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Li J, Deng Z, Soerensen SJC, Kachuri L, Cardenas A, Graff RE, Leppert JT, Langston ME, Chung BI. Ambient air pollution and urological cancer risk: A systematic review and meta-analysis of epidemiological evidence. Nat Commun 2024; 15:5116. [PMID: 38879581 PMCID: PMC11180144 DOI: 10.1038/s41467-024-48857-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 05/13/2024] [Indexed: 06/19/2024] Open
Abstract
Exposure to ambient air pollution has significant adverse health effects; however, whether air pollution is associated with urological cancer is largely unknown. We conduct a systematic review and meta-analysis with epidemiological studies, showing that a 5 μg/m3 increase in PM2.5 exposure is associated with a 6%, 7%, and 9%, increased risk of overall urological, bladder, and kidney cancer, respectively; and a 10 μg/m3 increase in NO2 is linked to a 3%, 4%, and 4% higher risk of overall urological, bladder, and prostate cancer, respectively. Were these associations to reflect causal relationships, lowering PM2.5 levels to 5.8 μg/m3 could reduce the age-standardized rate of urological cancer by 1.5 ~ 27/100,000 across the 15 countries with the highest PM2.5 level from the top 30 countries with the highest urological cancer burden. Implementing global health policies that can improve air quality could potentially reduce the risk of urologic cancer and alleviate its burden.
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Affiliation(s)
- Jinhui Li
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA.
| | - Zhengyi Deng
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
| | - Simon John Christoph Soerensen
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Linda Kachuri
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Andres Cardenas
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Rebecca E Graff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - John T Leppert
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Division of Urology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Marvin E Langston
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Benjamin I Chung
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
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Kayyal-Tarabeia I, Zick A, Kloog I, Levy I, Blank M, Agay-Shay K. Beyond lung cancer: air pollution and bladder, breast and prostate cancer incidence. Int J Epidemiol 2024; 53:dyae093. [PMID: 39018665 DOI: 10.1093/ije/dyae093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 07/03/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND The carcinogenicity of air pollution and its impact on the risk of lung cancer is well known; however, there are still knowledge gaps and mixed results for other sites of cancer. METHODS The current study aimed to evaluate the associations between ambient air pollution [fine particulate matter (PM2.5) and nitrogen oxides (NOx)] and cancer incidence. Exposure assessment was based on historical addresses of >900 000 participants. Cancer incidence included primary cancer cases diagnosed from 2007 to 2015 (n = 30 979). Cox regression was used to evaluate the associations between ambient air pollution and cancer incidence [hazard ratio (HR), 95% CI]. RESULTS In the single-pollutant models, an increase of one interquartile range (IQR) (2.11 µg/m3) of PM2.5 was associated with an increased risk of all cancer sites (HR = 1.51, 95% CI: 1.47-1.54), lung cancer (HR = 1.73, 95% CI: 1.60-1.87), bladder cancer (HR = 1.50, 95% CI: 1.37-1.65), breast cancer (HR = 1.50, 95% CI: 1.42-1.58) and prostate cancer (HR = 1.41, 95% CI: 1.31-1.52). In the single-pollutant and the co-pollutant models, the estimates for PM2.5 were stronger compared with NOx for all the investigated cancer sites. CONCLUSIONS Our findings confirm the carcinogenicity of ambient air pollution on lung cancer and provide additional evidence for bladder, breast and prostate cancers. Further studies are needed to confirm our observation regarding prostate cancer. However, the need for more research should not be a barrier to implementing policies to limit the population's exposure to air pollution.
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Affiliation(s)
- Inass Kayyal-Tarabeia
- The Health & Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
- The Galilee Society, The Arab National Society for Research and Health, Shefa-Amr, Israel
| | - Aviad Zick
- Sharett Institute for Oncology, Hadassah Medical Centre, Jerusalem, Israel
- The Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ilan Levy
- Air Quality and Climate Change Division, Israel Ministry of Environmental Protection, Jerusalem, Israel
| | - Michael Blank
- Laboratory of Molecular and Cellular Cancer Biology, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Keren Agay-Shay
- The Health & Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
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Li TF, Xu Z, Zhang K, Yang X, Thakur A, Zeng S, Yan Y, Liu W, Gao M. Effects and mechanisms of N6-methyladenosine RNA methylation in environmental pollutant-induced carcinogenesis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 277:116372. [PMID: 38669875 DOI: 10.1016/j.ecoenv.2024.116372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 03/20/2024] [Accepted: 04/20/2024] [Indexed: 04/28/2024]
Abstract
Environmental pollution, including air pollution, plastic contamination, and heavy metal exposure, is a pressing global issue. This crisis contributes significantly to pollution-related diseases and is a critical risk factor for chronic health conditions, including cancer. Mounting evidence underscores the pivotal role of N6-methyladenosine (m6A) as a crucial regulatory mechanism in pathological processes and cancer progression. Governed by m6A writers, erasers, and readers, m6A orchestrates alterations in target gene expression, consequently playing a vital role in a spectrum of RNA processes, covering mRNA processing, translation, degradation, splicing, nuclear export, and folding. Thus, there is a growing need to pinpoint specific m6A-regulated targets in environmental pollutant-induced carcinogenesis, an emerging area of research in cancer prevention. This review consolidates the understanding of m6A modification in environmental pollutant-induced tumorigenesis, explicitly examining its implications in lung, skin, and bladder cancer. We also investigate the biological mechanisms that underlie carcinogenesis originating from pollution. Specific m6A methylation pathways, such as the HIF1A/METTL3/IGF2BP3/BIRC5 network, METTL3/YTHDF1-mediated m6A modification of IL 24, METTL3/YTHDF2 dynamically catalyzed m6A modification of AKT1, METTL3-mediated m6A-modified oxidative stress, METTL16-mediated m6A modification, site-specific ATG13 methylation-mediated autophagy, and the role of m6A in up-regulating ribosome biogenesis, all come into play in this intricate process. Furthermore, we discuss the direction regarding the interplay between pollutants and RNA metabolism, particularly in immune response, providing new information on RNA modifications for future exploration.
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Affiliation(s)
- Tong-Fei Li
- Shiyan Key Laboratory of Natural Medicine Nanoformulation Research, Hubei Key Laboratory of Embryonic Stem Cell Research, School of Basic Medical Sciences, Hubei University of Medicine, Renmin road No. 30, Shiyan, Hubei 442000, China
| | - Zhijie Xu
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Kui Zhang
- Pritzker School of Molecular Engineering, Ben May Department for Cancer Research, University of Chicago, Chicago, IL 60637, USA
| | - Xiaoxin Yang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Abhimanyu Thakur
- Pritzker School of Molecular Engineering, Ben May Department for Cancer Research, University of Chicago, Chicago, IL 60637, USA
| | - Shuangshuang Zeng
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Yuanliang Yan
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
| | - Wangrui Liu
- Department of Thoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
| | - Ming Gao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China.
