Do we underestimate the effect of air pollution on lung cancer incidence?

Cumulative exposure to ambient air pollutants should be included in the assessment of individual lung cancer risk, according to the authors of a Canadian study evaluating the association between outdoor air pollution and lung cancer in non-smoking women. However, 20-year exposure data may not be enough to capture the true effects of air pollution [1].

“Non-smoking women have a higher risk of lung cancer than non-smoking men,” stated Dr Renelle Myers (University of British Columbia, Canada). “Also, evidence indicates that air pollution is a major cause of lung cancer in non-smoking individuals [2].” The current study aimed to compare the cumulative 3-year versus 20-year exposure to particulate matter 2.5 (PM2.5) in newly diagnosed women with lung cancer who had never smoked. Data from a detailed residential history questionnaire was uploaded into a geographic information system that quantified PM2.5 with a high-spatial resolution global exposure model.

In total, 236 women with newly diagnosed lung cancer (46.7% EGFR-mutated) were analysed; 71.2% of the patients was Asian, 18.6% was White, and 10.2% was classified as ‘Other’. Interestingly, 188 patients were born outside of Canada and 96 of them were born . Among the foreign-born Canadians, the 3-year cumulative PM2.5 data showed that 2.1% of the participants had an exposure >10 μg/m³. This rate increased to 20.2% when observing the 20-year cumulative PM2.5 data. Of note, an effect of 3-year cumulative PM2.5 exposure on the incidence of EGFR mutations was observed (P=0.049), but this effect was not preserved when looking at the 20-year data (P=0.188).

Based on the current results, Dr Myers argued that the 20-year cumulative PM2.5 exposure data may underestimate the effects of PM2.5 during childhood and adolescence, given the fact that the average age of the included patients was 66.1 years and that most of the patients were foreign-born Canadians, raised in highly polluted areas of the world.

1. Myers R, et al. Evaluation of outdoor air pollution in female non-smoking lung cancer patients. OA13.03, WCLC 2022, Vienna, Austria, 06–09 August.
2. Tseng CH, et al. J Thoracic Oncol. 2019;14(5):784-792.

 

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Posted on 23 August 202223 August 2022