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Zheng L, Kwan MP, Liu Y, Liu D, Huang J, Kan Z. How mobility pattern shapes the association between static green space and dynamic green space exposure. ENVIRONMENTAL RESEARCH 2024; 258:119499. [PMID: 38942258 DOI: 10.1016/j.envres.2024.119499] [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: 04/19/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
Greenspaces are crucial for enhancing mental and physical health. Recent research has shifted from static methods of assessing exposure to greenspaces, based on fixed locations, to dynamic approaches that account for individual mobility. These dynamic evaluations utilize advanced technologies like GPS tracking and remote sensing to provide more precise exposure estimates. However, little work has been conducted to compare dynamic and static exposure assessments and the effect of individual mobility on these evaluations. This study delves into how greenspaces around homes and workplaces, along with mobility patterns, affect dynamic greenspace exposure in Hong Kong. Data was collected from 787 participants in four communities in Hong Kong using GPS, portable sensors, and surveys. Using multiple statistical tests, our study revealed significant variations in participants' daily mobility patterns across socio-demographic and temporal factors. Further, using linear mixed-effects models, we identified complex and statistically significant interactions between participants' static greenspace exposure and their mobility patterns. Our findings suggest that individual mobility patterns significantly modify the relationship between static and dynamic greenspace exposure and play a critical role in explaining socio-demographic and temporal context differences in the relationship between static and dynamic greenspace exposure.
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Affiliation(s)
- Lingwei Zheng
- Department of Geography and Resource Management, Wong Foo Yuan Building, The Chinese University of Hong Kong, Hong Kong SAR, China; Institute of Space and Earth Information Science, Fok Ying Tung Remote Sensing Science Building, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Mei-Po Kwan
- Department of Geography and Resource Management, Wong Foo Yuan Building, The Chinese University of Hong Kong, Hong Kong SAR, China; Institute of Space and Earth Information Science, Fok Ying Tung Remote Sensing Science Building, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Yang Liu
- Department of Geography and Resource Management, Wong Foo Yuan Building, The Chinese University of Hong Kong, Hong Kong SAR, China; Institute of Space and Earth Information Science, Fok Ying Tung Remote Sensing Science Building, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Dong Liu
- Institute of Space and Earth Information Science, Fok Ying Tung Remote Sensing Science Building, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Jianwei Huang
- Institute of Space and Earth Information Science, Fok Ying Tung Remote Sensing Science Building, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Zihan Kan
- Department of Geography and Resource Management, Wong Foo Yuan Building, The Chinese University of Hong Kong, Hong Kong SAR, China; Institute of Space and Earth Information Science, Fok Ying Tung Remote Sensing Science Building, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Yiallourou A, Pantavou K, Markozannes G, Pilavas A, Georgiou A, Hadjikou A, Economou M, Christodoulou N, Letsos K, Khattab E, Kossyva C, Constantinou M, Theodoridou M, Piovani D, Tsilidis KΚ, Bonovas S, Nikolopoulos GK. Non-genetic factors and breast cancer: an umbrella review of meta-analyses. BMC Cancer 2024; 24:903. [PMID: 39061008 PMCID: PMC11282738 DOI: 10.1186/s12885-024-12641-8] [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: 04/05/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Previous research has found associations between various non-genetic factors and breast cancer (BrCa) risk. This study summarises and appraises the credibility of the available evidence on the association between non-genetic factors and BrCa risk. METHODS We conducted an umbrella review of meta-analyses. Medline, Scopus, and the Cochrane databases were systematically searched for meta-analyses examining non-genetic factors and BrCa incidence or mortality. The strength of the evidence was graded in four categories (i.e., weak, suggestive, highly suggestive, convincing). RESULTS A total of 781 meta-analyses from 280 publications were evaluated and graded. We included exposures related to anthropometric measurements, biomarkers, breast characteristics and diseases, diet and supplements, environment, exogenous hormones, lifestyle and social factors, medical history, medication, reproductive history, and pregnancy. The largest number of examined associations was found for the category of diet and supplements and for exposures such as aspirin use and active smoking. The statistically significant (P-value < 0.05) meta-analyses were 382 (49%), of which 204 (53.4%) reported factors associated with increased BrCa risk. Most of the statistically significant evidence (n = 224, 58.6%) was graded as weak. Convincing harmful associations with heightened BrCa risk were found for increased body mass index (BMI), BMI and weight gain in postmenopausal women, oral contraceptive use in premenopausal women, increased androstenedione, estradiol, estrone, and testosterone concentrations, high Breast Imaging Reporting and Data System (BIRADS) classification, and increased breast density. Convincing protective factors associated with lower BrCa risk included high fiber intake and high sex hormone binding globulin (SHBG) levels while highly suggestive protective factors included high 25 hydroxy vitamin D [25(OH)D] levels, adherence to healthy lifestyle, and moderate-vigorous physical activity. CONCLUSIONS Our findings suggest some highly modifiable factors that protect from BrCa. Interestingly, while diet was the most studied exposure category, the related associations failed to reach higher levels of evidence, indicating the methodological limitations in the field. To improve the validity of these associations, future research should utilise more robust study designs and better exposure assessment techniques. Overall, our study provides knowledge that supports the development of evidence-based BrCa prevention recommendations and guidance, both at an individual level and for public health initiatives. TRIAL REGISTRATION PROSPERO CRD42022370675.