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Craver A, Luo J, Kibriya MG, Randorf N, Bahl K, Connellan E, Powell J, Zakin P, Jones RR, Argos M, Ho J, Kim K, Daviglus ML, Greenland P, Ahsan H, Aschebrook-Kilfoy B. Air quality and cancer risk in the All of Us Research Program. Cancer Causes Control 2024; 35:749-760. [PMID: 38145439 PMCID: PMC11045436 DOI: 10.1007/s10552-023-01823-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 10/31/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION The NIH All of Us Research Program has enrolled over 544,000 participants across the US with unprecedented racial/ethnic diversity, offering opportunities to investigate myriad exposures and diseases. This paper aims to investigate the association between PM2.5 exposure and cancer risks. MATERIALS AND METHODS This work was performed on data from 409,876 All of Us Research Program participants using the All of Us Researcher Workbench. Cancer case ascertainment was performed using data from electronic health records and the self-reported Personal Medical History questionnaire. PM2.5 exposure was retrieved from NASA's Earth Observing System Data and Information Center and assigned using participants' 3-digit zip code prefixes. Multivariate logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI). Generalized additive models (GAMs) were used to investigate non-linear relationships. RESULTS A total of 33,387 participants and 46,176 prevalent cancer cases were ascertained from participant EHR data, while 20,297 cases were ascertained from self-reported survey data from 18,133 participants; 9,502 cancer cases were captured in both the EHR and survey data. Average PM2.5 level from 2007 to 2016 was 8.90 μg/m3 (min 2.56, max 15.05). In analysis of cancer cases from EHR, an increased odds for breast cancer (OR 1.17, 95% CI 1.09-1.25), endometrial cancer (OR 1.33, 95% CI 1.09-1.62) and ovarian cancer (OR 1.20, 95% CI 1.01-1.42) in the 4th quartile of exposure compared to the 1st. In GAM, higher PM2.5 concentration was associated with increased odds for blood cancer, bone cancer, brain cancer, breast cancer, colon and rectum cancer, endocrine system cancer, lung cancer, pancreatic cancer, prostate cancer, and thyroid cancer. CONCLUSIONS We found evidence of an association of PM2.5 with breast, ovarian, and endometrial cancers. There is little to no prior evidence in the literature on the impact of PM2.5 on risk of these cancers, warranting further investigation.
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Affiliation(s)
- Andrew Craver
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Jiajun Luo
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Muhammad G Kibriya
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Nina Randorf
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Kendall Bahl
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Elizabeth Connellan
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Johnny Powell
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Paul Zakin
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Joyce Ho
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Karen Kim
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Habibul Ahsan
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA
| | - Briseis Aschebrook-Kilfoy
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA.
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.
- Comprehensive Cancer Center, University of Chicago, Chicago, IL, USA.
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Ramamoorthy T, Nath A, Singh S, Mathew S, Pant A, Sheela S, Kaur G, Sathishkumar K, Mathur P. Assessing the Global Impact of Ambient Air Pollution on Cancer Incidence and Mortality: A Comprehensive Meta-Analysis. JCO Glob Oncol 2024; 10:e2300427. [PMID: 38513187 DOI: 10.1200/go.23.00427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/14/2023] [Accepted: 01/30/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE This study aims to examine the association between exposure to major ambient air pollutants and the incidence and mortality of lung cancer and some nonlung cancers. METHODS This meta-analysis used PubMed and EMBASE databases to access published studies that met the eligibility criteria. Primary analysis investigated the association between exposure to air pollutants and cancer incidence and mortality. Study quality was assessed using the Newcastle Ottawa Scale. Meta-analysis was conducted using R software. RESULTS The meta-analysis included 61 studies, of which 53 were cohort studies and eight were case-control studies. Particulate matter 2.5 mm or less in diameter (PM2.5) was the exposure pollutant in half (55.5%), and lung cancer was the most frequently studied cancer in 59% of the studies. A pooled analysis of exposure reported in cohort and case-control studies and cancer incidence demonstrated a significant relationship (relative risk [RR], 1.04 [95% CI, 1.02 to 1.05]; I2, 88.93%; P < .05). A significant association was observed between exposure to pollutants such as PM2.5 (RR, 1.08 [95% CI, 1.04 to 1.12]; I2, 68.52%) and nitrogen dioxide (NO2) (RR, 1.03 [95% CI, 1.01 to 1.05]; I2, 73.52%) and lung cancer incidence. The relationship between exposure to the air pollutants and cancer mortality demonstrated a significant relationship (RR, 1.08 [95% CI, 1.07 to 1.10]; I2, 94.77%; P < .001). Among the four pollutants, PM2.5 (RR, 1.15 [95% CI, 1.08 to 1.22]; I2, 95.33%) and NO2 (RR, 1.05 [95% CI, 1.02 to 1.08]; I2, 89.98%) were associated with lung cancer mortality. CONCLUSION The study confirms the association between air pollution exposure and lung cancer incidence and mortality. The meta-analysis results could contribute to community cancer prevention and diagnosis and help inform stakeholders and policymakers in decision making.
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Affiliation(s)
- Thilagavathi Ramamoorthy
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Anita Nath
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Shubhra Singh
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Stany Mathew
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Apourv Pant
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Samvedana Sheela
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Gurpreet Kaur
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Krishnan Sathishkumar
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Prashant Mathur
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
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Lim EH, Franklin P, Trevenen ML, Nieuwenhuijsen M, Yeap BB, Almeida OP, Hankey GJ, Golledge J, Etherton-Beer C, Flicker L, Robinson S, Heyworth J. Exposure to low-level ambient air pollution and the relationship with lung and bladder cancer in older men, in Perth, Western Australia. Br J Cancer 2023; 129:1500-1509. [PMID: 37684355 PMCID: PMC10628106 DOI: 10.1038/s41416-023-02411-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 08/06/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Air pollution is a cause of lung cancer and is associated with bladder cancer. However, the relationship between air pollution and these cancers in regions of low pollution is unclear. We investigated associations between fine particulate matter (PM2.5), nitrogen dioxide, and black carbon (BC), and both these cancers in a low-pollution city. METHODS A cohort of 11,679 men ≥65 years old in Perth (Western Australia) were followed from 1996-1999 until 2018. Pollutant concentrations, as a time-varying variable, were estimated at participants' residential addresses using land use regression models. Incident lung and bladder cancer were identified through the Western Australian Cancer Registry. Risks were estimated using Cox proportional-hazard models (age as the timescale), adjusting for smoking, socioeconomic status, and co-pollutants. RESULTS Lung cancer was associated with PM2.5 and BC in the adjusted single-pollutant models. A weak positive association was observed between ambient air pollution and squamous cell lung carcinoma but not lung adenocarcinoma. Positive associations were observed with bladder cancer, although these were not statistically significant. Associations were attenuated in two-pollutant models. CONCLUSION Low-level ambient air pollution is associated with lung, and possibly bladder, cancer among older men, suggesting there is no known safe level for air pollution as a carcinogen.
