Roswall Nina, Thacher Jesse D, Ögren Mikael, Pyko Andrei, Åkesson Agneta, Oudin Anna, Tjønneland Anne, Rosengren Annika, Poulsen Aslak H, Eriksson Charlotta, Segersson David, Rizzuto Debora, Helte Emilie, Andersson Eva M, Aasvang Gunn Marit, Gudjonsdottir Hrafnhildur, Khan Jibran, Selander Jenny, Christensen Jesper H, Brandt Jørgen, Leander Karin, Mattisson Kristoffer, Eneroth Kristina, Stucki Lara, Barregard Lars, Stockfelt Leo, Albin Maria, Simonsen Mette K, Spanne Mårten, Jousilahti Pekka, Tiittanen Pekka, Molnàr Peter, Ljungman Petter L S, Yli-Tuomi Tarja, Cole-Hunter Thomas, Lanki Timo, Hvidtfeldt Ulla A, Lim Youn-Hee, Andersen Zorana J, Pershagen Göran, Sørensen Mette
Danish Cancer Society Research Centre, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark.
Danish Cancer Society Research Centre, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark; Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Environ Res. 2023 May 1;224:115454. doi: 10.1016/j.envres.2023.115454. Epub 2023 Feb 9.
Background Colon cancer incidence is rising globally, and factors pertaining to urbanization have been proposed involved in this development. Traffic noise may increase colon cancer risk by causing sleep disturbance and stress, thereby inducing known colon cancer risk-factors, e.g. obesity, diabetes, physical inactivity, and alcohol consumption, but few studies have examined this. Objectives The objective of this study was to investigate the association between traffic noise and colon cancer (all, proximal, distal) in a pooled population of 11 Nordic cohorts, totaling 155,203 persons. Methods We identified residential address history and estimated road, railway, and aircraft noise, as well as air pollution, for all addresses, using similar exposure models across cohorts. Colon cancer cases were identified through national registries. We analyzed data using Cox Proportional Hazards Models, adjusting main models for harmonized sociodemographic and lifestyle data. Results During follow-up (median 18.8 years), 2757 colon cancer cases developed. We found a hazard ratio (HR) of 1.05 (95% confidence interval (CI): 0.99-1.10) per 10-dB higher 5-year mean time-weighted road traffic noise. In sub-type analyses, the association seemed confined to distal colon cancer: HR 1.06 (95% CI: 0.98-1.14). Railway and aircraft noise was not associated with colon cancer, albeit there was some indication in sub-type analyses that railway noise may also be associated with distal colon cancer. In interaction-analyses, the association between road traffic noise and colon cancer was strongest among obese persons and those with high NO-exposure. Discussion A prominent study strength is the large population with harmonized data across eleven cohorts, and the complete address-history during follow-up. However, each cohort estimated noise independently, and only at the most exposed façade, which may introduce exposure misclassification. Despite this, the results of this pooled study suggest that traffic noise may be a risk factor for colon cancer, especially of distal origin.
全球范围内结肠癌发病率呈上升趋势，城市化相关因素被认为与这一发展有关。交通噪音可能通过导致睡眠障碍和压力，进而引发已知的结肠癌风险因素，如肥胖、糖尿病、缺乏身体活动和饮酒等，从而增加患结肠癌的风险，但对此进行研究的较少。
本研究旨在调查11个北欧队列总计155,203人的合并人群中交通噪音与结肠癌（所有类型、近端、远端）之间的关联。
我们利用各队列相似的暴露模型，确定了居住地址历史，并估算了所有地址的道路、铁路和飞机噪音以及空气污染情况。通过国家登记处识别结肠癌病例。我们使用Cox比例风险模型分析数据，并对主要模型进行调整，纳入统一的社会人口统计学和生活方式数据。
在随访期间（中位时间18.8年），共出现2757例结肠癌病例。我们发现，5年平均时间加权道路交通噪音每增加10分贝，风险比（HR）为1.05（95%置信区间（CI）：0.99 - 1.10）。在亚组分析中，这种关联似乎仅限于远端结肠癌：HR为1.06（95% CI：0.98 - 1.14）。铁路和飞机噪音与结肠癌无关，尽管在亚组分析中有一些迹象表明铁路噪音也可能与远端结肠癌有关。在交互分析中，道路交通噪音与结肠癌之间的关联在肥胖者和高氮氧化物暴露者中最为明显。
本研究的一个显著优势是样本量大，且各队列数据统一，随访期间有完整的地址历史记录。然而，每个队列独立估算噪音，且仅在最暴露的正面进行估算，这可能导致暴露误分类。尽管如此，这项合并研究的结果表明，交通噪音可能是结肠癌的一个风险因素，尤其是远端结肠癌。
