Breast cancer risk in relation to ambient concentrations of nitrogen dioxide and particulate matter: results of a population-based case-control study corrected for potential selection bias (the CECILE study)

Clémentine Lemarchand; Stephan Gabet; Sylvie Cénée; Nastassia Tvardik; Rémy Slama; Pascal Guénel

doi:10.1016/j.envint.2021.106604

Breast cancer risk in relation to ambient concentrations of nitrogen dioxide and particulate matter: results of a population-based case-control study corrected for potential selection bias (the CECILE study)

Environ Int. 2021 Oct:155:106604. doi: 10.1016/j.envint.2021.106604. Epub 2021 May 21.

Authors

Clémentine Lemarchand¹, Stephan Gabet², Sylvie Cénée¹, Nastassia Tvardik¹, Rémy Slama², Pascal Guénel³

Affiliations

¹ University Paris-Saclay, UVSQ, Gustave Roussy, Inserm, CESP, Team Exposome and Heredity, 94800 Villejuif, France.
² Univ. Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, IAB, 38000 Grenoble, France.
³ University Paris-Saclay, UVSQ, Gustave Roussy, Inserm, CESP, Team Exposome and Heredity, 94800 Villejuif, France. Electronic address: pascal.guenel@inserm.fr.

PMID: 34030067
DOI: 10.1016/j.envint.2021.106604

Abstract

Background: There is only scant evidence that air pollution increases the risk of breast cancer.

Objectives: We investigated this relationship for three air pollutants: nitrogen dioxide (NO₂) and particulate matter with an aerodynamical diameter below 10 µm (PM₁₀) and 2.5 µm (PM_2.5).

Methods: We conducted a population-based case-control study on breast cancer in two French départements, including 1,229 women diagnosed with breast cancer in 2005-2007 and 1,316 control women frequency-matched on age. Concentrations of NO₂, PM₁₀ and PM_2.5 at participants' addresses occupied during the last 10 years were assessed using a chemistry transport model. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using multivariable logistic regression models where each woman was assigned a weight depending on her probability of selection into the study.

Results: The OR for breast cancer per 10-µg/m³ increase in NO₂ was 1.11 (95% CI, 0.98, 1.26), and 1.41 (95% CI 1.07, 1.86) in the highest exposure quintile (Q5), compared to the first. The ORs per 10-µg/m³ NO₂ did not markedly differ between pre- (OR 1.09, 95% CI 0.89, 1.35)) and post-menopausal women (OR 1.14, 95% CI 0.97, 1.33)), but the OR was substantially higher for hormone-receptor positive (ER+/PR+) breast tumor subtypes (OR 1.15, 95% CI 1.00, 1.31) than for ER-/PR- tumors (OR 0.95, 95% CI 0.72, 1.26). Breast cancer risk was not associated with either PM₁₀ (OR per 1 µg/m³ 1.01, 95% CI, 0.96, 1.06) or PM_2.5 (OR per 1 µg/m³ 1.02, 95% CI 0.95, 1.08), regardless of the menopausal status or of the breast tumor subtype.

Discussion: Our study provides evidence that NO₂ exposure, a marker of traffic-related air pollutants, may be associated with an increased risk of breast cancer, particularly ER+/PR+ tumors.

Keywords: Air pollution; Breast cancer; Breast cancer subtypes; Case-control study; Menopausal status.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / adverse effects
Air Pollution* / analysis
Breast Neoplasms* / chemically induced
Breast Neoplasms* / epidemiology
Case-Control Studies
Environmental Exposure / adverse effects
Environmental Exposure / analysis
Female
Humans
Nitrogen Dioxide / analysis
Nitrogen Dioxide / toxicity
Particulate Matter / analysis
Particulate Matter / toxicity
Selection Bias

Substances

Air Pollutants
Particulate Matter
Nitrogen Dioxide