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Affiliation(s)
- Elizabeth H Lim
- School of Population and Global Health, The University of Western Australia, Crawley, WA, Australia
| | - Peter Franklin
- School of Population and Global Health, The University of Western Australia, Crawley, WA, Australia.
| | - Michelle L Trevenen
- Western Australian Centre for Health and Ageing, The University of Western Australia, Crawley, WA, Australia
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health - Campus MAR, Barcelona Biomedical Research Park, Barcelona, Spain
| | - Bu B Yeap
- Medical School, The University of Western Australia, Crawley, WA, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia
| | - Osvaldo P Almeida
- Western Australian Centre for Health and Ageing, The University of Western Australia, Crawley, WA, Australia
| | - Graeme J Hankey
- Medical School, The University of Western Australia, Crawley, WA, Australia
- Perron Institute for Neurological and Translational Science, Perth, WA, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, James Cook University and Townsville University Hospital, Townsville, QLD, Australia
| | - Christopher Etherton-Beer
- Western Australian Centre for Health and Ageing, The University of Western Australia, Crawley, WA, Australia
| | - Leon Flicker
- Western Australian Centre for Health and Ageing, The University of Western Australia, Crawley, WA, Australia
| | - Suzanne Robinson
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Burwood, VIC, Australia
| | - Jane Heyworth
- School of Population and Global Health, The University of Western Australia, Crawley, WA, Australia.
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Dummer TJB, Yu X, Cui Y, Nauta L, Saint-Jacques N, Sweeney Magee M, Rainham DGC. Traffic-Related Air Pollution and Risk of Lung, Breast, and Urinary Tract Cancer in Halifax, Nova Scotia. J Occup Environ Med 2023; 65:e485-e490. [PMID: 37072926 DOI: 10.1097/jom.0000000000002867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
OBJECTIVES We assessed the association of traffic-related air pollution (TRAP) with the incidence of lung, breast, and urinary tract cancer in Halifax, Nova Scotia. METHODS Our case-control study included 2315 cancers and 8501 age-sex-matched controls. Land-use regression was used to estimate TRAP concentrations. Logistic regression was used to assess cancer risk in relation to TRAP, adjusting for community social and material deprivation. RESULTS There was no association between the risk of lung, breast, or urinary tract cancer in relation to TRAP. Lung cancer risk was significantly increased in the most deprived communities, whereas breast cancer risk was highest in the least deprived communities. CONCLUSIONS In a city characterized by low levels of ambient air pollution, there was no evidence of a linear increased lung, breast, or urinary tract cancer risk in relation to TRAP.
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Affiliation(s)
- Trevor J B Dummer
- From the School of Population and Public Health, University of British Columbia, Vancouver, Canada (T.J.B.D., X.Y., M.S.M.); Population Cancer Research Program, Dalhousie University, Halifax, Canada (Y.C., L.N.); Nova Scotia Health Cancer Care Program, Nova Scotia Health, Halifax, Canada (N.S.-J.); and Healthy Populations Institute and School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Canada (D.G.C.R.)
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Global trends in the epidemiology of bladder cancer: challenges for public health and clinical practice. Nat Rev Clin Oncol 2023; 20:287-304. [PMID: 36914746 DOI: 10.1038/s41571-023-00744-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 03/16/2023]
Abstract
Bladder cancer is among the ten most common cancers globally, causes considerable morbidity and mortality and is, therefore, a substantial burden for health-care systems. The incidence of bladder cancer is affected by demographic trends, most notably population growth and ageing, as well as exposure to risk factors, especially tobacco smoking. Consequently, the incidence has not been stable throughout the world over time, nor will it be in the near future. Further primary prevention efforts are of the utmost importance to reduce the medical and financial burden of bladder cancer on populations and health-care systems. Simultaneously, less-invasive and lower-cost approaches for the diagnosis of both primary and recurrent bladder cancers are required to address challenges posed by the increasing shortage of health-care professionals and limited financial resources worldwide. In this regard, urinary biomarkers have demonstrated promising diagnostic accuracy and efficiency. Awareness of the risk factors and symptoms of bladder cancer should also be increased in society, particularly among health-care professionals and high-risk groups. Studies investigating the associations between lifestyle factors and bladder cancer outcomes are scarce and should be a research priority. In this Review, we outline global trends in bladder cancer incidence and mortality, and discuss the main risk factors influencing bladder cancer occurrence and outcomes. We then discuss the implications, challenges and opportunities of these epidemiological trends for public health and clinical practice.
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Liu H, Zhang X, Sun Z, Chen Y. Ambient Fine Particulate Matter and Cancer: Current Evidence and Future Perspectives. Chem Res Toxicol 2023; 36:141-156. [PMID: 36688945 DOI: 10.1021/acs.chemrestox.2c00216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The high incidence of cancer has placed an enormous health and economic burden on countries around the world. In addition to evidence of epidemiological studies, conclusive evidence from animal experiments and mechanistic studies have also shown that morbidity and mortality of some cancers can be attributed to ambient fine particulate matter (PM2.5) exposure, especially in lung cancer. However, the underlying carcinogenetic mechanisms of PM2.5 remain unclear. Furthermore, in terms of risks of other types of cancer, both epidemiological and mechanistic evidence are more limited and scattered, and the results are also inconsistent. In order to sort out the carcinogenic effect of PM2.5, this paper reviews the association of cancers with PM2.5 based on epidemiological and biological evidence including genetic, epigenetic, and molecular mechanisms. The limitations of existing researches and the prospects for the future are also well clarified in this paper to provide insights for future studies.
