Long-term exposure to air pollution and liver cancer incidence in six European cohorts
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Supporting information
Accepted version
Author(s)
Type
Journal Article
Abstract
Particulate matter air pollution and diesel engine exhaust have been classified as carcinogenic for lung cancer, yet few studies have explored associations with liver cancer. We used six European adult cohorts which were recruited between 1985 and 2005, pooled within the 'Effects of low-level air pollution: A study in Europe' (ELAPSE) project, and followed for the incidence of liver cancer until 2011 to 2015. The annual average exposure to nitrogen dioxide (NO2 ), particulate matter with diameter < 2.5 μm (PM2.5 ), black carbon (BC), warm-season ozone (O3 ), and eight elemental components of PM2.5 (copper, iron, zinc, sulfur, nickel, vanadium, silicon, potassium) were estimated by European-wide hybrid land-use regression models at participants' residential addresses. We analyzed the association between air pollution and liver cancer incidence by Cox proportional hazards models adjusting for potential confounders. Of 330,064 cancer-free adults at baseline, 512 developed liver cancer during a mean follow-up of 18.1 years. We observed positive linear associations between NO2 (hazard ratio, 95% confidence interval: 1.17, 1.02-1.35 per 10 μg/m3 ), PM2.5 (1.12, 0.92-1.36 per 5 μg/m3 ), and BC (1.15, 1.00-1.33 per 0.5 10-5 /m) and liver cancer incidence. Associations with NO2 and BC persisted in two-pollutant models with PM2.5 . Most components of PM2.5 were associated with the risk of liver cancer, with the strongest associations for sulfur and vanadium, which were robust to adjustment for PM2.5 or NO2 . Our study suggests that ambient air pollution may increase the risk of liver cancer, even at concentrations below current EU standards. This article is protected by copyright. All rights reserved.
Date Issued
2021-12-01
Date Acceptance
2021-06-16
Citation
International Journal of Cancer, 2021, 149 (11), pp.1887-1897
ISSN
0020-7136
Publisher
Wiley
Start Page
1887
End Page
1897
Journal / Book Title
International Journal of Cancer
Volume
149
Issue
11
Copyright Statement
© 2021 Owner. This is the accepted version of the following article: So, R., Chen, J., Mehta, A.J., Liu, S., Strak, M., Wolf, K., Hvidtfeldt, U.A., Rodopoulou, S., Stafoggia, M., Klompmaker, J.O., Samoli, E., Raaschou-Nielsen, O., Atkinson, R., Bauwelinck, M., Bellander, T., Boutron-Ruault, M.-C., Brandt, J., Brunekreef, B., Cesaroni, G., Concin, H., Forastiere, F., van Gils, C.H., Gulliver, J., Hertel, O., Hoffmann, B., de Hoogh, K., Janssen, N., Lim, Y.-h., Westendorp, R., Jørgensen, J.T., Katsouyanni, K., Ketzel, M., Lager, A., Lang, A., Ljungman, P.L., Magnusson, P.K., Nagel, G., Simonsen, M.K., Pershagen, G., Peter, R.S., Peters, A., Renzi, M., Rizzuto, D., Sigsgaard, T., Vienneau, D., Weinmayr, G., Severi, G., Fecht, D., Tjønneland, A., Leander, K., Hoek, G. and Andersen, Z.J. (2021), Long-term exposure to air pollution and liver cancer incidence in six European cohorts. Int. J. Cancer. Accepted Author Manuscript, which has been published in final form at https://doi.org/10.1002/ijc.33743
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34278567
Subjects
air pollution
liver cancer incidence
particulate matter; cohort study
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2021-07-18