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Affiliation(s)
- Anneza Yiallourou
- Medical School, University of Cyprus, P.O. Box 20537, Nicosia, 1678, Cyprus
| | - Katerina Pantavou
- Medical School, University of Cyprus, P.O. Box 20537, Nicosia, 1678, Cyprus
| | - Georgios Markozannes
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, SW7 2AZ, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, 45110, Greece
| | - Antonis Pilavas
- Medical School, University of Cyprus, P.O. Box 20537, Nicosia, 1678, Cyprus
| | - Andrea Georgiou
- Medical School, University of Cyprus, P.O. Box 20537, Nicosia, 1678, Cyprus
| | - Andria Hadjikou
- Medical School, University of Cyprus, P.O. Box 20537, Nicosia, 1678, Cyprus
| | - Mary Economou
- Medical School, University of Cyprus, P.O. Box 20537, Nicosia, 1678, Cyprus
| | | | | | - Elina Khattab
- Medical School, University of Cyprus, P.O. Box 20537, Nicosia, 1678, Cyprus
| | | | - Maria Constantinou
- Medical School, University of Cyprus, P.O. Box 20537, Nicosia, 1678, Cyprus
| | | | - Daniele Piovani
- Department of Biomedical Sciences, Humanitas University, Milan, 20072, Italy
- IRCCS Humanitas Research Hospital, Milan, 20089, Italy
| | - Konstantinos Κ Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, SW7 2AZ, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, 45110, Greece
| | - Stefanos Bonovas
- Department of Biomedical Sciences, Humanitas University, Milan, 20072, Italy
- IRCCS Humanitas Research Hospital, Milan, 20089, Italy
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Zhao J, Ren R, Beeraka NM, PA M, Xue N, Lu P, Bai W, Mao Z, PR HV, Bulygin KV, Nikolenko VN, Fan R, Liu J. Correlation of time trends of air pollutants, greenspaces and tracheal, bronchus and lung cancer incidence and mortality among the adults in United States. Front Oncol 2024; 14:1398679. [PMID: 39119087 PMCID: PMC11306054 DOI: 10.3389/fonc.2024.1398679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Background Tracheal, Bronchus, and Lung (TBL) cancer continues to represent the majority of cancer-related incidence and mortality in United States (U.S.). While air pollutants are considered essential risk factors, both global and national average concentrations of major harmful air pollutants have significantly decreased over the decades. Green space may have a beneficial effect on human health. Methods We obtained data on national and state-level burden of TBL cancer, the annual average concentration of main air pollutants, and levels of green spaces in 2007, 2013, and 2019. According to generalized estimating equation (GEE), we examine the associations among incidence and mortality of TBL cancer, air pollutants, and greenspaces, represented by the Normalized Difference Vegetation Index (NDVI) in different age groups with models adjusted with meteorological, and socio-demographic. We observed additional effects of the interaction between the NDVI, Ozone, PM2.5, and other factors, which helped us to interpret and understand our results. Also, we collated states that witnessed net increments in forest coverage and conducted the same analysis separately. Results In our analysis, the majority of associations between NDVI and air pollutants with TBL cancer remained significantly positive, particularly noticeable among individuals aged 20 to 54. However, our findings did not explore air pollution as a potential mediator between greenspace exposure and TBL cancer. While the associations of PM2.5 with TBL cancer remained positive, the other four pollutants showed positive but statistically insignificant associations. Our interaction analysis yielded that there were positive associations between NDVI and ozone, PM2.5, and tobacco use. Max NDVI acts as a protective factor along with high HDI. Additionally, PM2.5 and HDI also showed a negative association. In 18 states with more forest, NDVI acts as a protective factor along with higher health care coverage, better health status, and participation in physical activities. Conclusion In the state-level of U.S., the effects of total greenspace with TBL cancer are mixed and could be modified by various socio-economic factors. PM2.5 has a direct correlation with TBL cancer and the effects can be influenced by underlying socioeconomic conditions.
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Affiliation(s)
- Jia Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruihang Ren
- Department of Radiation Oncology & Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Narasimha M. Beeraka
- Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research (RIPER), Andhra Pradesh, Ananthapuramu, India
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Mahesh PA
- Department of Pulmonary Medicine, JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru, Karnataka, India
| | - Nannan Xue
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Centre (CNIO) and CIBERONC, Madrid, Spain
| | - Pengfei Lu
- Cancer Center of the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Wenhua Bai
- Department of Radiation Oncology & Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhihan Mao
- Department of Radiation Oncology & Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hemanth Vikram PR
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, JSS Academy of Higher Education & Research (JSS AHER), Mysuru, Karnataka, India
| | - Kirill V. Bulygin
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Vladimir N. Nikolenko
- Department of Human Anatomy and Histology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Ruitai Fan
- Department of Radiation Oncology & Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junqi Liu
- Department of Radiation Oncology & Cancer Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Jones RR. The complexities of PM2.5, greenspace, and childhood cancer. J Natl Cancer Inst 2024; 116:779-781. [PMID: 38641417 PMCID: PMC11160489 DOI: 10.1093/jnci/djae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 04/21/2024] Open
Affiliation(s)
- Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Thomas AL, Rhee J, Fisher JA, Horner MJ, Jones RR. Fine Particulate Matter, Noise Pollution, and Greenspace and Prostate Cancer Risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Cohort. Cancer Epidemiol Biomarkers Prev 2024; 33:857-860. [PMID: 38497801 PMCID: PMC11147690 DOI: 10.1158/1055-9965.epi-23-1413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/09/2024] [Accepted: 03/12/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Greenspace is hypothesized as being protective against cancer, whereas noise pollution and fine particulate matter (<2.5 μm in diameter, PM2.5) are both potential risk factors. Findings from recent studies of greenspace and PM2.5 with prostate cancer are not conclusive and the association between noise exposure and cancer has not been evaluated in a U.S. study. METHODS We assessed PM2.5, noise, and greenspace exposure using spatiotemporal models and satellite-based estimates at enrollment addresses for N = 43,184 male participants of the prospective Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening Trial cohort (enrolled 1994-2001). We used Cox regression models adjusted for age, race and ethnicity, study center, family history of prostate cancer, and Area Deprivation Index to estimate associations between ambient PM2.5 (μg/m3), greenspace (index range from -1 to 1), and noise pollution (loudest 10% of total existing sound, decibels) and incident prostate cancer risk through December 2017. RESULTS A total of 6,327 cases of prostate cancer were diagnosed among male participants during follow-up. PM2.5 and noise exposures were moderately positively correlated (Spearman ρ = 0.46), and PM2.5 and greenspace were not correlated (ρ = 0.10); greenspace and noise were inversely correlated (ρ = -0.32). In single-pollutant and multipollutant models mutually adjusted for coexposures, we found no associations with prostate cancer risk. CONCLUSIONS We did not find evidence that PM2.5, greenspace, and noise pollution were associated with prostate cancer risk in this large, geographically spread cohort. IMPACT This study contributes to a small body of existing literature investigating these biologically plausible associations.