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Affiliation(s)
- Hanrui Liu
- Department of Toxicology and Sanitary Chemistry, School of Public Health, and Beijing Key Laboratory of Environment Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Xiaoke Zhang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, and Beijing Key Laboratory of Environment Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, and Beijing Key Laboratory of Environment Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Yueyue Chen
- Department of Toxicology and Sanitary Chemistry, School of Public Health, and Beijing Key Laboratory of Environment Toxicology, Capital Medical University, Beijing 100069, PR China
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10
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Zhang HW, Tsai ZR, Kok VC, Peng HC, Chen YH, Tsai JJP, Hsu CY. Long-term ambient hydrocarbon exposure and incidence of urinary bladder cancer. Sci Rep 2022; 12:20799. [PMID: 36460770 PMCID: PMC9718740 DOI: 10.1038/s41598-022-25425-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022] Open
Abstract
Particulate matter and volatile organic compounds, including total hydrocarbons (THCs), are major ambient air pollutants. Primary nonmethane hydrocarbons (NMHCs) originate from vehicle emissions. The association between air pollution and urinary bladder cancer (UBC) is debatable. We investigated whether long-term exposure to ambient hydrocarbons increases UBC risk among people aged ≥ 20 years in Taiwan. Linkage dataset research with longitudinal design was conducted among 589,135 initially cancer-free individuals during 2000-2013; 12 airborne pollutants were identified. Several Cox models considering potential confounders were employed. The study outcomes were invasive or in situ UBC incidence over time. The targeted pollutant concentration was divided into three tertiles: T1/T2/T3. The mean age of individuals at risk was 42.5 (SD 15.7), and 50.5% of the individuals were men. The mean daily average over 10 years of airborne THC concentration was 2.25 ppm (SD 0.13), and NMHC was 0.29 ppm (SD 0.09). Both pollutants show long-term monotonic downward trend over time using the Mann-Kendall test. There was a dose-dependent increase in UBC at follow-up. UBC incidence per 100,000 enrollees according to T1/T2/T3 exposure to THC was 60.9, 221.2, and 651.8, respectively; it was 170.0/349.5/426.7 per 100,000 enrollees, corresponding to T1/T2/T3 exposure to NMHC, respectively. Without controlling for confounding air pollutants, the adjusted hazard ratio (adj.HR) was 1.83 (95% CI 1.75-1.91) per 0.13-ppm increase in THC; after controlling for PM2.5, adj.HR was even higher at 2.09 (95% CI 1.99-2.19). The adj.HR was 1.37 (95% CI 1.32-1.43) per 0.09-ppm increase in ambient NMHC concentration. After controlling for SO2 and CH4, the adj.HR was 1.10 (95% CI 1.06-1.15). Sensitivity analyses showed that UBC development risk was not sex-specific or influenced by diabetes status. Long-term exposure to THC and NMHC may be a risk factor for UBC development. Acknowledging pollutant sources can inform risk management strategies.
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Affiliation(s)
- Han-Wei Zhang
- Program for Aging, China Medical University, Taichung, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Institute of Electrical Control Engineering, Department of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Biomedica Corporation, New Taipei, Taiwan
| | - Zhi-Ren Tsai
- Department of Computer Science and Information Engineering, Asia University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Center for Precision Medicine Research, Asia University, Taichung, Taiwan
| | - Victor C Kok
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
- Division of Medical Oncology, Kuang Tien General Hospital Cancer Center, 117 Shatien Rd Shalu Dist., Taichung, 43303, Taiwan.
| | | | - Yau-Hung Chen
- Department of Chemistry, Tamkang University, New Taipei City, 25137, Taiwan
| | - Jeffrey J P Tsai
- Center for Precision Medicine Research, Asia University, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chung Y Hsu
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan
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11
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Lobo N, Afferi L, Moschini M, Mostafid H, Porten S, Psutka SP, Gupta S, Smith AB, Williams SB, Lotan Y. Epidemiology, Screening, and Prevention of Bladder Cancer. Eur Urol Oncol 2022; 5:628-639. [PMID: 36333236 DOI: 10.1016/j.euo.2022.10.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/09/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
CONTEXT Bladder cancer (BC) represents a significant health problem due to the potential morbidity and mortality associated with disease burden, which has remained largely unaltered over time. OBJECTIVE To provide an expert collaborative review and describe the incidence, prevalence, and mortality of BC and to evaluate current evidence for BC screening and prevention. EVIDENCE ACQUISITION Data on the estimated incidence and mortality of BC for 2020 in 185 countries were derived from the International Agency for Research on Cancer GLOBOCAN database. A review of English-language articles published over the past 5 yr was conducted using PubMed/MEDLINE to identify risk factors in addition to contemporary evidence on BC screening and prevention. EVIDENCE SYNTHESIS BC is the tenth most common cancer worldwide, with 573 278 cases in 2020. BC incidence is approximately fourfold higher in men than women. Tobacco smoking remains the principal risk factor, accounting for approximately 50% of cases. There is insufficient evidence to recommend routine BC screening. However, targeted screening of high-risk individuals (defined according to smoking history or occupational exposure) may reduce BC mortality and should be the focus of prospective randomized trials. In terms of disease prevention, smoking cessation represents the most important intervention, followed by a reduction in exposure to occupational and environmental carcinogens. CONCLUSIONS BC confers a significant disease burden. An understanding of BC epidemiology and risk factors provides an optimal foundation for disease prevention and the care of affected patients. PATIENT SUMMARY Bladder cancer is the tenth most common cancer worldwide and is approximately four times more common among men than among women. The main risk factors are tobacco smoking, followed by exposure to carcinogens in the workplace or the environment. Routine screening is not currently recommended, but may be beneficial in individuals at high risk, such as heavy smokers. Primary prevention is extremely important, and smoking cessation represents the most important action for reducing bladder cancer cases and deaths.
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Affiliation(s)
- Niyati Lobo
- Royal Surrey NHS Foundation Trust, Guildford, UK
| | | | - Marco Moschini
- Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Sima Porten
- University of California-San Francisco, San Francisco, CA, USA
| | - Sarah P Psutka
- University of Washington, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | | | - Angela B Smith
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | | | - Yair Lotan
- University of Texas Southwestern Medical Centre, Dallas, TX, USA.
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12
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Air Pollution from Global Health to Individual Risk Factor—Is It Time for Enviropathies in Everyday Clinical Practice? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159595. [PMID: 35954950 PMCID: PMC9367743 DOI: 10.3390/ijerph19159595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 02/04/2023]
Abstract
While the link between cardiovascular and respiratory conditions and air pollution is well-known, recent studies provided a growing body of evidence that polluted air, particularly air with high levels of particulate matter with a diameter smaller than 2.5 micrometers (PM 2.5), can have a range of negative impacts on health, both in terms of mortality and morbidity. It is time to emphasize the role of environmental factors as contributory factors or determinants of both global and individual health levels, and to consider them together as a health priority, as enviropathies (meant as pathologies caused, triggered or worsened by environmental exposure). Bringing attention to harmful air pollution exposure has fostered population studies, which developed accurate quantification of environmental exposure in polluted regions, aiding our understanding of the dose-response relationship between pollutants and diseases. Those efforts have influenced local and global health policy strategies. Now we face the challenge of controlling environmental pollution and limiting individual exposure to prevent or avoid serious health risks. Is it time for enviropathies in everyday clinical practice?
