Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of the Marche Region, 60126 Ancona, Italy.
Department of Chemistry, Biology and Biotechnology, University of Perugia, 06123 Perugia, Italy.
Int J Environ Res Public Health. 2024 Feb 9;21(2):205. doi: 10.3390/ijerph21020205.
Lung cancer is a leading cause of death with nearly 1.8 million deaths estimated worldwide in 2020. Although benzene is classified as a human carcinogen (Group 1) on the basis of its association with acute myeloid/non-lymphocytic leukaemia, there is still limited evidence that it may influence lung cancer risk. This study examined the potential link between benzene exposure and risk of lung cancer using a systematic review of epidemiological studies and meta-analysis. We searched through PubMed, Web of Science and Scopus databases up to 10 February 2023 to identify all articles on the association between benzene exposure and lung cancer (incidence or prevalence) and/or mortality. We extracted the risk estimates of the highest and the lowest reported categories of benzene exposure and conducted a meta-analysis using a random-effects model. Heterogeneity and publication bias were analysed using an I test and funnel plots asymmetry, respectively. Twenty-one studies were included in the final analysis, with a total of 10,750 lung cancer cases and 2899 lung cancer deaths. Overall, risk estimates of lung cancer prevalence and mortality in association with benzene exposure were 1.20 ( = 14; 95% CI 1.05-1.37) and 1.15 ( = 13; 95% CI 1.02-1.30), respectively. In all cases, heterogeneity was quite large, while no significant publication bias was observed. When only studies that adjusted for smoking habit were selected, the risk for lung cancer increased by up to 34% ( = 9; 95% CI 1.10-1.64). Our data, which show a strong association between benzene exposure and lung cancer risk, may have important public health implications. However, further studies are needed to identify the lung cancer risk associated with benzene exposure considering different smoking conditions.
肺癌是全球主要死因之一，2020 年全球估计有近 180 万人死于肺癌。尽管苯因与急性髓系/非淋巴细胞白血病有关而被归类为人类致癌物（第 1 组），但仍有有限的证据表明它可能会影响肺癌风险。本研究通过系统评价和荟萃分析，检查了苯暴露与肺癌风险之间的潜在联系。我们通过 PubMed、Web of Science 和 Scopus 数据库检索，截至 2023 年 2 月 10 日，以确定所有关于苯暴露与肺癌（发病率或患病率）和/或死亡率之间关联的文章。我们提取了苯暴露的最高和最低报告类别中的风险估计值，并使用随机效应模型进行荟萃分析。通过 I 检验和漏斗图不对称性分别分析异质性和发表偏倚。最终分析纳入了 21 项研究，共有 10750 例肺癌病例和 2899 例肺癌死亡病例。总体而言，苯暴露与肺癌患病率和死亡率相关的风险估计值分别为 1.20（ = 14；95%CI 1.05-1.37）和 1.15（ = 13；95%CI 1.02-1.30）。在所有情况下，异质性都相当大，而没有观察到显著的发表偏倚。当仅选择调整了吸烟习惯的研究时，肺癌的风险增加了高达 34%（ = 9；95%CI 1.10-1.64）。我们的数据表明，苯暴露与肺癌风险之间存在很强的关联，这可能对公共卫生具有重要意义。然而，需要进一步研究以确定考虑不同吸烟条件的苯暴露与肺癌风险之间的关联。