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Affiliation(s)
- Aleah L Thomas
- Trans-divisional Research Program, Division of Cancer Epidemiology and Genetics (DCEG), NCI, Rockville, Maryland
| | - Jongeun Rhee
- Occupational and Environmental Epidemiology Branch, DCEG, NCI, Rockville, Maryland
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, DCEG, NCI, Rockville, Maryland
| | - Marie-Josephe Horner
- Trans-divisional Research Program, Division of Cancer Epidemiology and Genetics (DCEG), NCI, Rockville, Maryland
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, DCEG, NCI, Rockville, Maryland
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Patwary MM, Bardhan M, Disha AS, Dzhambov AM, Parkinson C, Browning MHEM, Labib SM, Larson LR, Haque MZ, Rahman MA, Alam MA, Tareq MF, Shuvo FK. Nature exposure and mental health during the COVID-19 pandemic: A Navigation Guide systematic review with meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 356:124284. [PMID: 38821342 DOI: 10.1016/j.envpol.2024.124284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/02/2024]
Abstract
Prior reviews have highlighted that nature exposure was a valuable coping strategy enhancing mental health during the COVID-19 pandemic. However, no existing reviews have determined the quality of evidence and risk of bias of the empirical studies supporting this claim. To address this gap, we employed a Navigation Guide systematic review and meta-analysis approach to investigate associations between nature exposure and mental health during the pandemic. Searches in PubMed, Web of Science, Scopus, CINAHL, and PsycInfo retrieved relevant articles published between January 1, 2020, and March 4, 2024. We used the Navigation Guide methodology to assess the risk of bias and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessments to evaluate the overall quality of evidence. Our search retrieved 113 studies that met the inclusion criteria and reported diverse types of exposure, including nature availability, nature visit frequency, green space accessibility, and green space type, alongside associations with 12 mental health outcomes. Meta-analyses found access to gardens was associated with lower odds of depression [(Pooled odds ratio [OR] = 0.71, 95%CI = 0.61, 0.82), I2 = 0%, n = 3] and anxiety [(Pooled OR = 0.73, 95%CI = 0.63, 0.84), I2 = 0%, n = 3]. Increased time in green spaces was associated with lower level of stress [(Pooled Corr = -0.11, 95%CI = -0.17, -0.05), I2 = 0%, n = 2]. Higher frequency of visits to nature was associated with improved mental well-being [(Pooled standardized beta = 0.10, 95%CI = 0.07, 0.14), I2 = 0%, n = 2] and general mental health [(Pooled standardized beta = 0.11, 95%CI = 0.03-0.38), I2 = 82%, n = 2]. However, the number of pooled studies was small and the overall quality of evidence was "very low" for all outcomes, and high levels of bias were observed (26% of studies had high, 71% probably high). Nonetheless, given the trends in the results, nature-based solutions emphasizing exposure to gardens and green spaces near the home may have promoted psychological resilience during this public health crisis.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Mondira Bardhan
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, USA
| | - Asma Safia Disha
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Department of Environmental Science and Management, North South University, Bashundhara, Dhaka, 1229, Bangladesh
| | - Angel M Dzhambov
- Research Group "Health and Quality of Life in a Green and Sustainable Environment", Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Colby Parkinson
- Department of Recreation, Park, and Tourism Management, Pennsylvania State University, University Park, PA, USA
| | - Matthew H E M Browning
- Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC, USA
| | - S M Labib
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Vening Meineszgebouw A, Princetonlaan 8a, 3584 CB, Utrecht, the Netherlands
| | - Lincoln R Larson
- Department of Parks, Recreation & Tourism Management, North Carolina State University, Raleigh, NC, USA
| | - Md Zahidul Haque
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Md Atiqur Rahman
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Md Ashraful Alam
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Md Faysal Tareq
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Institute of Environmental Sciences (CML), Leiden University, Netherlands
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Banwell N, Michel S, Senn N. Greenspaces and Health: Scoping Review of studies in Europe. Public Health Rev 2024; 45:1606863. [PMID: 38831866 PMCID: PMC11144923 DOI: 10.3389/phrs.2024.1606863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/22/2024] [Indexed: 06/05/2024] Open
Abstract
Objectives Access to greenspaces and contact with nature can promote physical activity and have positive effects on physical and mental health. This scoping literature review aims to examine current evidence linking greenspaces and (a) behaviour change, (b) health outcomes and (c) co-benefits. Methods This review was conducted in accordance with the PRISMA scoping review guidelines. Searches were conducted through PubMed and EMBASE databases for studies published between 2000 and March 2023 with a focus on Europe. Results 122 scientific articles and grey literature reports were identified. Access to greenspaces is positively associated with physical and mental health, and reduced risk of all-cause mortality and some non-communicable diseases. Greenspace quality is associated with increased physical activity and reduced risk of obesity. Nature-based therapies or green prescription are effective in improving mental health outcomes and overall health. Importantly, numerous co-benefits of greenspaces are identified. Conclusion Increasing access to greenspaces for populations with particular attention to greenspace quality is important for co-benefits. Responsible governance and use of greenspaces are crucial to minimize public health risks and human disturbance of nature.