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13
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Markozannes G, Pantavou K, Rizos EC, Sindosi OΑ, Tagkas C, Seyfried M, Saldanha IJ, Hatzianastassiou N, Nikolopoulos GK, Ntzani E. Outdoor air quality and human health: An overview of reviews of observational studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119309. [PMID: 35469927 DOI: 10.1016/j.envpol.2022.119309] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/15/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
The epidemiological evidence supporting putative associations between air pollution and health-related outcomes continues to grow at an accelerated pace with a considerable heterogeneity and with varying consistency based on the outcomes assessed, the examined surveillance system, and the geographic region. We aimed to evaluate the strength of this evidence base, to identify robust associations as well as to evaluate effect variation. An overview of reviews (umbrella review) methodology was implemented. PubMed and Scopus were systematically screened (inception-3/2020) for systematic reviews and meta-analyses examining the association between air pollutants, including CO, NOX, NO2, O3, PM10, PM2.5, and SO2 and human health outcomes. The quality of systematic reviews was evaluated using AMSTAR. The strength of evidence was categorized as: strong, highly suggestive, suggestive, or weak. The criteria included statistical significance of the random-effects meta-analytical estimate and of the effect estimate of the largest study in a meta-analysis, heterogeneity between studies, 95% prediction intervals, and bias related to small study effects. Seventy-five systematic reviews of low to moderate methodological quality reported 548 meta-analyses on the associations between outdoor air quality and human health. Of these, 57% (N = 313) were not statistically significant. Strong evidence supported 13 associations (2%) between elevated PM2.5, PM10, NO2, and SO2 concentrations and increased risk of cardiorespiratory or pregnancy/birth-related outcomes. Twenty-three (4%) highly suggestive associations were identified on elevated PM2.5, PM10, O3, NO2, and SO2 concentrations and increased risk of cardiorespiratory, kidney, autoimmune, neurodegenerative, cancer or pregnancy/birth-related outcomes. Sixty-seven (12%), and 132 (24%) meta-analyses were graded as suggestive, and weak, respectively. Despite the abundance of research on the association between outdoor air quality and human health, the meta-analyses of epidemiological studies in the field provide evidence to support robust associations only for cardiorespiratory or pregnancy/birth-related outcomes.
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Affiliation(s)
- Georgios Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | | | - Evangelos C Rizos
- Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece; School of Medicine, European University Cyprus, Nicosia, Cyprus; Hellenic Open University, Patra, Greece
| | - Ourania Α Sindosi
- Laboratory of Meteorology, Department of Physics, University of Ioannina, Ioannina, Greece
| | - Christos Tagkas
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Maike Seyfried
- Faculty of Medicine, University of Tuebingen, Tuebingen, Germany
| | - Ian J Saldanha
- Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, and Department of Epidemiology, School of Public Health, Brown University, RI, USA
| | - Nikos Hatzianastassiou
- Laboratory of Meteorology, Department of Physics, University of Ioannina, Ioannina, Greece
| | | | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, and Department of Epidemiology, School of Public Health, Brown University, RI, USA.
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14
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Ammons S, Aja H, Ghazarian AA, Lai GY, Ellison GL. Perception of worry of harm from air pollution: results from the Health Information National Trends Survey (HINTS). BMC Public Health 2022; 22:1254. [PMID: 35752789 PMCID: PMC9233822 DOI: 10.1186/s12889-022-13450-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 05/17/2022] [Indexed: 11/28/2022] Open
Abstract
Background Air pollution exposure has been associated with a multitude of diseases and poses a significant concern to public health. For targeted environmental risk communication and interventions to be effective, it is important to correctly identify characteristics associated with worry of harm from air pollution. Methods Using responses from 3,630 participants of the Health Information National Trends Survey 4 Cycle 2, we assessed worry of harm from exposure to indoor (IAP) and outdoor (OAP) air pollution separately. Multinomial logistic regression models were used to calculate odds ratios and 95% confidence intervals. Results Hispanics were more likely to worry about harm from IAP and OAP compared to non-Hispanic whites. Participants who lived in metropolitan counties were more likely to worry about harm from IAP and OAP compared to those who lived in rural counties. Finally, those who believed their chance of getting cancer was high were more likely to worry about harm from IAP and OAP compared to those who thought their likelihood of getting cancer was low. Conclusions Worry of harm from IAP and OAP varied across sociodemographic and cancer-related characteristics. Public health professionals should consider these characteristics when developing targeted environmental risk communication and interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13450-z.
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Affiliation(s)
- Samantha Ammons
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, MD, Bethesda, USA
| | - Hayley Aja
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, MD, Bethesda, USA.,Extramural Research Branch, Extramural Research and Partnerships Division, Office of Science Advisor, Policy, and Engagement, U.S. Environmental Protection Agency, Washington, DC, USA
| | - Armen A Ghazarian
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, MD, Bethesda, USA
| | - Gabriel Y Lai
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, MD, Bethesda, USA
| | - Gary L Ellison
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, MD, Bethesda, USA.
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15
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Long-term exposure to ambient air pollution and bladder cancer incidence in a pooled European cohort: the ELAPSE project. Br J Cancer 2022; 126:1499-1507. [PMID: 35173304 PMCID: PMC9090745 DOI: 10.1038/s41416-022-01735-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/21/2022] [Accepted: 02/02/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The evidence linking ambient air pollution to bladder cancer is limited and mixed. METHODS We assessed the associations of bladder cancer incidence with residential exposure to fine particles (PM2.5), nitrogen dioxide (NO2), black carbon (BC), warm season ozone (O3) and eight PM2.5 elemental components (copper, iron, potassium, nickel, sulfur, silicon, vanadium, and zinc) in a pooled cohort (N = 302,493). Exposures were primarily assessed based on 2010 measurements and back-extrapolated to the baseline years. We applied Cox proportional hazard models adjusting for individual- and area-level potential confounders. RESULTS During an average of 18.2 years follow-up, 967 bladder cancer cases occurred. We observed a positive though statistically non-significant association between PM2.5 and bladder cancer incidence. Hazard Ratios (HR) were 1.09 (95% confidence interval (CI): 0.93-1.27) per 5 µg/m3 for 2010 exposure and 1.06 (95% CI: 0.99-1.14) for baseline exposure. Effect estimates for NO2, BC and O3 were close to unity. A positive association was observed with PM2.5 zinc (HR 1.08; 95% CI: 1.00-1.16 per 10 ng/m3). CONCLUSIONS We found suggestive evidence of an association between long-term PM2.5 mass exposure and bladder cancer, strengthening the evidence from the few previous studies. The association with zinc in PM2.5 suggests the importance of industrial emissions.
