Air pollution may increase the risk of cardiovascular disease, mortality, and health disparities in patients with cancer, according to a recent study published by Zhu et al in JACC: CardioOncology.
Background
Although modern therapies may help extend the lives of patients with cancer, cancer survivors often live with chronic health conditions such as cardiovascular disease.
Air pollution has previously been recognized as a significant risk factor for both cardiovascular disease and cancer. However, there have been few studies researching the effects of air pollution on cardio-oncology or the overlap of both diseases.
Study Methods and Results
In the recent study, investigators reviewed the literature for papers published between 2000 and 2023 and identified eight studies focused on the combined effect of air pollution on cardiovascular disease and cancer. They found that exposure to particulate matter 2.5 µm in diameter (PM2.5) was significantly associated with higher incidence and mortality rates of cardiovascular disease among patients with cancer. They also found a correlation between exposure to PM2.5 and higher incidence and mortality rates of cancer among patients with cardiovascular disease.
Further, air pollution exposure appeared to impact multiple common risk factors shared by both cancer and cardiovascular disease—including inflammatory and oxidative stress pathways. Of note, even short-term exposure to high pollution levels rapidly impacted the cardiovascular health of patients with cancer.
“This suggests that even temporary deteriorations in air quality can have immediate adverse effects on vulnerable populations such as cardio-oncology patients,” suggested senior study author Xiaoquan Rao, MD, PhD, a cardiologist at Tongji Hospital at the Tongji Medical College in Wuhan, China.
The investigators highlighted how air pollution may contribute to health disparities worldwide. Disadvantaged populations are more likely to be exposed to higher levels of air pollution, and patients with cancer who have a lower socioeconomic status may face a higher risk of cardiovascular disease–related mortality linked to air pollution compared with the general population.
Conclusions
“The review underscores the critical need to consider environmental factors, especially air pollution, in cardio-oncology risk assessment and patient management. By highlighting the significant role of air pollution in the cardiovascular health of patients [with cancer], our work aims to catalyze further research in this field and inform clinical practices and public health policies,” emphasized Dr. Rao. “More research is needed, including clinical studies, to understand the impacts of air pollution on cardiovascular disease and cancer in greater detail,” he added.
The investigators hope their findings can be used to better understand the risks of air pollution and help identify more vulnerable populations within cardio-oncology. “This awareness is crucial for developing tailored air pollution exposure control measures and individualized patient management strategies aimed at mitigating cardiovascular disease risks among patients [with cancer],” underscored Dr. Rao.
In future studies, the investigators plan to explore air pollution–related health disparities across different types of cancer and cardiovascular diseases as well as evaluate the effectiveness of environmental interventions in reducing the impact of air pollution on cardio-oncology patients.
Disclosure: For full disclosures of the study authors, visit jacc.org.