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Affiliation(s)
- Nicola Banwell
- Interdisciplinary Centre for Research in Ethics (CIRE), University of Lausanne, Lausanne, Switzerland
| | - Sarah Michel
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Nicolas Senn
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Kayyal-Tarabeia I, Michael Y, Lensky IM, Levy I, Blank M, Agay-Shay K. Residential greenness and lower breast and prostate cancer incidence: Evidence from a retrospective cohort study of 977,644 participants from Israel. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 918:170631. [PMID: 38309370 DOI: 10.1016/j.scitotenv.2024.170631] [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: 11/19/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND There is limited evidence on the associations between residential greenness and cancer incidence in longitudinal studies. OBJECTIVES The aim of the study was to evaluate the associations between weighted mean residential greenness exposure and cancer incidence. METHODS This is a registry based retrospective cohort study of 977,644 participants. The residential greenness exposure was estimated for every participant, as the weighted mean residential greenness exposure. This was based on the mean Normalized Difference Vegetation Index (NDVI) in the residential small geographic area and the duration of the residence in this area. Cancer incidence cases included consecutive newly diagnosed cases of primary cancer. Analyses were conducted for all cancer sites, lung cancer, bladder cancer, breast cancer, prostate cancer and melanoma-skin cancer. Cox regression models were used to evaluate the crude and adjusted associations (hazards ratios (HR) and its 95 % confidence intervals (CIs)) between tertiles of residential greenness and cancer incidence. Further adjusted models to nitrogen oxides (NOx) were estimated. RESULTS After adjustment to covariates, exposure to the highest tertile of residential greenness, compared to the lowest, were associated with lower risk for all cancer sites (HR = 0.88, 95 % CI: 0.86-0.90), breast cancer (HR = 0.85, 95 % CI: 0.80-0.89) and prostate cancer (HR = 0.85, 95 % CI: 0.79-0.91). In addition, lower risk were observed for the middle tertile of exposure and all cancer sites (HR = 0.88, 95 % CI: 0.86-0.90), breast cancer (HR = 0.88, 95 % CI: 0.84-0.92) and prostate cancer (HR = 0.83, 95 % CI: 0.79-0.89). There was no evidence for mediation by air pollution (NOx). DISCUSSION Residential greenness demonstrated beneficial associations with lower risk for all cancers, breast and prostate cancers. If our observations will be replicated, it may present a useful avenue for public-health intervention to reduce cancer burden through the provision of greenness exposure.
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Affiliation(s)
- Inass Kayyal-Tarabeia
- The Health & Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
| | - Yaron Michael
- The Health & Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel; Department of Soil & Water Sciences, Institute of Environmental Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel
| | - Itamar M Lensky
- Department of Geography and Environment, Bar-Ilan University, Ramat-Gan, Israel.
| | - Ilan Levy
- Air Quality and Climate Change Division, Israel Ministry of Environmental Protection, Jerusalem 34033, Israel.
| | - Michael Blank
- Laboratory of Molecular and Cellular Cancer Biology, Azrieli Faculty of Medicine, Bar Ilan University, Israel.
| | - Keren Agay-Shay
- The Health & Environment Research (HER) Lab, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
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Wu W, Wu G, Wei J, Lawrence WR, Deng X, Zhang Y, Chen S, Wang Y, Lin X, Chen D, Ruan X, Lin Q, Li Z, Lin Z, Hao C, Du Z, Zhang W, Hao Y. Potential causal links and mediation pathway between urban greenness and lung cancer mortality: Result from a large cohort (2009 to 2020). SUSTAINABLE CITIES AND SOCIETY 2024; 101:105079. [PMID: 38222851 PMCID: PMC10783447 DOI: 10.1016/j.scs.2023.105079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Urban greenness, as a vital component of the urban environment, plays a critical role in mitigating the adverse effects of rapid urbanization and supporting urban sustainability. However, the causal links between urban greenness and lung cancer mortality and its potential causal pathway remain poorly understood. Based on a prospective community-based cohort with 581,785 adult participants in southern China, we applied a doubly robust Cox proportional hazard model to estimate the causal associations between urban greenness exposure and lung cancer mortality. A general multiple mediation analysis method was utilized to further assess the potential mediating roles of various factors including particulate matter (PM1, PM2.5-1, and PM10-2.5), temperature, physical activity, and body mass index (BMI). We observed that each interquartile range (IQR: 0.06) increment in greenness exposure was inversely associated with lung cancer mortality, with a hazard ratio (HR) of 0.89 (95 % CI: 0.83, 0.96). The relationship between greenness and lung cancer mortality might be partially mediated by particulate matter, temperature, and physical activity, yielding a total indirect effect of 0.826 (95 % CI: 0.769, 0.887) for each IQR increase in greenness exposure. Notably, the protective effect of greenness against lung cancer mortality could be achieved primarily by reducing the particulate matter concentration.
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Affiliation(s)
- Wenjing Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Gonghua Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, USA
| | - Wayne R Lawrence
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Xinlei Deng
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, USA
| | - Yuqin Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Shirui Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Ying Wang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xiao Lin
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Dan Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xinling Ruan
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Qiaoxuan Lin
- Department of Statistics, Guangzhou Health Technology Identification & Human Resources Assessment Center, China
| | - Zhiqiang Li
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Ziqiang Lin
- Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Chun Hao
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, China
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10
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Felici A, Peduzzi G, Giorgolo F, Spinelli A, Calderisi M, Monreale A, Farinella R, Pellungrini R, Canzian F, Campa D. The local environment and germline genetic variation predict cancer risk in the UK Biobank prospective cohort. ENVIRONMENTAL RESEARCH 2024; 241:117562. [PMID: 37944693 DOI: 10.1016/j.envres.2023.117562] [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: 07/17/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND There is a growing body of evidence on the effect of the local environment exposure on cancer susceptibility. Nonetheless, several of the associations remain controversial. Moreover, our understanding of the possible interaction between the local environment and the genetic variability is still very limited. OBJECTIVE The aim of this study was to clarify the role of the local environment and its possible interplay with genetics on common cancers development. METHODS Using the UK Biobank (UKBB) prospective cohort, we selected 12 local environment exposures: nitrogen oxides, nitrogen dioxides, particulate matter (10 and 2.5 μm), noise pollution, urban traffic, living distance from the coast, percentage of greenspace, natural environment, water, and domestic garden within 1000 m from the residential coordinates of each participant. All these exposures were tested for association with 17 different types of cancer for a total of 53,270 cases and 302,645 controls. Additionally, a polygenic score (PGS) was computed for each cancer, to test possible gene-environment interactions. Finally, mediation analyses were carried out. RESULTS Thirty-six statistically significant associations considering multiple testing (p < 2.19 × 10-4) were observed. Among the novel associations we observed that individuals living farther from the coast had a higher risk of developing prostate cancer (OR = 1.13, CI95% = 1.06-1.20, P = 1.98 × 10-4). This association was partially mediated by physical activity (indirect effect (IE) = -8.48 × 10-7) and the time spent outdoor (IE = 9.07 × 10-6). All PGSs showed statistically significant associations. Finally, genome-environment interaction analysis showed that local environment and genetic variability affect cancer risk independently. DISCUSSION Living close to the coast and air pollution were associated with a decreased risk of prostate cancer and skin melanoma, respectively. These findings from the UKBB support the role of the local environment on cancer development, which is independent from genetics and may be mediated by several lifestyle factors.
