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WCLC 2018: Outdoor Air Pollution Exposure and Lung Cancer in Female Never-Smokers

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Key Points

  • Median air pollution exposure of all patients with cancer was 7.1 PM2.5 mg/m3.
  • Of the ever-smokers, 6.1% had a PM2.5 > 10 ug/m3, whereas 15.1% of the never-smokers had a PM2.5 > 10 ug/m3.
  • Among never-smokers with lung cancer with high PM2.5 exposure > 10 ug/m3, 74% were female and 83% were of Asian descent.

Findings from a recent study demonstrate that female patients with lung cancer who have never smoked have significantly greater exposure rates to outdoor air pollution than female patients with lung cancer who have a history of smoking. Renelle L. Myers, MD, FRCPC, of the British Columbia Cancer Agency, presented these findings at the International Association for the Study of Lung Cancer 19th World Conference on Lung Cancer (Abstract OA09.07).

Study Methods

The study enrolled 681 patients with newly diagnosed lung cancer, including 439 “ever-smokers” and 242 “never-smokers.” A detailed residential history was conducted to estimate the patients’ air pollution exposure since 1996—when accurate high-resolution concentration estimates of ambient particulate matter (PM2.5) derived from satellite observations and ground measurements became available. The average PM2.5 exposure was then quantified by combining residential histories with exposure data.

Findings

The results of the study showed median air pollution exposure of all patients with cancer was 7.1 PM2.5 ug/m3 (interquartile range 6.8–7.3 PM2.5 ug/m3; range 4.3–65.8 PM2.5 ug/m3). Of the ever-smokers, 6.1% had a PM2.5 > 10 ug/m3, whereas more than double—15.1%—of the never-smokers had a PM2.5 > 10 ug/m3. Among never-smokers with lung cancer with high PM2.5 exposure >10 ug/m3, 74% were female and 83% were of Asian descent. Using a logistic regression model, researchers demonstrated a significant association between air pollution exposure and never-smokers compared to ever-smokers in women, an association that was absent in males.

“The results of this study underscore the importance of factoring outdoor air pollution into lung cancer development among women, particularly those who have never smoked,” said Dr. Myers. “Although long-term exposure to ambient particulate matter has been associated with an increased risk of developing lung cancer and is estimated to be responsible for almost 25% of global lung cancer deaths, there is currently no lung cancer screening risk prediction model that includes air pollution as an individual risk factor in its calculation.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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