Tang Xuwei, Hu Chanchan, Lin Zhifeng, Lin Yulan, Xie Xiaoxu, Chen Weilin, Wang Jianwen, Ye Joshua, Hu Zhijian, Zhan Zhi-Ying
Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, China.
Department of Radiation Oncology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, 363000, China.
Environ Res. 2025 Aug 1;278:121694. doi: 10.1016/j.envres.2025.121694. Epub 2025 Apr 25.
Epidemiological evidence regarding the association between long-term air pollution exposures and esophageal cancer is limited and controversial. This study aims to investigate this association further and assess its impact on different histological subtypes of esophageal cancer.
Data from the UK Biobank cohort, which included 444,932 participants, was utilized for this study. High-resolution 1 × 1 km data from the UK's Department for Environment, Food and Rural Affairs was used to estimate annual concentrations of air pollutants based on participants' residential addresses. The Time-Dependent Cox proportional hazard model was employed to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for the incidence of esophageal cancer associated with air pollutant exposure.
Over a follow-up duration of 4,777,149 person-years, 1008 new esophageal cancer cases were observed. No association between PM and PM exposure and esophageal cancer was found. However, long-term exposure to NO, NOx, SO and benzene demonstrated a linear relationship with the risk of esophageal cancer incidence. The HRs were 1.278 (95 % CI: 1.104-1.480) per 10 μg/m for NO, 1.129 (95 % CI: 1.046-1.218) per 10 μg/m for NOx, 1.109 (95 % CI: 1.041-1.182) per 1 μg/m for SO and 1.086 (95 % CI: 1.010-1.167) per 0.1 μg/m for benzene, respectively. No statistically significant heterogeneity was detected between the histological subtypes of squamous cell carcinoma and adenocarcinoma. Elderly individuals were more vulnerable to nitrogen oxides, while smokers or former smokers were more susceptible to the effects of sulfur dioxide.
Long-term exposure to air pollutants may significantly increase the risk of esophageal cancer. Effective and targeted control of ambient air pollutant concentrations could potentially reduce the disease burden of esophageal cancer.
关于长期空气污染暴露与食管癌之间关联的流行病学证据有限且存在争议。本研究旨在进一步调查这种关联，并评估其对食管癌不同组织学亚型的影响。
本研究使用了英国生物银行队列的数据，该队列包括444,932名参与者。利用英国环境、食品和农村事务部提供的1×1千米高分辨率数据，根据参与者的居住地址估算空气污染物的年浓度。采用时间依赖性Cox比例风险模型来估计与空气污染物暴露相关的食管癌发病率的风险比（HRs）和95%置信区间（CIs）。
在4,777,149人年的随访期间，观察到1008例新发食管癌病例。未发现PM和PM暴露与食管癌之间存在关联。然而，长期暴露于NO、NOx、SO和苯与食管癌发病风险呈线性关系。NO每10μg/m³的HR为1.278（95%CI：1.104 - 1.480），NOx每10μg/m³的HR为1.129（95%CI：1.046 - 1.218），SO每1μg/m³的HR为1.109（95%CI：1.041 - 1.182），苯每0.1μg/m³的HR为1.086（95%CI：1.010 - 1.167）。在鳞状细胞癌和腺癌的组织学亚型之间未检测到统计学上的显著异质性。老年人更容易受到氮氧化物的影响，而吸烟者或既往吸烟者更容易受到二氧化硫影响。
长期暴露于空气污染物可能会显著增加患食管癌的风险。有效且有针对性地控制环境空气污染物浓度可能会降低食管癌的疾病负担。