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Affiliation(s)
| | | | | | | | | | - Anna Monreale
- Department of Computer Science, University of Pisa, Pisa, Italy
| | | | | | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniele Campa
- Department of Biology, University of Pisa, Pisa, Italy.
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11
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Tian T, Kwan MP, Vermeulen R, Helbich M. Geographic uncertainties in external exposome studies: A multi-scale approach to reduce exposure misclassification. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 906:167637. [PMID: 37816406 DOI: 10.1016/j.scitotenv.2023.167637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/15/2023] [Accepted: 10/05/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Many studies on environment-health associations have emphasized that the selected buffer size (i.e., the scale of the geographic context when exposures are assigned at people's address location) may affect estimated effect sizes. However, there is limited methodological progress in addressing these buffer size-related uncertainties. AIM We aimed to 1) develop a statistical multi-scale approach to address buffer-related scale effects in cohort studies, and 2) investigate how environment-health associations differ between our multi-scale approach and ad hoc selected buffer sizes. METHODS We used lacunarity analyses to determine the largest meaningful buffer size for multiple high-resolution exposure surfaces (i.e., fine particulate matter [PM2.5], noise, and the normalized difference vegetation index [NDVI]). Exposures were linked to 7.7 million Dutch adults at their home addresses. We assigned exposure estimates based on buffers with fine-grained distance increments until the lacunarity-based upper limit was reached. Bayesian Cox model averaging addressed geographic uncertainties in the estimated exposure effect sizes within the exposure-specific upper buffer limits on mortality. Z-tests assessed statistical differences between averaged effect sizes and those obtained through pre-selected 100, 300, 1200, and 1500 m buffers. RESULTS The estimated lacunarity curves suggested exposure-specific upper buffer size limits; the largest was for NDVI (960 m), followed by noise (910 m) and PM2.5 (450 m). We recorded 845,229 deaths over eight years of follow-up. Our multi-scale approach indicated that higher values of NDVI were health-protectively associated with mortality risk (hazard ratio [HR]: 0.917, 95 % confidence interval [CI]: 0.886-0.948). Increased noise exposure was associated with an increased risk of mortality (HR: 1.003, 95 % CI: 1.002-1.003), while PM2.5 showed null associations (HR:0.998, 95 % CI: 0.997-1.000). Effect sizes of NDVI and noise differed significantly across the averaged and prespecified buffers (p < 0.05). CONCLUSIONS Geographic uncertainties in residential-based exposure assessments may obscure environment-health associations or risk spurious ones. Our multi-scale approach produced more consistent effect estimates and mitigated contextual uncertainties.
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Affiliation(s)
- Tian Tian
- Department of Human Geography and Spatial Planning, Utrecht University, Princetonlaan 8a, 3584 CB Utrecht, the Netherlands.
| | - Mei-Po Kwan
- Department of Human Geography and Spatial Planning, Utrecht University, Princetonlaan 8a, 3584 CB Utrecht, the Netherlands; Department of Geography and Resource Management and Institute of Space and Earth Information Science, Chinese University of Hong Kong, Hong Kong, China
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Utrecht University, Princetonlaan 8a, 3584 CB Utrecht, the Netherlands
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12
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Zhan K, Pan H, Zhou Z, Tang W, Ye Z, Huang S, Luo L. Biological role of long non-coding RNA KCNQ1OT1 in cancer progression. Biomed Pharmacother 2023; 169:115876. [PMID: 37976888 DOI: 10.1016/j.biopha.2023.115876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
Long non-coding RNAs (lncRNAs) are a type of RNAs that are more than 200 nucleotides without protein-coding potential. In recent years, more and more attention has been paid to the role of lncRNAs in cancer pathogenesis. LncRNA KCNQ1 overlapping transcript 1 (KCNQ1OT1) is located on chromosome 11p15.5 with a total length of 91 kb and is highly expressed in various malignancies, which is closely related to tumor growth, lymph node metastasis, survival cycle and recurrence rate. In addition, KCNQ1OT1 is involved in the regulation of PI3K/AKT and Wnt/β-catenin signaling pathways. In this review, the mechanism and related progress of KCNQ1OT1 in different cancers were reviewed. It was found that KCNQ1OT1 can stabilize mRNA expression through sponging miRNA, which not only induced tumor cell proliferation, migration, invasion, drug resistance, epithelial-mesenchymal transition (EMT) and inhibited cell apoptosis in vitro, but also promoted tumor growth and metastasis in vivo. Therefore, as a new biomarker and therapeutic target, KCNQ1OT1 has broad prospects for the diagnosis and treatment of different cancers.
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Affiliation(s)
- Kai Zhan
- Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan 523000, China
| | - Huafeng Pan
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Zhang Zhou
- Department of Anesthesiology, Wuhan Fourth Hospital, Wuhan 430000, China
| | - Wenqian Tang
- Department of Health Management Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430070, China
| | - Zhining Ye
- Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan 523000, China
| | - Shaogang Huang
- Dongguan Hospital of Guangzhou University of Chinese Medicine, Dongguan 523000, China; The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510000, China
| | - Lei Luo
- Department of Health Management Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430070, China.
