Objective: To investigate associations between air particulate matter of ≤2.5 μm in diameter (PM ) and ovarian cancer.
Design: County-level ecological study.
Setting: Surveillance, epidemiology, and end results from a collection of state-level cancer registries across 744 counties. Data from the Environmental Protection Agency's network for PM monitoring was used to calculate trailing 5- and 10-year PM county-level values. County-level data on demographic characteristics were obtained from the American Community Survey.
Population: A total of 98 751 patients with histologically confirmed ovarian cancer as a primary malignancy from 2000 to 2016.
Methods: Generalised linear regression models were developed to estimate the association between PM and PM levels, over 5- and 10-year periods of exposure, and ovarian cancer risk, after accounting for county-level covariates.
Main Outcome Measures: Risk ratios for associations between ovarian cancer (both overall and specifically epithelial ovarian cancer) and PM levels.
Results: For the 744 counties included, the average PM level from 1990 through 2018 was 11.75 μg/m (SD = 3.7) and the average PM level was 22.7 μg/m (SD = 5.7). After adjusting for county-level covariates, the overall annualised ovarian cancer incidence was significantly associated with increases in 5-year PM (RR = 1.11 per 10 units (μg/m ) increase, 95% CI 1.06-1.16). Similarly, when the analysis was limited to epithelial cell tumours and adjusted for county-level covariates there was a significant association with trailing 5-year PM exposure models (RR = 1.12 per 10 units increase, 95% CI 1.08-1.17). Likewise, 10-year PM exposure was associated with ovarian cancer overall and with epithelial ovarian cancer.
Conclusions: Higher county-level ambient PM levels are associated with 5- and 10-year incidences of ovarian cancer, as measurable in an ecological study.
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http://dx.doi.org/10.1111/1471-0528.17689 | DOI Listing |
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