasonality-adjusted PM as the main effect.
A 10 μg/m increase in PM was estimated to be with a 6.5 % (95 % CI: 4.8 %, 8.2 %) increase in the mortality rates. The association was heterogeneous and modified by individual-level characteristics. The clean air actions were estimated to have prevented 3548 (95 % CI: 3280, 3825) premature deaths and to have prolonged survival time by 4.29 months (95 % CI: 0.01, 25.11).
Our findings suggest that PM exposure lowers the survival rate for lung cancer. The clean air actions implemented in Beijing can protect lung cancer patients by increasing their survival time.
Long-term exposure to PM can lower lung patients' survival rates whereas the clean air actions in Beijing have prolonged these patients' survival time by reducing PM level.
长期暴露于环境细颗粒物（PM）已与肺癌发病率的增加有关。然而，需要更多的证据来得出其对肺癌生存的影响。
本研究旨在探讨长期 PM 暴露与肺癌生存之间的关系，并评估北京清洁空气行动的效果。
对 2001 年至 2017 年间诊断为肺癌的患者进行了全人群队列研究。使用大气化学输送模型来估计没有政策情况下的暴露情况，并量化政策的效果。使用季节调整后的 PM 作为主要影响因素的 Cox 回归模型进行分析。
估计 PM 每增加 10μg/m，死亡率就会增加 6.5%（95%CI：4.8%，8.2%）。这种关联具有异质性，并受个体特征的影响。清洁空气行动估计可以预防 3548 例（95%CI：3280，3825）过早死亡，并延长 4.29 个月（95%CI：0.01，25.11）的生存时间。
我们的研究结果表明，PM 暴露降低了肺癌患者的生存率。北京实施的清洁空气行动可以通过降低 PM 水平来延长肺癌患者的生存时间。