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13
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Carroll R, Ish JL, Sandler DP, White AJ, Zhao S. Understanding the role of environmental and socioeconomic factors in the geographic variation of breast cancer risk in the US-wide Sister Study. ENVIRONMENTAL RESEARCH 2023; 239:117349. [PMID: 37821066 PMCID: PMC10841999 DOI: 10.1016/j.envres.2023.117349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE To describe the geographic pattern of breast cancer incidence in a nationwide prospective cohort and investigate whether environmental exposures and/or neighborhood socioeconomic status explain observed geographic disparities. METHODS Using accelerated failure time models with a spatial random effect term, we mapped the health region-level association between residential location and breast cancer incidence for 44,707 participants in the Sister Study after controlling for established individual-level breast cancer risk factors. We performed a variable selection process to select environmental exposures [i.e., ambient nitrogen dioxide (NO2) and fine particulate matter (PM2.5), PM2.5 chemical composition, outdoor light at night (LAN), ambient noise, ultraviolet radiation, and greenspace] and neighborhood-level factors [i.e., population density and area deprivation index (ADI)] that predicted breast cancer incidence and quantified the spatial variation explained by the selected factors. We also considered whether the geographic pattern and predictors were similar when restricting to estrogen receptor-positive (ER+) tumors. RESULTS We observed a spatial patterning in the incidence of overall breast cancer (Moran's I = 16.7, p < 0.05) and ER+ breast cancer (Moran's I = 13.2, p < 0.05), with a lower risk observed in the South and Southeast and a greater risk in the Northwest and certain areas of the Midwest and Northeast. NO2, LAN, and ADI explained 21.4% of the spatial variation in overall breast cancer incidence whereas NO2, PM2.5 chemical composition, LAN, greenspace, and ADI together explained 63.3% of the spatial variation in ER+ breast cancer incidence. CONCLUSIONS Our findings provide additional evidence for a role of environmental exposures in breast cancer incidence and suggest that geographic-based risk factors may vary according to breast cancer subtype. Our findings support the need for additional research to quantify the relative contributions of geographic-based risk factors for breast cancer.
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Affiliation(s)
- Rachel Carroll
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, 27709, USA; Human Services Division, American Institutes for Research, 400 Crystal Drive 10th Floor, Arlington, VA, 22202, USA
| | - Jennifer L Ish
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, 27709, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, 27709, USA
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, 27709, USA.
| | - Shanshan Zhao
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, 27709, USA
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14
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Tang M, Liu W, Li H, Li F. Greenness and chronic respiratory health issues: a systematic review and meta-analysis. Front Public Health 2023; 11:1279322. [PMID: 38125839 PMCID: PMC10732026 DOI: 10.3389/fpubh.2023.1279322] [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: 08/17/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction The number of chronic respiratory disease (CRD) individuals worldwide has been continuously increasing. Numerous studies have shown that greenness can improve chronic respiratory health issues through different mechanisms, with inconsistent evidence. By quantitatively summarizing existing studies, our purpose is to determine the connection between greenness exposure and various chronic respiratory health. Methods We conducted a comprehensive search on PubMed, EMBASE, and Web of Science core databases to identify relevant studies on the correlation between greenness exposure and chronic respiratory health issues. Studies published up to January 2023 were included in the search. The study used the most frequent indicator (normalized difference vegetation index [NDVI]) as the definition of greenness exposure. Results We finally identified 35 studies for meta-analysis. We calculated pooled effects across studies using a random-effects model and conducted a subgroup analysis by age and buffer zones to discuss the effects on chronic respiratory health issues. This study showed that 0.1 increments in NDVI were significantly related to lower rates of asthma incidence, lung cancer incidence, and chronic obstructive pulmonary disease (COPD) mortality risk; the pooled RRs were 0.92 (95% CI: 0.85-0.98), 0.62 (95% CI: 0.40-0.95), and 0.95 (95% CI: 0.92- 0.99), respectively. For the age subgroup, the higher greenness exposure level was related to the incidence rate of asthma among teenagers aged 13-18years (RR: 0.91; 95% CI: 0.83-0.99). For the buffer subgroup, a positive relationship with greenness exposure and asthma incidence/prevalence at 200-300m and 800- 1000m buffers, as well as the COPD mortality at 800-1000m buffer, the pooled RRs were 0.92 (95% CI: 0.86-0.98), 0.87 (95% CI: 0.81-0.93), and 0.93 (95% CI: 0.88- 0.98), respectively. Evidence of publication bias was not detected in this study. Discussion Our study is the first global meta-analysis between greenness and various CRDs to report an inverse association. Further research is needed in order to determine the effect of greenness exposure on different CRDs. Therefore, when planning for green development, more consideration must be given to public health and green management as intervention measures. https://www.crd.york.ac.uk/PROSPEROFILES/384029_STRATEGY_20230116.pdf.
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Affiliation(s)
- Mingcheng Tang
- School of Landscape Architecture and Forestry, Qingdao Agricultural University, Qingdao, China
| | - Wei Liu
- School of Art, Qufu Normal University, Rizhao, Shandong, China
| | - Haifang Li
- School of Landscape Architecture and Forestry, Qingdao Agricultural University, Qingdao, China
| | - Fengyi Li
- School of Landscape Architecture and Forestry, Qingdao Agricultural University, Qingdao, China
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15
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Chandwani R, Brokamp C, Salfity H, Starnes SL, Van Haren RM. Impact of Environmental Exposures on Lung Cancer in Patients Who Never Smoked. World J Surg 2023; 47:2578-2586. [PMID: 37402836 DOI: 10.1007/s00268-023-07085-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Despite the rising incidence of lung cancer in patients who never smoked, environmental risk factors such as ambient air pollution in this group are poorly described. Our objective was to identify the relationship of environmental exposures with lung cancer in patients who never smoked. METHODS A prospectively collected database was reviewed for all patients with non-small cell lung carcinoma (NSCLC) who underwent resection from 2006 to 2021. Environmental exposures were estimated using the geocoded home address of patients. Logistic regression was used to determine the association of clinical and environmental variables with smoking status. Kaplan-Meier and Cox proportional hazards analyses were used to assess survival. RESULTS A total of 665 patients underwent resection for NSCLC, of which 67 (10.1%) were patients who never smoked and 598 (89.9%) were current/former smokers. Patients who never smoked were more likely of white race (p = 0.001) and had well-differentiated tumors with carcinoid or adenocarcinoma histology (p < 0.001). Environmental exposures were similar between groups, but patients who never smoked had less community material deprivation (p = 0.002) measured by household income, education, health insurance, and vacancies. They had improved overall survival (p = 0.012) but equivalent cancer recurrence (p = 0.818) as those who smoked. In univariable Cox analyses, fine particulate matter (HR: 1.447 [95% CI 1.197-1.750], p < 0.001), distance to nearest major roadway (HR: 1.067 [1.024-1.111], p = 0.002), and greenspace (HR: 0.253 [0.087-0.737], p = 0.012) were associated with overall survival in patients who never smoked. CONCLUSIONS Lung cancer patients who never smoked have unique clinical and pathologic characteristics, including higher socioeconomic status. Interventions to reduce environmental exposures may improve lung cancer survival in this population.
