Long-term exposure to ambient fine particulate matter and risk of liver cancer in the NIH-AARP Diet and Health Study

Xiuqi Ma; Jared A Fisher; Katherine A McGlynn; Linda M Liao; Vasilis Vasiliou; Ning Sun; Joel D Kaufman; Debra T Silverman; Rena R Jones

doi:10.1016/j.envint.2024.108637

Long-term exposure to ambient fine particulate matter and risk of liver cancer in the NIH-AARP Diet and Health Study

Environ Int. 2024 May:187:108637. doi: 10.1016/j.envint.2024.108637. Epub 2024 Apr 5.

Authors

Xiuqi Ma¹, Jared A Fisher², Katherine A McGlynn², Linda M Liao², Vasilis Vasiliou³, Ning Sun⁴, Joel D Kaufman⁵, Debra T Silverman², Rena R Jones⁶

Affiliations

¹ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
² Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
³ Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
⁴ Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
⁵ Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
⁶ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA. Electronic address: rena.jones@nih.gov.

PMID: 38636274
DOI: 10.1016/j.envint.2024.108637

Abstract

Background: Fine particulate matter (PM_2.5) exposure has been associated with liver cancer incidence and mortality in a limited number of studies. We sought to evaluate this relationship for the first time in a U.S. cohort with historical exposure assessment.

Methods: We used spatiotemporal prediction models to estimate annual average historical PM_2.5 concentrations (1980-2015) at residential addresses of 499,729 participants in the NIH-AARP Diet and Health Study, a cohort in 6 states (California, Florida, Louisiana, New Jersey, North Carolina, and Pennsylvania) and 2 metropolitan areas (Atlanta, Georgia, and Detroit, Michigan) enrolled in 1995-1996 and followed up through 2017. We used a time-varying Cox model to estimate the association for liver cancer and the predominant histologic type, hepatocellular carcinoma (HCC), per 5 µg/m³ increase in estimated outdoor PM_2.5 levels, incorporating a 5-year average, lagged 10 years prior to cancer diagnosis and adjusting for age, sex, race/ethnicity, education level and catchment state. We also evaluated PM_2.5 interactions with hypothesized effect modifiers.

Results: We observed a non-significantly increased risk of liver cancer associated with estimated PM_2.5 exposure (Hazard ratio [HR] = 1.05 [0.96-1.14], N = 1,625); associations were slightly stronger for HCC, (84 % of cases; HR = 1.08 [0.98-1.18]). Participants aged 70 or older at enrollment had an increased risk of liver cancer versus other age groups (HR = 1.50 [1.01-2.23]); p-interaction = 0.01) and risk was elevated among participants who did not exercise (HR = 1.81 [1.22-2.70]; p-interaction = 0.01). We found no evidence of effect modification by sex, smoking status, body mass index, diabetes status, or alcohol consumption (p-interaction > 0.05).

Conclusions: Our findings in this large cohort suggest that residential ambient PM_2.5 levels may be associated with liver cancer risk. Further exploration of the variation in associations by age and physical activity are important areas for future research.

Keywords: Air pollution; Hepatocellular carcinoma; Liver cancer; PM(2.5); Particulate matter.

Published by Elsevier Ltd.

MeSH terms

Aged
Air Pollutants* / analysis
Air Pollution / statistics & numerical data
Cohort Studies
Environmental Exposure* / statistics & numerical data
Female
Humans
Liver Neoplasms* / chemically induced
Liver Neoplasms* / epidemiology
Male
Middle Aged
Particulate Matter* / analysis
Risk Factors
United States / epidemiology