Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
Green Energy and Environment Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan.
Environ Res. 2024 Jul 1;252(Pt 2):118889. doi: 10.1016/j.envres.2024.118889. Epub 2024 Apr 8.
The effects of long-term PM exposures since 1968 on adenocarcinoma lung cancer (AdLC) were not studied before.
This case-referent study used nationwide cancer registry data since 1997 and air pollution data since 1968 in Taiwan to estimate risks of 30-year PM exposures on AdLC. Cases were all AdLC, while references were all non-AdLC. Individuals' 30-year PM exposures were estimated by PM levels at their residence for 30 years prior their diagnosis dates. We applied multiple logistic regression analyses to estimate PM exposures on incidence rate ratios (IRRs) between cases and references, adjusting for sex, age, smoking, cancer stage, and EGFR mutation.
Elevation in annual ambient PM concentrations since 1968 were associated with increase in annual age-adjusted AdLC incidence since 1997. AdLC incidences were higher among females, nonsmokers, the elderly aged above 65, cases of stages IIIB to IV, and EGFR mutation. Study subjects' PM exposures averaged at 33.7 ± 7.4 μg/m with 162 ± 130 high PM pollution days over 30 years. Multiple logistic models showed an increase in 10 μg/m of PM exposures were significantly associated with 1.044 of IRR between all AdLC and all non-AdLC cases during 2011-2020. Our models also showed that females and nonsmokers and adults less than 65 years had higher IRRs than their respective counterparts. Restricted analyses showed similar effects of PM exposures on IRRs between stage 0-IIIA and IIIB-IV cases and between EGFR+ and EGFR- cases.
Long-term exposures to PM over 30 years were associated with elevated risks of AdLC against non-AdLC, regardless of gender, age, smoking status, cancer stage, or EGFR mutation.
此前尚未研究过自 1968 年以来长期 PM 暴露对肺腺癌（AdLC）的影响。
本病例对照研究使用了 1997 年以来的全国癌症登记数据和台湾自 1968 年以来的空气污染数据，以估计 30 年 PM 暴露对 AdLC 的风险。病例均为 AdLC，对照均为非 AdLC。个体的 30 年 PM 暴露量通过诊断日期前 30 年其居住地的 PM 水平来估计。我们应用多变量逻辑回归分析来估计病例与对照之间的 PM 暴露与发病率比（IRR），并调整了性别、年龄、吸烟状况、癌症分期和 EGFR 突变。
自 1968 年以来，年环境 PM 浓度的升高与自 1997 年以来年年龄调整的 AdLC 发病率的升高有关。女性、不吸烟者、65 岁以上的老年人、IIIb 期至 IV 期病例和 EGFR 突变病例的 AdLC 发病率较高。研究对象的 PM 暴露平均值为 33.7±7.4μg/m，30 年中有 162±130 天高 PM 污染日。多变量逻辑模型显示，PM 暴露量增加 10μg/m 与 2011-2020 年间所有 AdLC 和所有非 AdLC 病例之间的 IRR 增加 1.044 显著相关。我们的模型还显示，女性、不吸烟者和 65 岁以下的成年人比各自的对照组具有更高的 IRR。限制分析显示，PM 暴露对 0-IIIA 期和 IIIB-IV 期病例以及 EGFR+和 EGFR-病例之间的 IRR 也有类似的影响。
30 年以上的长期 PM 暴露与 AdLC 相对于非 AdLC 的风险增加有关，无论性别、年龄、吸烟状况、癌症分期或 EGFR 突变如何。
