Outdoor ambient air pollution and breast cancer survival among California participants of the Multiethnic Cohort Study

Iona Cheng; Juan Yang; Chiuchen Tseng; Jun Wu; Shannon M. Conroy; Salma Shariff-Marco; Scarlett Lin Gomez; Alice S. Whittemore; Daniel O. Stram; Loïc Le Marchand; Lynne R. Wilkens; Beate Ritz; Anna H. Wu

Environment International (Mar 2022)

Outdoor ambient air pollution and breast cancer survival among California participants of the Multiethnic Cohort Study

Iona Cheng,
Juan Yang,
Chiuchen Tseng,
Jun Wu,
Shannon M. Conroy,
Salma Shariff-Marco,
Scarlett Lin Gomez,
Alice S. Whittemore,
Daniel O. Stram,
Loïc Le Marchand,
Lynne R. Wilkens,
Beate Ritz,
Anna H. Wu

Affiliations

Iona Cheng: Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, San Francisco, CA, USA; Corresponding author at: University of California, San Francisco, Department of Epidemiology and Biostatistics 550 16th Street, San Francisco, California 94158, USA.
Juan Yang: Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
Chiuchen Tseng: Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Jun Wu: Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, USA
Shannon M. Conroy: Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
Salma Shariff-Marco: Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, San Francisco, CA, USA
Scarlett Lin Gomez: Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, San Francisco, CA, USA
Alice S. Whittemore: Stanford University School of Medicine, Stanford, CA, USA
Daniel O. Stram: Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Loïc Le Marchand: Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
Lynne R. Wilkens: Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
Beate Ritz: Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
Anna H. Wu: Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

Journal volume & issue: Vol. 161
p. 107088

Abstract

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Background: Within the Multiethnic Cohort (MEC), we examined the association between air pollution and mortality among African American, European American, Japanese American, and Latina American women diagnosed with breast cancer. Methods: We used a land use regression (LUR) model and kriging interpolation to estimate nitrogen oxides (NOx , NO2) and particulate matter (PM2.5, PM10) exposures for 3,089 breast cancer cases in the MEC, who were diagnosed from 1993 through 2013 and resided largely in Los Angeles County, California. Cox proportional hazards models were used to examine the association of time-varying air pollutants with all-cause, breast cancer, cardiovascular disease (CVD), and non-breast cancer/non-CVD mortality, accounting for key covariates. Results: We identified 1,125 deaths from all causes (474 breast cancer, 272 CVD, 379 non-breast cancer/non-CVD deaths) among the 3,089 breast cancer cases with 8.1 years of average follow-up. LUR and kriged NOX (per 50 ppb) and NO2 (per 20 ppb), PM2.5 (per 10 µg/m3), and PM10 (per 10 µg/m3) were positively associated with risks of all-cause (Hazard Ratio (HR) range = 1.13–1.25), breast cancer (HR range = 1.19–1.45), and CVD mortality (HR range = 1.37–1.60). Associations were statistically significant for LUR NOX and CVD mortality (HR = 1.60; 95% CI: 1.08–2.37) and kriged NO2 and breast cancer mortality (HR = 1.45; 95% CI 1.02–2.07). Gaseous and PM pollutants were positively associated with breast cancer mortality across racial/ethnic group. Conclusion: In this study, air pollutants have a harmful impact on breast cancer survival. Additional studies should evaluate potential confounding by socioeconomic factors. These data support maintaining clean air laws to improve survival for women with breast cancer.

Published in Environment International

ISSN: 0160-4120 (Print)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Geography. Anthropology. Recreation: Environmental sciences
Website: https://www.journals.elsevier.com/environment-international

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