Long-Term Exposure to Air Pollution Is a Risk Factor for Esophageal Cancer
Prateek Sharma, MD, FASGE, reviewing Sun D, et al. Gastroenterology 2023 Apr 12.
Long-term exposure to PM2.5 (fine particulate matter) is a known risk factor for lung cancer. However, the evidence linking PM2.5 to esophageal cancer is sparse and inconclusive. Long-term exposure to PM2.5 can cause chronic low-grade inflammation and oxidative stress locally and systemically, which can trigger genetic changes that increase the risk of lung and non-lung cancer.
The study analyzed China’s Kadoorie Biobank and identified 510,125 participants who did not have esophageal cancer at the start. The study used a satellite-based model to estimate PM2.5 exposure during the study period. Using a Cox proportional hazard model, the study found a linear concentration-response relationship between PM2.5 exposure and esophageal cancer. For each 10 μg/m3 increase in PM2.5, the hazard ratio was 1.16 (95% confidence interval, 1.04-1.30) for esophageal cancer incidence. The study also found that the population-attributable risk due to PM2.5 exposure was higher than that due to lifestyle risk factors.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Sun D, Liu C, Zhu Y, et al.; China Kadoorie Biobank Collaborative Group. Long-term exposure to fine particulate matter and incidence of esophageal cancer: a prospective study of 0.5 million Chinese adults. Gastroenterology 2023 Apr 12. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2023.03.233)