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Affiliation(s)
- Rahul Chandwani
- Division of Thoracic Surgery, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML-0558, Cincinnati, OH, 45267-0558, USA
| | - Cole Brokamp
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Hai Salfity
- Division of Thoracic Surgery, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML-0558, Cincinnati, OH, 45267-0558, USA
| | - Sandra L Starnes
- Division of Thoracic Surgery, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML-0558, Cincinnati, OH, 45267-0558, USA
| | - Robert M Van Haren
- Division of Thoracic Surgery, Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way ML-0558, Cincinnati, OH, 45267-0558, USA.
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16
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Zhang P, Zhou C, Zhao K, Liu C, Liu C, He F, Peng W, Jia X, Mi J. Associations of air pollution and greenness with global burden of breast cancer: an ecological study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:103921-103931. [PMID: 37697184 DOI: 10.1007/s11356-023-29579-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023]
Abstract
Despite the significance of the associations of air pollution and greenness with the risk of breast cancer, this topic has not been investigated on a global scale. We conducted an ecological study using 7 years of data from 162 countries. Disability-adjusted life years (DALYs) and incidence data were used to represent the breast cancer disease burden. Particulate matter with a diameter < 2.5 μm (PM2.5), ozone (O3), nitrogen dioxide (NO2), and the normalized difference vegetation index (NDVI) were adopted as our exposures. We employed generalized linear mixed models to explore the relationship between air pollution and greenness on breast cancer disease burden. The rate ratio (RR) and its 95% confidence interval (CI) indicate the effect size. There is a positive association between air pollution and the burden of breast cancer disease. Contrarily, per interquartile range increment in NDVI was negatively associated with DALYs and incidence. In terms of air pollutants and breast cancer, NDVI seems to have a significant influence on the relationship between these two conditions. A higher amount of greenness helps to alleviate the negative association of air pollution on breast cancer. PM2.5 and O3 play a mediating role in the relationship between greenness and breast cancer disease burden. In areas with higher levels of greenness, there is a possibility that the inverse association between air pollutants and the burden of breast cancer may be influenced.
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Affiliation(s)
- Peiyao Zhang
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Cheng Zhou
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Ke Zhao
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Chengrong Liu
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Chao Liu
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Fenfen He
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China
| | - Xianjie Jia
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Jing Mi
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China.
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17
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Liu Z, Chen X, Cui H, Ma Y, Gao N, Li X, Meng X, Lin H, Abudou H, Guo L, Liu Q. Green space exposure on depression and anxiety outcomes: A meta-analysis. ENVIRONMENTAL RESEARCH 2023; 231:116303. [PMID: 37268208 DOI: 10.1016/j.envres.2023.116303] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/31/2023] [Accepted: 05/31/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND The development of urbanization has led to emerging mental health issues. Green space was becoming increasingly important for mental health. Previous studies have demonstrated the value of green space for a variety of outcomes connected to mental health. However, uncertainty remains regarding the association between green spaces and the risk of depression and anxiety outcomes. This study aimed to integrate present evidence from observational studies to define the association of exposure to green space with depression and anxiety. METHODS A thorough electronic search of PubMed, Web of Science and Embase database was performed. We transformed the odds ratio (OR) of different green increments into per 0.1 unit increase in normalized difference vegetation index (NDVI) and per 10% increase in percentage of green space. Cochrane's Q and I2 statistics were used to assess study heterogeneity, and random-effects models were employed to calculate combined effect estimation OR with 95% confidence intervals (CIs). Pooled analysis was completed using Stata 15.0. RESULTS According to this meta-analysis, a 10% increase in the proportion of green space was linked to a lower risk of depression (merged OR (95% CI) = 0.963 (0.948, 0.979)) and anxiety (merged OR (95% CI) = 0.938 (0.858, 1.025)) and a 0.1 unit increase in NDVI was linked to a lower risk of depression (merged OR (95% CI) = 0.931 (0.887, 0.977)). CONCLUSIONS Results of this meta-analysis supported improving green space exposure in preventing depression and anxiety. Higher green space exposure might be helpful for depression and anxiety disorders. Therefore, improving or preserving green space should be regarded as a promising intervention for public health.
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Affiliation(s)
- Ziquan Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China; Tianjin Fourth Central Hospital, Tianjin 300140, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, 325000, China
| | - Xuemei Chen
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China; Tianjin Fourth Central Hospital, Tianjin 300140, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, 325000, China
| | - Huanhuan Cui
- Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, 325000, China
| | - Yuxuan Ma
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China; Tianjin Fourth Central Hospital, Tianjin 300140, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, 325000, China
| | - Ning Gao
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, 325000, China
| | - Xinyu Li
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, 325000, China
| | - Xiangyan Meng
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, 325000, China
| | - Huishu Lin
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China; Tianjin Fourth Central Hospital, Tianjin 300140, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, 325000, China
| | - Halidan Abudou
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, 325000, China
| | - Liqiong Guo
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, 300072, China; Tianjin Fourth Central Hospital, Tianjin 300140, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, 325000, China.
| | - Qisijing Liu
- Research Institute of Public Health, School of Medicine, Nankai University, Tianjin 300081, China.
