Association of outdoor air pollution, lifestyle, genetic factors with the risk of lung cancer: A prospective cohort study

• Published in: Environmental research 2023-02, Vol.218, p.114996, Article 114996
• Main Authors: Liang, Huaying, Zhou, Xin, Zhu, Yiqun, Li, Dianwu, Jing, Danrong, Su, Xiaoli, Pan, Pinhua, Liu, Hong, Zhang, Yan
• Format: Article
• Language: English
• Subjects: Air Pollutants - analysis; Air Pollutants - toxicity; Air pollution; Air Pollution - adverse effects; Air Pollution - analysis; Cohort Studies; Environmental Exposure - analysis; Genetic risk; Humans; Life Style; Lifestyle; Lung cancer; Lung Neoplasms - chemically induced; Lung Neoplasms - epidemiology; Nitrogen Dioxide - analysis; Particulate Matter - analysis; Prospective Studies
• ISSN: 0013-9351; 1096-0953
• DOI: 10.1016/j.envres.2022.114996

The effect of air pollution exposure on incident lung cancer remains uncertain, and the modifying role of lifestyle and genetic susceptibility in association between air pollution and lung cancer is ambiguous. A total of 367,623 participants from UK biobank cohort were enrolled in the analysis. The concentrations of particle matter (PM2.5, PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx), were evaluated by land-use regression model. Cox proportional hazard model was applied to assess the associations between air pollution and incident lung cancer. A lifestyle risk score and a polygenic risk score were established to investigate whether lifestyle and heritable risk could modify the effect of air pollution on lung cancer risk. Per interquartile range (IQR) increment in annual concentrations of PM2.5 (HR = 1.22, 95% CI, 1.15∼1.30), NO2 (HR = 1.19, 95% CI, 1.10∼1.27), and NOx (HR = 1.14, 95% CI, 1.09∼1.20) were associated with increased risk of lung cancer. We observed an additive interaction between air pollution including PM2.5 and NOx and lifestyle or genetic risk. Individuals with high air pollution exposure, poor lifestyle and high genetic risk had the highest risk of incident lung cancer. Long-term exposures to air pollution is associated with increased risk of lung cancer, and this effect was modified by lifestyle or genetic risk. Integrated interventions for environmental pollution by government and adherence to healthy lifestyle by individuals are advocated for lung cancer prevention. •Exposure to air pollution was associated with increased risk of lung cancer.•The effect of air pollution was modified by lifestyle and genetic risk.•Improving air pollution is important in lung cancer prevention.•Adherence to healthy lifestyle is necessary in lung cancer prevention.