Lung cancer is the leading cause of cancer death worldwide. Though advances in early detection and therapeutics have increased the number of long-term lung cancer survivors, these survivors are at high risk of developing second primary lung cancer (SPLC). Survivors diagnosed with SPLC have a significantly increased risk of mortality compared to those without it, but the risk factors for the disease remain understudied. While air pollution is associated with the risk of initial primary lung cancer, especially among never-smokers, its effect on SPLC risk among lung cancer survivors is largely unknown.
In a study in the British Journal of Cancer, Dr. Eunji Choi, assistant professor of population health sciences, and colleagues examined whether exposure to residential air pollution is associated with risk of developing SPLC among lung cancer survivors. The study used data from the UK Biobank, a large-scale prospective cohort study with extensive long-term health data.
The Biobank provides annual average estimates of ambient air pollutants, including PM10. PM10 are particles derived from different emission sources, including combustion of gasoline, oil, diesel fuel, or wood. It also includes dust from construction sites, landfills, wildfires, pollen, and more. Importantly, these pollutants can be inhaled into the lungs.
Dr. Choi’s study found a clear dose-response relationship between annual PM10 exposure and SPLC risk, meaning that increased exposure to PM10 is associated with increased risk of SPLC. The adverse effects of PM10 were particularly pronounced among lung cancer survivors who had never smoked. These findings support PM10 as a modifiable risk factor for SPLC and lend support to incorporating PM10 in predicting SPLC risk for all lung cancer survivors. Researchers suggest that regional and national policymakers across sectors such as energy, transportation, and waste management should coordinate efforts to reduce PM10 levels in the atmosphere.
- Highlights