Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE)

Gabriele Nagel, Massimo Stafoggia, Marie Pedersen, Zorana J Andersen, Claudia Galassi, Jule Munkenast, Andrea Jaensch, Johan Sommar, Bertil Forsberg, David Olsson, Bente Oftedal, Norun H Krog, Geir Aamodt, Andrei Pyko, Göran Pershagen, Michal Korek, Ulf De Faire, Nancy L Pedersen, Claes-Göran Östenson, Laura FratiglioniMette Sørensen, Anne Tjønneland, Petra H Peeters, Bas Bueno-de-Mesquita, Roel Vermeulen, Marloes Eeftens, Michelle Plusquin, Timothy J Key, Hans Concin, Alois Lang, Meng Wang, Ming-Yi Tsai, Sara Grioni, Alessandro Marcon, Vittorio Krogh, Fulvio Ricceri, Carlotta Sacerdote, Andrea Ranzi, Giulia Cesaroni, Francesco Forastiere, Ibon Tamayo-Uria, Pilar Amiano, Miren Dorronsoro, Kees de Hoogh, Rob Beelen, Paolo Vineis, Bert Brunekreef, Gerard Hoek, Ole Raaschou-Nielsen, Gudrun Weinmayr

Research output: Contribution to journalArticlepeer-review

Abstract

Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancers of the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient air pollution with incidence of gastric and UADT cancer in 11 European cohorts. Air pollution exposure was assigned by land-use regression models for particulate matter (PM) below 10 µm (PM10 ), below 2.5 µm (PM2.5 ), between 2.5 and 10 µm (PMcoarse ), PM2.5 absorbance and nitrogen oxides (NO2 and NOX ) as well as approximated by traffic indicators. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. During average follow-up of 14.1 years of 305,551 individuals, 744 incident cases of gastric cancer and 933 of UADT cancer occurred. The hazard ratio for an increase of 5 µg/m3 of PM2.5 was 1.38 (95% CI 0.99; 1.92) for gastric and 1.05 (95% CI 0.62; 1.77) for UADT cancers. No associations were found for any of the other exposures considered. Adjustment for additional confounders and restriction to study participants with stable addresses did not influence markedly the effect estimate for PM2.5 and gastric cancer. Higher estimated risks of gastric cancer associated with PM2.5 was found in men (HR 1.98 [1.30; 3.01]) as compared to women (HR 0.85 [0.5; 1.45]). This large multicentre cohort study shows an association between long-term exposure to PM2.5 and gastric cancer, but not UADT cancers, suggesting that air pollution may contribute to gastric cancer risk.

Original languageEnglish
JournalInternational Journal of Cancer
DOIs
Publication statusE-pub ahead of print - Apr 26 2018

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