Ambient Ozone, PM1 and Female Lung Cancer Incidence in 436 Chinese Counties

Ozone air pollution has been increasingly severe and has become another major air pollutant in Chinese cities, while PM1 is more harmful to human health than coarser PMs. However, nationwide studies estimating the effects of ozone and PM1 are quite limited in China. This study aims to assess the spatial associations between ozone (and PM1) and the incidence rate of female lung cancer in 436 Chinese cancer registries (counties/districts). The effects of ozone and PM1 were estimated, respectively, using statistical models controlling for time, location and socioeconomic covariates. Then, three sensitivity analyses including the adjustments of smoking covariates and co-pollutant (SO2) and the estimates of ozone, PM1 and SO2 effects in the same model, were conducted to test the robustness of the effects of the two air pollutants. Further still, we investigated the modifying role of urban–rural division on the effects of ozone and PM1. According to the results, a 10 μg/m3 increase in ozone and PM1 was associated with a 4.57% (95% CI: 4.32%, 16.16%) and 4.89% (95% CI: 4.37%, 17.56%) increase in the incidence rate of female lung cancer relative to its mean, respectively. Such ozone and PM1 effects were still significant in three sensitivity analyses. Regarding the modifying role of urban–rural division, the effect of PM1 was greater by 2.98% (95% CI: 1.01%, 4.96%) in urban than in rural areas when PM1 changed by 10 μg/m3. However, there was no modification effect of urban–rural division for ozone. In conclusion, there were positive associations between ozone (and PM1) and the incidence rate of female lung cancer in China. Urban-rural division may modify the effect of PM1 on the incidence rate of female lung cancer, which is seldom reported. Continuous and further prevention and control measures should be developed to alleviate the situation of the two air pollutants.

Socioeconomic disparities in cancer incidence and mortality in England and the impact of age-at-diagnosis on cancer mortality

Background We identify socioeconomic disparities by region in cancer morbidity and mortality in England for all-cancer and type-specific cancers, and use incidence data to quantify the impact of cancer diagnosis delays on cancer deaths between 2001–2016. Methods and findings We obtain population cancer morbidity and mortality rates at various age, year, gender, deprivation, and region levels based on a Bayesian approach. A significant increase in type-specific cancer deaths, which can also vary among regions, is shown as a result of delay in cancer diagnoses. Our analysis suggests increase of 7.75% (7.42% to 8.25%) in female lung cancer mortality in London, as an impact of 12-month delay in cancer diagnosis, and a 3.39% (3.29% to 3.48%) increase in male lung cancer mortality across all regions. The same delay can cause a 23.56% (23.09% to 24.30%) increase in male bowel cancer mortality. Furthermore, for all-cancer mortality, the highest increase in deprivation gap happened in the East Midlands, from 199 (186 to 212) in 2001, to 239 (224 to 252) in 2016 for males, and from 114 (107 to 121) to 163 (155 to 171) for females. Also, for female lung cancer, the deprivation gap has widened with the highest change in the North West, e.g. for incidence from 180 (172 to 188) to 272 (261 to 282), whereas it has narrowed for prostate cancer incidence with the biggest reduction in the South West from 165 (139 to 190) in 2001 to 95 (72 to 117) in 2016. Conclusions The analysis reveals considerable disparities in all-cancer and some type-specific cancers with respect to socioeconomic status. Furthermore, a significant increase in cancer deaths is shown as a result of delays in cancer diagnoses which can be linked to concerns about the effect of delay in cancer screening and diagnosis during the COVID-19 pandemic. Public health interventions at regional and deprivation level can contribute to prevention of cancer deaths.

Associations between female lung cancer risk and sex steroid hormones: a systematic review and meta-analysis of the worldwide epidemiological evidence on endogenous and exogenous sex steroid hormones

Background Published findings suggest sex differences in lung cancer risk and a potential role for sex steroid hormones. Our aim was to perform a meta-analysis to investigate the effects of sex steroid hormone exposure specifically on the risk of lung cancer in women. Methods The PubMed, MEDLINE, Web of Science, and EMBASE databases were searched. The pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) for female lung cancer risk associated with sex steroid hormones were calculated overall and by study design, publication year, population, and smoking status. Sensitivity analysis, publication bias, and subgroup analysis were performed. Results Forty-eight studies published between 1987 and 2019 were included in the study with a total of 31,592 female lung cancer cases and 1,416,320 subjects without lung cancer. Overall, higher levels of sex steroid hormones, both endogenous (OR: 0.92, 95% CI: 0.87–0.98) and exogenous (OR: 0.86, 95% CI: 0.80–0.93), significantly decreased the risk of female lung cancer by 10% (OR: 0.90, 95% CI: 0.86–0.95). The risk of lung cancer decreased more significantly with a higher level of sex steroid hormones in non-smoking women (OR: 0.88, 95% CI: 0.78–0.99) than in smoking women (OR: 0.98, 95% CI: 0.77–1.03), especially in Asia women (OR: 0.84, 95% CI: 0.74–0.96). Conclusions Our meta-analysis reveals an association between higher levels of sex steroid hormone exposure and the decreased risk of female lung cancer. Surveillance of sex steroid hormones might be used for identifying populations at high risk for lung cancer, especially among non-smoking women.