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Li J, Xie Y, Xu J, Zhang C, Wang H, Huang D, Li G, Tian J. Association between greenspace and cancer: evidence from a systematic review and meta-analysis of multiple large cohort studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:91140-91157. [PMID: 37474858 DOI: 10.1007/s11356-023-28461-5] [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: 01/27/2023] [Accepted: 06/23/2023] [Indexed: 07/22/2023]
Abstract
Cancer is a chronic disease that seriously endangers human health, and studies on its association with greenspace have been published. We aimed to systematically review the epidemiological evidence and obtain the best available evidence. PubMed, Web of Science, Embase, and Cochrane Library were used as search databases, the time limit was September 12, 2022, and the cited articles were manually supplemented. Two researchers independently performed literature screening and data extraction. We performed a meta-analysis of data using a normalized difference vegetation index (NDVI) as the greenspace measure, providing hazard ratio (HR) and corresponding 95% CI. After standardization of the data, we used a random effects model for pooling. We also assessed the risk of bias for each study and the quality of each evidence body. We identified 10,108 items and included 14 studies from 11 institutions in eight countries. All studies had a low risk of bias. Quantitative analysis of 13 studies found a beneficial association of greenspace with the mortality of lung cancer (pooled HR [95% CI]=0.965 [0.947, 0.983]) and prostate cancer (HR [95% CI]=0.939 [0.898, 0.980]) based on 0.1-unit NDVI increment and a potential beneficial association with the incidence of prostate, lung, and breast cancer. Greenspace had opposite associations with cancer mortality for urban and rural populations. Indirect comparisons did not find statistically significant differences in the effects of greenspace on different cancer outcomes. The evidence body assessment was considered to be "very low." This review indicated potential beneficial associations between greenspace for lung, prostate, and breast cancer outcomes. However, there was a lack of mediation analysis to explore the underlying mechanism of a causal association. Meanwhile, the interstudy heterogeneity was large. Therefore, future studies should consider more accurate exposure assessment and more comprehensive covariate coverage, while focusing on mediating analysis. PROSPERO: CRD42022361068.
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Affiliation(s)
- Jiang Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yafei Xie
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, 730000, China
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, China
| | - Jianguo Xu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Chun Zhang
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Huilin Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Danqi Huang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Guoqiang Li
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Jinhui Tian
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, 730000, China.
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China.
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Masdor NA, Abu Bakar MF, Hod R, Mohammed Nawi A. Green space exposure and colorectal cancer: A systematic review. Heliyon 2023; 9:e15572. [PMID: 37153430 PMCID: PMC10160744 DOI: 10.1016/j.heliyon.2023.e15572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 05/09/2023] Open
Abstract
Green space has been linked to colorectal cancer, but the evidence is still limited and inconclusive. This review aimed to investigate the relationship between green space and CRC. The studies were searched using three primary journal databases: PubMed, Scopus, and Web of Science. The retrieved citations were screened, and data from articles about GS exposure and CRC were extracted. The Newcastle-Ottawa Quality Assessment Form for Cohort Studies was used to evaluate the studies' quality. Five of the 1792 articles identified were eligible for the final review, which included five cohort studies published between 2017 and 2022. Each one article from the United States, the United Kingdom, France, Belgium, and Germany and All studies are of high quality. Four studies reported CRC incidence and one study reported CRC mortality from GS exposure. There was no significant association between GS attributes (Normalized Difference Vegetation Index (NDVI), surrounding greenness, surrounding green area, proximity to GS (agricultural lands, urban GSs, and forests), and count of recreational facilities and parks) with CRC. Only one study discovered that a healthier ecosystem was linked to a lower CRC risk. Although the evidence is still limited, the findings may indicate the presence of other factors in the relationship between GS and CRC. Future research should continue to focus on the variation of GS and the factors that influence it. Specific attention to the development of GS has the potential to produce benefits while mitigating cancer risk.
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Cao Z, Xu C, Li S, Wang Y, Yang H. Residential greenspace and risk of cancer: A prospective cohort study from the UK Biobank. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 871:162145. [PMID: 36773899 DOI: 10.1016/j.scitotenv.2023.162145] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/10/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Growing evidence suggests that proximity to greenspace is linked to multiple health outcomes, but its association with the risk of cancer is not fully understood. The mechanism for greenspace's influences on cancer incidence may be through reducing depressive symptoms and increasing physical activity. Our study aimed to investigate the associations between exposure to residential greenspace and the risk of common types of cancer and whether the associations were modified or mediated by depressive symptoms and physical activity. METHODS This prospective cohort study included 401,189 participants in the UK Biobank between 2006 and 2010 who were free of cancer and followed up until 2021. Residential greenspace was defined as the percentage of outdoor greenspace surrounding the residential location of each participant across 1000 m and 300 m buffers, which were estimated with land use data. Electronic health records were used to assess the incidence of 25 types of cancer. Cox proportional hazards regressions were performed to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) per an interquartile range (IQR) increase of greenspace after multiple comparisons using Bonferroni correction. RESULTS During a median follow-up of 12.4 years, a total of 43,273 incident cancer cases were documented. We found that exposure to greenspace at a 1000 m buffer was significantly associated with prostate cancer (HR = 0.93, 95 % CI: 0.89-0.96), and suggestively associated with oral cavity (HR = 0.86, 95 % CI: 0.76-0.98) and bladder cancer (HR = 1.08, 95 % CI: 1.01-1.15), but not with other cancers. Moreover, the association between greenspace and prostate cancer was mediated by physical activity, and was modified by depressive symptoms (P for heterogeneity = 0.022). Similar findings were also observed for greenspace at a 300 m buffer. CONCLUSION Our study revealed an association between exposure to greenspace and prostate cancer, but not with other cancers.
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Affiliation(s)
- Zhi Cao
- School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shu Li
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongxi Yang
- School of Public Health, Tianjin Medical University, Tianjin, China; Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China.
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