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Particulate matter air pollution components and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts of Air Pollution Effects (ESCAPE)
Authors
Geir Aamodt
Zorana J. Andersen
+38 more
Rob Beelen
Bert Brunekreef
Bas Bueno-de-Mesquita
Giulia Cesaroni
Hans Concin
Ulf De Faire
Kees de Hoogh
Marloes Eeftens
Francesco Forastiere
Claudia Galassi
Gerard Hoek
Andrea Jaensch
Ingeborg Kooter
Michal Korek
Norun H. Krog
Alois Lang
Jule Munkenast
Gabriele Nagel
Bente Oftedal
Marie Pedersen
Nancy L. Pedersen
Göran Pershagen
Andrei Pyko
Ole Raaschou-Nielsen
Andrea Ranzi
Fulvio Ricceri
Debora Rizzuto
Carlotta Sacerdote
Ranjeet Sokhi
Massimo Stafoggia
Mette Sørensen
Anne Tjønneland
Ming Yi Tsai
Roel Vermeulen
Paolo Vineis
Meng Wang
Gudrun Weinmayr
Claes Göran Östenson
Publication date
1 January 2018
Publisher
'Elsevier BV'
Doi
Cite
Abstract
© 2020 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/.Introduction: Previous analysis from the large European multicentre ESCAPE study showed an association of ambient particulate matter <2.5 μm (PM2.5) air pollution exposure at residence with the incidence of gastric cancer. It is unclear which components of PM are most relevant for gastric and also upper aerodigestive tract (UADT) cancer and some of them may not be strongly correlated with PM mass. We evaluated the association between long-term exposure to elemental components of PM2.5 and PM10 and gastric and UADT cancer incidence in European adults. Methods: Baseline addresses of individuals were geocoded and exposure was assessed by land-use regression models for copper (Cu), iron (Fe) and zinc (Zn) representing non-tailpipe traffic emissions; sulphur (S) indicating long-range transport; nickel (Ni) and vanadium (V) for mixed oil-burning and industry; silicon (Si) for crustal material and potassium (K) for biomass burning. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. Results: Ten cohorts in six countries contributed data on 227,044 individuals with an average follow-up of 14.9 years with 633 incident cases of gastric cancer and 763 of UADT cancer. The combined hazard ratio (HR) for an increase of 200 ng/m3 of PM2.5_S was 1.92 (95%-confidence interval (95%-CI) 1.13;3.27) for gastric cancer, with no indication of heterogeneity between cohorts (I2 = 0%), and 1.63 (95%-CI 0.88;3.01) for PM2.5_Zn (I2 = 70%). For the other elements in PM2.5 and all elements in PM10 including PM10_S, non-significant HRs between 0.78 and 1.21 with mostly wide CIs were seen. No association was found between any of the elements and UADT cancer. The HR for PM2.5_S and gastric cancer was robust to adjustment for additional factors, including diet, and restriction to study participants with stable addresses over follow-up resulted in slightly higher effect estimates with a decrease in precision. In a two-pollutant model, the effect estimate for total PM2.5 decreased whereas that for PM2.5_S was robust. Conclusion: This large multicentre cohort study shows a robust association between gastric cancer and long-term exposure to PM2.5_S but not PM10_S, suggesting that S in PM2.5 or correlated air pollutants may contribute to the risk of gastric cancer.Peer reviewedFinal Accepted Versio
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