Zhu Yiqun, Wu Yao, Zhu Zhuanxing, Liang Huaying, Chang Qinyu, Lin Fengyu, Li Dianwu, Cheng Jun, Pan Pinhua, Guo Yuming, Zhang Yan
Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410008, China; Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Ecotoxicol Environ Saf. 2025 Apr 1;294:118027. doi: 10.1016/j.ecoenv.2025.118027. Epub 2025 Mar 12.
Growing evidence suggests that greenness is associated with multiple health outcomes, but its association with lung cancer risk remains limited and far from consistent. In particular, it is unclear whether this association varies across different types of lung cancer and whether it is influenced by factors such as genetics, air pollution, and physical activity.
This prospective cohort study included 425108 participants aged 37-73 years from the UK Biobank. Residential greenness was estimated with the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI) within the 500 m buffer. Cox proportional hazards regression was performed to evaluate the hazard ratios (HR) and 95 % confidence intervals (CI) of the relationship between greenness and risk of lung cancer. A genetic risk was calculated using 18 independent susceptibility loci for lung cancer. Mediation analysis was conducted to assess the indirect effects through air pollutants (including PM, PM, NO, NO) and physical activity.
During a median follow-up of 14.0 years, 3814 lung cancer cases identified. An inversely linear correlation between residential greenness and incident lung cancer was found. Specifically, each interquartile range increase in NDVI and EVI within the 500 m buffer was linked to 8 % (HR 0.92, 95 % CI: 0.88, 0.96) and 9 % (HR 0.91, 95 % CI: 0.87, 0.94) decreased in lung cancer risk, respectively. Moreover, the association was particularly pronounced for adenocarcinoma (HR 0.88, 95 % CI: 0.83, 0.94 for NDVI; HR 0.87, 95 % CI: 0.82, 0.92 for EVI). Mediation analysis suggested that reductions in PM exposure and increased physical activity accounted for approximately 45 % and 1.5 % of the observed association.
Increased residential greenness was linearly associated with reduced risk of lung cancer, particularly adenocarcinoma, and such an association may be substantially mediated by mitigating air pollutants, especially PM and increased physical activity. The study provides promising evidence and strategy of improving greenness during urbanization to reduce the risk of lung adenocarcinoma in the context of the grimmer trend of rapidly increasing risk of adenocarcinoma.
越来越多的证据表明，绿化程度与多种健康结果相关，但其与肺癌风险的关联仍然有限且远未一致。特别是，尚不清楚这种关联在不同类型的肺癌中是否存在差异，以及它是否受到遗传、空气污染和体育活动等因素的影响。
这项前瞻性队列研究纳入了英国生物银行的425108名年龄在37至73岁之间的参与者。利用500米缓冲区内的归一化植被指数（NDVI）和增强植被指数（EVI）估算居住绿化程度。进行Cox比例风险回归以评估绿化程度与肺癌风险之间关系的风险比（HR）和95%置信区间（CI）。使用18个独立的肺癌易感基因座计算遗传风险。进行中介分析以评估通过空气污染物（包括PM、PM、NO、NO）和体育活动产生的间接影响。
在中位随访14.0年期间，共确定了3814例肺癌病例。发现居住绿化程度与肺癌发病率呈负线性相关。具体而言，500米缓冲区内NDVI和EVI每增加一个四分位数间距，肺癌风险分别降低8%（HR 0.92，95%CI：0.88，0.96）和9%（HR 0.91，95%CI：0.87，0.94）。此外，这种关联在腺癌中尤为明显（NDVI的HR为0.88，95%CI：0.83，0.94；EVI的HR为0.87，95%CI：0.82，0.92）。中介分析表明，PM暴露的减少和体育活动的增加分别占观察到的关联的约45%和1.5%。
居住绿化程度的增加与肺癌风险降低呈线性相关，尤其是腺癌，这种关联可能主要通过减少空气污染物，特别是PM和增加体育活动来介导。在腺癌风险迅速上升的严峻趋势背景下，该研究为城市化进程中改善绿化程度以降低肺腺癌风险提供了有前景的证据和策略。
