Air Pollutants and Breast Cancer Risk: A Parallel Analysis of Five Large US Prospective Cohorts
Alexandra J White1, Jaime E Hart1, Sabah M Quraishi1
1Alexandra J. White and Dale P. Sandler are with the Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC. Jaime E. Hart and Francine Laden are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA. At the time of this work, Sabah M. Quraishi was with the Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA. Deborah B. Bookwalter is with Public Health and Epidemiology Practice, Westat, Rockville, MD. Marina R. Sweeney is with Social & Scientific Systems, a DLH Holdings Company, Durham, NC. Elizabeth W. Spalt and Joel D. Kaufman are with the Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle. Michael S. Hendryx is with the Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington. Veronica L. Irvin is with the College of Health, Oregon State University, Corvallis. Dorothy S. Lane is with the Department of Family, Population, and Preventive Medicine, Stony Brook University, Stony Brook, NY. Aladdin H. Shadyab is with the Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla. Shawnita Sealy-Jefferson is with the Division of Epidemiology, College of Public Health, The Ohio State University, Columbus. Marian L. Neuhouser is with the Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington, Seattle. Eric A. Whitsel is with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill.
Outdoor air pollution, including nitrogen dioxide (NO2), fine particulate matter (PM2.5), and ozone, is linked to increased breast cancer incidence. This study found specific associations between PM2.5 and ozone with estrogen receptor-negative/progesterone receptor-negative tumors.
Area of Science:
- Environmental Epidemiology
- Oncology
- Public Health
Background:
- Outdoor air pollution is a significant environmental exposure with potential health implications.
- Previous research suggests links between air pollutants and various cancers, but evidence for breast cancer requires further investigation.
Purpose of the Study:
- To investigate the association between residential exposure to ambient nitrogen dioxide (NO2), fine particulate matter (PM2.5), and ozone and the incidence of breast cancer in the United States.
- To examine these associations across different breast cancer subtypes, specifically estrogen receptor (ER)/progesterone receptor (PR) positive and negative tumors, and by geographic region.
Main Methods:
- Utilized data from large US cohorts: Nurses' Health Studies, Women's Health Initiative, and Sister Study.
- Estimated individual-level air pollutant concentrations (NO2, PM2.5, ozone) using high-resolution spatiotemporal models.
- Employed Cox proportional hazards regression and random effects models to estimate hazard ratios (HRs) and confidence intervals (CIs).
Main Results:
- Nitrogen dioxide (NO2) exposure was positively associated with overall breast cancer incidence (HR=1.03).
- Fine particulate matter (PM2.5) exposure showed an association with higher incidence of ER-/PR- tumors (HR=1.14) and overall incidence in the Midwest (HR=1.15).
- Ozone exposure was associated with a higher incidence of ER-/PR- tumors (HR=1.10).
Conclusions:
- This large-scale US study confirms the association between NO2 exposure and breast cancer incidence.
- Novel associations were identified between PM2.5 and ozone exposure and the incidence of ER-/PR- breast tumors.
- Findings highlight the importance of air quality in breast cancer prevention strategies.
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