Department of Epidemiology, School of Public Health, Sun Yat-sen University, China.
Department of Public Health, Faculty of Medicine, Macau University of Science and Technology, China.
Sci Total Environ. 2023 Feb 1;858(Pt 2):159890. doi: 10.1016/j.scitotenv.2022.159890. Epub 2022 Nov 2.
Fine particulate matter (PM), smoking, and genetic factors are associated with lung cancer. However, the relationship between PM, smoking and subtypes of lung cancer remains unclear. Moreover, it is unclear whether genetic risk modifies the impact of PM and smoking on incident lung cancer.
A total of 298,069 participants from the UK Biobank study without lung cancer at baseline were included in this study. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were estimated using multivariable Cox proportional models for the association of lung cancer and its subtypes with PM, smoking, and genetic risk. Potential gene-smoking or gene-PM interactions were also estimated. We further estimated population attributable fractions for incident lung cancer.
During 10.4 years of follow-up, 1683 incident lung cancer cases were identified. Our analysis found that genetic variants, smoking, and PM were significantly associated with incident lung cancer. For different histological types of lung cancer, the HRs for squamous cell lung carcinoma associated with PM (per 5 μg/m increment) and current smoking were 2.76 (95 % CI: 1.72, 4.42, p < 0.001) and 48.64 (95 % CI: 27.96, 84.61, p < 0.001), while the HRs for lung adenocarcinoma were 1.59 (95 % CI: 1.13, 2.23, p < 0.001) and 9.89 (95 % CI: 7.91, 12.36, p < 0.001), respectively. We further found that participants with high levels of PM pollution and high genetic risk had the highest risk of incident lung cancer (HR = 1.81, 95 % CI: 1.39, 2.35, p < 0.001), while the interaction between PM and genetic risk was not statistically significant. We observed that the population attributable fractions of lung cancer attributable to current smoking and high PM exposure were estimated to be 67.45 % and 17.59 %.
Genetic susceptibility, smoking, and PM are important risk factors for lung cancer. Both smoking and PM are more closely associated with an elevated risk of squamous cell lung cancer.
细颗粒物（PM）、吸烟和遗传因素与肺癌有关。然而，PM、吸烟与肺癌亚型之间的关系仍不清楚。此外，遗传风险是否会改变 PM 和吸烟对肺癌发病的影响尚不清楚。
本研究共纳入 298069 名英国生物库研究中基线时无肺癌的参与者。使用多变量 Cox 比例模型估计肺癌及其亚型与 PM、吸烟和遗传风险之间的关联的风险比（HR）及其 95%置信区间（CI）。还估计了潜在的基因-吸烟或基因-PM 相互作用。我们进一步估计了肺癌发病的人群归因分数。
在 10.4 年的随访期间，发现了 1683 例肺癌发病病例。我们的分析发现，遗传变异、吸烟和 PM 与肺癌发病显著相关。对于不同组织学类型的肺癌，PM（每增加 5μg/m）和当前吸烟与鳞状细胞肺癌相关的 HR 分别为 2.76（95%CI：1.72，4.42，p<0.001）和 48.64（95%CI：27.96，84.61，p<0.001），而肺腺癌的 HR 分别为 1.59（95%CI：1.13，2.23，p<0.001）和 9.89（95%CI：7.91，12.36，p<0.001）。我们还发现，PM 污染水平高和遗传风险高的参与者患肺癌的风险最高（HR=1.81，95%CI：1.39，2.35，p<0.001），而 PM 和遗传风险之间的交互作用无统计学意义。我们观察到，归因于当前吸烟和高 PM 暴露的肺癌人群归因分数估计分别为 67.45%和 17.59%。
遗传易感性、吸烟和 PM 是肺癌的重要危险因素。吸烟和 PM 与鳞状细胞肺癌风险的升高更为密切相关。