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16
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Yu P, Guo S, Xu R, Ye T, Li S, Sim MR, Abramson MJ, Guo Y. Cohort studies of long-term exposure to outdoor particulate matter and risks of cancer: A systematic review and meta-analysis. Innovation (N Y) 2021; 2:100143. [PMID: 34557780 PMCID: PMC8454739 DOI: 10.1016/j.xinn.2021.100143] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/11/2021] [Indexed: 11/11/2022] Open
Abstract
Robust evidence is needed for the hazardous effects of outdoor particulate matter (PM) on mortality and morbidity from all types of cancers. To summarize and meta-analyze the association between PM and cancer, published articles reporting associations between outdoor PM exposure and any type of cancer with individual outcome assessment that provided a risk estimate in cohort studies were identified via systematic searches. Of 3,256 records, 47 studies covering 13 cancer sites (30 for lung cancer, 12 for breast cancer, 11 for other cancers) were included in the quantitative evaluation. The pooled relative risks (RRs) for lung cancer incidence or mortality associated with every 10-μg/m3 PM2.5 or PM10 were 1.16 (95% confidence interval [CI], 1.10–1.23; I2 = 81%) or 1.22 (95% CI, 1.02–1.45; I2 = 96%), respectively. Increased but non-significant risks were found for breast cancer. Other cancers were shown to be associated with PM exposure in some studies but not consistently and thus warrant further investigation. Updated evidence for the association between PM and lung cancer risk has been provided Associations between PM and cancer risks from 13 sites were summarized Further studies should be conducted to fill the research gaps
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Affiliation(s)
- Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Suying Guo
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention), Shanghai 200025, China
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Tingting Ye
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Malcolm R Sim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
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17
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Chuang YH, Lin IF, Lao XQ, Lin C, Chan TC. The Association Between Renal Function Decline and the Incidence of Urothelial Carcinoma: A 16-year Retrospective Cohort Study in Taiwan. EUR UROL SUPPL 2021; 27:1-9. [PMID: 34337511 PMCID: PMC8317881 DOI: 10.1016/j.euros.2021.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 02/06/2023] Open
Abstract
Background The incidence of cancer is higher among patients with end-stage renal disease but it remains uncertain whether a mild decrease in renal function affects cancer. Objective To measure the effect of impaired renal function, represented by the estimated glomerular filtration rate (eGFR), personal health behaviors, and long-term exposure to fine particulate matter (PM2.5) on the risk of urothelial carcinoma (UC) incidence. Design, setting, and participants We performed a population-based cohort study of 372 008 participants aged ≥30 yr with no prior cancer history using the MJ health examination database (2000–2015) and UC diagnosis data from the Taiwan Cancer Registry database. Outcome measurements and statistical analysis Cox proportional hazards models were used to quantify the association between eGFR and UC incidence. Results and limitations We detected 383 UC cases during a median follow-up of 10.3 yr. Low eGFR was significantly associated with UC (p value for trend <0.01): compared to eGFR ≥90 ml/min/1.73 m2, the adjusted hazard ratio (HR) was 1.36 (95% confidence interval [CI] 0.98–1.88), 1.86 (95% CI 1.22–2.84), and 1.95 (95% CI 1.06–3.56) for eGFR strata of 60–89, 45–59, and <45 ml/min/1.73 m2, respectively. The risk remained elevated after stratifying the follow-up duration to check for reverse causality, and the dose-response relationship was stronger for women than for men. Current smoking (HR 1.34, 95% CI 1.02–1.77) and long-term exposure to PM2.5 concentrations ≥25.1 μg/m3 (HR 1.54, 95% CI 1.14–2.09) both significantly increased the risk of UC incidence. A significant dose-response relationship between PM2.5 and UC was also noted (ptrend < 0.01). Limitations include the retrospective design and limited information on medical history. Conclusions Lower renal function showed a dose-response relationship in elevating UC risk. Long-term exposure to PM2.5 is also a possible UC risk factor. Patient summary People with kidney function that is lower than normal should monitor the health of their kidneys and other organs in the urinary system. Our study confirmed that as well as smoking, exposure to fine particulate matter in the air may be a risk factor for cancers of the urinary system.
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Affiliation(s)
- Yung-Hsin Chuang
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - I-Feng Lin
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.,Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Ta-Chien Chan
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
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18
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Zare Sakhvidi MJ, Lequy E, Goldberg M, Jacquemin B. Air pollution exposure and bladder, kidney and urinary tract cancer risk: A systematic review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 267:115328. [PMID: 32871482 DOI: 10.1016/j.envpol.2020.115328] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/07/2020] [Accepted: 07/27/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND Exposure to outdoor air pollution has been linked to lung cancer, and suspicion arose regarding bladder, kidney, and urinary tract cancer (urological cancers). However, most of evidence comes from occupational studies; therefore, little is known about the effect of exposure to air pollution on the risk of urological cancers in the general population. METHOD We systematically searched Medline, Scopus, and Web of Science for articles investigating the associations between long-term exposure to air pollution and the risk of urological cancer (incidence or mortality). We included articles using a specific air pollutant (PM10, PM2.5, …) or proxies (traffic, proximity index …). We assessed each study's quality with the Newcastle-Ottawa scale and rated the quality of the body of evidence for each pollutant-outcome with the GRADE approach. The different study methodologies regarding exposure or outcome prevented us to perform a meta-analysis. RESULTS twenty articles (four case-control, nine cohort, and seven ecologic) met our inclusion criteria and were included in this review: eighteen reported bladder, six kidney, and two urinary tract. Modeling air pollutants was the most common exposure assessment method. Most of the included studies reported positive associations between air pollution and urological cancer risk. However, only a few reached statistical significance (e.g. for bladder cancer mortality, adjusted odds-ratio of 1.13 (1.03-1.23) for an increase of 4.4 μg.m-3 of PM2.5). Most studies inadequately addressed confounding, and cohort studies had an insufficient follow-up. DISCUSSION Overall, studies suggested positive (even though mostly non-significant) associations between air pollution exposure and bladder cancer mortality and kidney cancer incidence. We need more studies with better confounding control and longer follow-ups.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- University Rennes 1, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, F-35000, Rennes, France; Occupational Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Emeline Lequy
- INSERM, UMS 011, F-94807, Villejuif, France; Université de Montréal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Marcel Goldberg
- INSERM, UMS 011, F-94807, Villejuif, France; Université Paris Descartes, 12, Rue de L'école de Médecine, F-75006, Paris, France
| | - Bénédicte Jacquemin
- University Rennes 1, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, F-35000, Rennes, France.
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19
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Pourvakhshoori N, Khankeh HR, Stueck M, Farrokhi M. The association between air pollution and cancers: controversial evidence of a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:38491-38500. [PMID: 32767014 DOI: 10.1007/s11356-020-10377-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
There are inconsistent reports on the association between air pollution and cancers. This systematic review was, therefore, conducted to ascertain the relationship between air pollution and some cancers. This is a systematic review study, which all articles published in this area were extracted from January 1, 1950 to December 31, 2018 from Web of Science, PubMed, Scopus, Cochrane Library, MEDLINE, EMBASE, Science Direct, Google scholar. Searching was performed independently by two search-method experts. The required data were extracted from the articles by an author-made questionnaire. Forty-eight articles were investigated. Evidence linking air pollution to some cancers is limited. Leukemia had the highest association with exposure to various air pollutants and bladder cancer had the lowest association. It is noteworthy that the specific type of pollutants in all studies was not specified. Based on the findings, the results are contradictory, and the role of air pollution in some cancers cannot be supported. Accordingly, studies are recommended to be performed at the individual level or multifactorial studies to specifically investigate the relationship between air pollution and these types of cancers. In this way, the role of air pollution in the incidence of these cancers can be determined more accurately.
