Long-term exposure to air pollution and lung cancer incidence: findings from improved exposure assessment and extended population
Menée notamment à l'aide de données de l'Assurance maladie coréenne portant sur 2 035 278 personnes âgées d'au moins 30 ans, cette étude analyse l'association entre une exposition résidentielle à long terme aux particules PM10 et PM2.5, au dioxyde d'azote ou à l'ozone et l'incidence du cancer du poumon (18 229 cas)
Purpose: Accumulating evidence suggested long-term exposure to air pollution as a risk factor of lung cancer. Recent efforts confirmed the association based on extended population and individual exposure by leveraging administrative databases and complete address information. However, few studies achieved simultaneous improvements. Using the 2 million cohort along with their individual residential exposures, this study aimed to investigate the association of four criteria pollutants and incident lung cancer in the Seoul Metropolitan Area, South Korea.
Methods: Our study population included 2,035,278 people aged ≥ 30 years and without cancer for 2002–2006 from the National Health Insurance System database. We identified lung cancer incidence for 2007–2016 and assessed individual long-term exposure to particulate matter ≤ 10 µm and 2.5 µm in diameter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone at participants’ home addresses by using previously validated exposure prediction models. Using time-varying Cox proportional hazard models, we estimated hazard ratios (HRs) per interquartile range increase in each pollutant concentration adjusting for individual and area-level characteristics.
Results: There were 18,229 lung cancer new cases over 10 years. We did not find the association for all four pollutants (PM10: HR = 0.99 [95% Confidence Interval = 0.93–1.04]; PM2.5: 0.97 [0.92–1.02]; NO2: 1.00 [0.96–1.05]; and ozone: 1.01 [0.98–1.04]). The extended stratified and sensitivity analyses mostly showed null associations.
Conclusion: Our findings of no association contradictory to existing evidence, despite the considerable improvement in exposure assessment and population size, suggest further examination by integrating histological variation and indoor and/or personal exposure.
Cancer Causes & Control , résumé, 2025