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Affiliation(s)
- Negar Pourvakhshoori
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Reza Khankeh
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
| | - Marcus Stueck
- DFPA Academy of Work and Health, Leipzig, Germany
- International Research Academy BIONET, Leipzig, Germany
| | - Mehrdad Farrokhi
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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20
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The Inducible Role of Ambient Particulate Matter in Cancer Progression via Oxidative Stress-Mediated Reactive Oxygen Species Pathways: A Recent Perception. Cancers (Basel) 2020; 12:cancers12092505. [PMID: 32899327 PMCID: PMC7563781 DOI: 10.3390/cancers12092505] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Particulate matter, especially the fine fraction PM2.5, is officially stated as carcinogenic to human. There are compelling evidences on the association between PM2.5 exposure and lung cancer, and there are also some preliminary data reporting the significant links between this fraction with non-lung cancers. The underlying mechanisms remain unclear. Further studies related to such scope are highly required. The purpose of this work is to systemically analyze recent findings concerning the relationship between PM2.5 and cancer, and to thoroughly present the oxidative stress pathways mediated by reactive oxygen species as the key mechanism for carcinogenesis induced by PM2.5. This will provide a more comprehensive and updated knowledge regarding carcinogenic capacity of PM2.5 to both clinicians and public health workers, contributing to preventive and therapeutic strategies to fight against cancer in human. Abstract Cancer is one of the leading causes of premature death and overall death in the world. On the other hand, fine particulate matter, which is less than 2.5 microns in aerodynamic diameter, is a global health problem due to its small diameter but high toxicity. Accumulating evidence has demonstrated the positive associations between this pollutant with both lung and non-lung cancer processes. However, the underlying mechanisms are yet to be elucidated. The present review summarizes and analyzes the most recent findings on the relationship between fine particulate matter and various types of cancer along with the oxidative stress mechanisms as its possible carcinogenic mechanisms. Also, promising antioxidant therapies against cancer induced by this poison factor are discussed.
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21
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Turner MC, Andersen ZJ, Baccarelli A, Diver WR, Gapstur SM, Pope CA, Prada D, Samet J, Thurston G, Cohen A. Outdoor air pollution and cancer: An overview of the current evidence and public health recommendations. CA Cancer J Clin 2020; 70:10.3322/caac.21632. [PMID: 32964460 PMCID: PMC7904962 DOI: 10.3322/caac.21632] [Citation(s) in RCA: 284] [Impact Index Per Article: 71.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/24/2022] Open
Abstract
Outdoor air pollution is a major contributor to the burden of disease worldwide. Most of the global population resides in places where air pollution levels, because of emissions from industry, power generation, transportation, and domestic burning, considerably exceed the World Health Organization's health-based air-quality guidelines. Outdoor air pollution poses an urgent worldwide public health challenge because it is ubiquitous and has numerous serious adverse human health effects, including cancer. Currently, there is substantial evidence from studies of humans and experimental animals as well as mechanistic evidence to support a causal link between outdoor (ambient) air pollution, and especially particulate matter (PM) in outdoor air, with lung cancer incidence and mortality. It is estimated that hundreds of thousands of lung cancer deaths annually worldwide are attributable to PM air pollution. Epidemiological evidence on outdoor air pollution and the risk of other types of cancer, such as bladder cancer or breast cancer, is more limited. Outdoor air pollution may also be associated with poorer cancer survival, although further research is needed. This report presents an overview of outdoor air pollutants, sources, and global levels, as well as a description of epidemiological evidence linking outdoor air pollution with cancer incidence and mortality. Biological mechanisms of air pollution-derived carcinogenesis are also described. This report concludes by summarizing public health/policy recommendations, including multilevel interventions aimed at individual, community, and regional scales. Specific roles for medical and health care communities with regard to prevention and advocacy and recommendations for further research are also described.
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Affiliation(s)
- Michelle C. Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Ontario, Canada
| | - Zorana J. Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andrea Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, United States
| | - W. Ryan Diver
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, United States
| | - Susan M. Gapstur
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia, United States
| | - C. Arden Pope
- Department of Economics, Brigham Young University, Provo, Utah, United States
| | - Diddier Prada
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, United States
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Jonathan Samet
- Colorado School of Public Health, Aurora, Colorado, United States
| | - George Thurston
- New York University School of Medicine, New York, New York, United States
| | - Aaron Cohen
- Health Effects Institute, Boston, Massachusetts, United States
- Institute for Health Metrics and Evaluation, Seattle, Washington, United States
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22
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Coleman NC, Burnett RT, Higbee JD, Lefler JS, Merrill RM, Ezzati M, Marshall JD, Kim SY, Bechle M, Robinson AL, Pope CA. Cancer mortality risk, fine particulate air pollution, and smoking in a large, representative cohort of US adults. Cancer Causes Control 2020; 31:767-776. [PMID: 32462559 DOI: 10.1007/s10552-020-01317-w] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/18/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Air pollution and smoking are associated with various types of mortality, including cancer. The current study utilizes a publicly accessible, nationally representative cohort to explore relationships between fine particulate matter (PM2.5) exposure, smoking, and cancer mortality. METHODS National Health Interview Survey and mortality follow-up data were combined to create a study population of 635,539 individuals surveyed from 1987 to 2014. A sub-cohort of 341,665 never-smokers from the full cohort was also created. Individuals were assigned modeled PM2.5 exposure based on average exposure from 1999 to 2015 at residential census tract. Cox Proportional Hazard models were utilized to estimate hazard ratios for cancer-specific mortality controlling for age, sex, race, smoking status, body mass, income, education, marital status, rural versus urban, region, and survey year. RESULTS The risk of all cancer mortality was adversely associated with PM2.5 (per 10 µg/m3 increase) in the full cohort (hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.08-1.22) and the never-smokers' cohort (HR 1.19, 95% CI 1.06-1.33). PM2.5-morality associations were observed specifically for lung, stomach, colorectal, liver, breast, cervix, and bladder, as well as Hodgkin lymphoma, non-Hodgkin lymphoma, and leukemia. The PM2.5-morality association with lung cancer in never-smokers was statistically significant adjusting for multiple comparisons. Cigarette smoking was statistically associated with mortality for many cancer types. CONCLUSIONS Exposure to PM2.5 air pollution contributes to lung cancer mortality and may be a risk factor for other cancer types. Cigarette smoking has a larger impact on cancer mortality than PM2.5 , but is associated with similar cancer types.
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Affiliation(s)
- Nathan C Coleman
- Department of Economics, Brigham Young University, 142 FOB, Provo, UT, 84602, USA
| | | | - Joshua D Higbee
- Department of Economics, University of Chicago, Chicago, IL, USA
| | - Jacob S Lefler
- Department of Agricultural and Resource Economics, University of California, Berkeley, CA, USA
| | - Ray M Merrill
- Department of Public Health, Brigham Young University, Provo, UT, USA
| | - Majid Ezzati
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, London, UK
| | - Julian D Marshall
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, Korea
| | - Matthew Bechle
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, USA
| | - Allen L Robinson
- Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, PA, USA
| | - C Arden Pope
- Department of Economics, Brigham Young University, 142 FOB, Provo, UT, 84602, USA.
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23
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Association between Post-Diagnosis Particulate Matter Exposure among 5-Year Cancer Survivors and Cardiovascular Disease Risk in Three Metropolitan Areas from South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082841. [PMID: 32326144 PMCID: PMC7215375 DOI: 10.3390/ijerph17082841] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 12/20/2022]
Abstract
Cancer survivors are at an increased risk for cardiovascular disease (CVD). However, the association between particulate matter (PM) and CVD risk among cancer survivors (alive >5 years since diagnosis) is unclear. We investigated the risk of CVD among 40,899 cancer survivors within the Korean National Health Insurance Service database. Exposure to PM was determined by assessing yearly average PM levels obtained from the Air Korea database from 2008 to 2011. PMs with sizes <2.5 (PM2.5), <10 (PM10), or 2.5-10 (PM2.5-10) μm in diameter were compared, with each PM level exposure further divided into quintiles. Patients were followed up from January 2012 to date of CVD event, death, or December 2017, whichever came earliest. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated using Cox proportional hazards regression by PM exposure levels. Compared with cancer survivors in the lowest quintile of PM2.5 exposure, those within the highest quintile had a greater risk for CVD (aHR 1.31, 95% CI 1.07-1.59). Conversely, increasing PM10 and PM2.5-10 levels were not associated with increased CVD risk (p for trend 0.078 and 0.361, respectively). Cancer survivors who reduce PM2.5 exposure may benefit from lower risk of developing CVD.
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Abstract
PURPOSE OF REVIEW Although smoking and gender are well-established bladder cancer (BCa) risk factors, a significant interaction with other risk factors could help in the identification of patterns for early detection and prevention strategies. RECENT FINDINGS Smoking appears to be more strongly associated with BCa risk in women than in men, which could be related to differences in metabolism, smoking behavior, exposure patterns, and DNA repair mechanisms. BMI is associated with a higher risk of BCa with negligible difference between genders. The risk for BCa is increased in postmenopausal women, specifically in women with earlier menopausal age (<45 years). Other potential risk factors such as alcohol, arsenic exposure, and particulate matter inhalation seem to affect the genders differently.Female smokers experience a higher risk of disease recurrence after bacillus Calmette-Guérin therapy than their male counterparts. Lastly, smoking appears to negatively affect the outcome of radiotherapy in women, but not that of men. SUMMARY Several lines of evidence point to an interaction between smoking and gender, whereas their impact on other potential risk factors remains to be elucidated. Identifying such differential effects could allow for gender-specific prevention, early detection, and treatment strategies.
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25
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Zhang Z, Yan W, Chen Q, Zhou N, Xu Y. The relationship between exposure to particulate matter and breast cancer incidence and mortality: A meta-analysis. Medicine (Baltimore) 2019; 98:e18349. [PMID: 31852135 PMCID: PMC6922579 DOI: 10.1097/md.0000000000018349] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/21/2019] [Accepted: 11/11/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Particulate matter (PM) acts as an environment pollutant and thus plays a vital role in the development of human lung cancer. Whether PM is a risk factor for breast cancer (BC) morbidity and mortality, however, is not clear. Recently, several studies have reported inconsistent results for the association between PM and BC risk. This meta-analysis examines the indefinite relationship between exposure to PM and BC morbidity and mortality. METHODS Based on a search of Pubmed, Embase, Web of Science and Cochrane Library, the hazard ratio (HR) and 95% confidence interval (CI) were extracted and analyzed by Review Manager 5.3 and Stata14.0 to estimate the association between PM and BC morbidity and mortality. The heterogeneity for the included studies was evaluated using a Chi-square test and the I statistic. Forest plot was used to illustrate the pooled HR and mean difference. A Funnel plot, Begg test, and Egger test were performed to explore the publication bias between the included studies.All analyses were based on previous published studies, thus, no ethical approval and patient consent are required. RESULTS A total of 14 of 284 publications with 1,004,128 BC cases were gathered. The analysis showed each 10 μg/m of PM2.5 (diameter ≤2.5 μm) was associated with 1.17 (95% CI: 1.05-1.30, P = .004) fold risk BC mortality, and each 10 μg/m of PM10 (diameter ≤10 μm) was associated with 1.11 (95% CI: 1.02-1.21, P = .021) fold risk BC mortality. However, neither PM10 nor PM2.5 was found to be significantly associated with BC morbidity. Publication bias was detected in studies on PM2.5 and BC mortality. CONCLUSIONS Our study suggests that PM exposure may raise the mortality but not the morbidity of BC. Still, further studies may be necessary to confirm this finding.
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Affiliation(s)
- Zhe Zhang
- Department of Breast and Thyroid Surgery, Daping Hospital
| | | | - Qing Chen
- Institute of Toxicology, College of Preventive Medicine, Army Military Medical University (Third Military Medical University), Chongqing, China
| | - Niya Zhou
- Institute of Toxicology, College of Preventive Medicine, Army Military Medical University (Third Military Medical University), Chongqing, China
| | - Yan Xu
- Department of Breast and Thyroid Surgery, Daping Hospital
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26
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Kawada T. Air pollution and incident bladder cancer: A risk assessment. Int J Cancer 2019; 145:3177. [PMID: 31423584 DOI: 10.1002/ijc.32633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 07/16/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
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27
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Kim EA. Particulate Matter (Fine Particle) and Urologic Diseases. Int Neurourol J 2017; 21:155-162. [PMID: 28954465 PMCID: PMC5636961 DOI: 10.5213/inj.1734954.477] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 09/08/2017] [Indexed: 12/28/2022] Open
Abstract
Particulate matter (PM) has been found to damage vital body organs, including the lungs and heart, through vascular damage and oxidative stress. Recently, renal function and chronic urologic diseases have also been found to be related to PM. To investigate this, we reviewed the characteristics of PM related to renal toxicity, including recent studies on the associations of urologic diseases with PM. PM can include constituents that cause renal toxicity, such as lead, cadmium, arsenic, and crystalline silica, which result in renal tubular or interstitial damage. Since 2008, 7 studies have evaluated the renal effects of PM. Two prospective cohort studies and a quantitative study of consecutive patients showed that PM may be related to decreased renal function, as shown by the estimated glomerular filtration rate of diseased or aged participants. Two cross-sectional studies found an association between PM and chronic kidney disease. One of those studies identified the specific renal diseases of immunoglobulin A nephropathy and membranous nephropathy. Two studies that analyzed renal cancer and PM showed no evidence that renal cancer is related to PM. Nine studies were evaluated regarding the relationship of bladder and prostate cancer with PM. The evidence for an association of PM with bladder and prostate cancer is still inconclusive. Although some recently published studies have shown a significant relationship, the causal relationship is not clear. Further well-designed studies on specific renal diseases are required.
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Affiliation(s)
- Eun-A Kim
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Korea
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