Andrew Craver, Jiajun Luo, Muhammad G Kibriya, Nina Randorf, Kendall Bahl, Elizabeth Connellan, Johnny Powell, Paul Zakin, Rena R Jones, Maria Argos, Joyce Ho, Karen Kim, Martha L Daviglus, Philip Greenland, Habibul Ahsan, Briseis Aschebrook-Kilfoy
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Cancer case ascertainment was performed using data from electronic health records and the self-reported Personal Medical History questionnaire. PM<sub>2.5</sub> exposure was retrieved from NASA's Earth Observing System Data and Information Center and assigned using participants' 3-digit zip code prefixes. Multivariate logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI). Generalized additive models (GAMs) were used to investigate non-linear relationships.</p><p><strong>Results: </strong>A total of 33,387 participants and 46,176 prevalent cancer cases were ascertained from participant EHR data, while 20,297 cases were ascertained from self-reported survey data from 18,133 participants; 9,502 cancer cases were captured in both the EHR and survey data. Average PM<sub>2.5</sub> level from 2007 to 2016 was 8.90 μg/m<sup>3</sup> (min 2.56, max 15.05). In analysis of cancer cases from EHR, an increased odds for breast cancer (OR 1.17, 95% CI 1.09-1.25), endometrial cancer (OR 1.33, 95% CI 1.09-1.62) and ovarian cancer (OR 1.20, 95% CI 1.01-1.42) in the 4th quartile of exposure compared to the 1st. In GAM, higher PM<sub>2.5</sub> concentration was associated with increased odds for blood cancer, bone cancer, brain cancer, breast cancer, colon and rectum cancer, endocrine system cancer, lung cancer, pancreatic cancer, prostate cancer, and thyroid cancer.</p><p><strong>Conclusions: </strong>We found evidence of an association of PM<sub>2.5</sub> with breast, ovarian, and endometrial cancers. 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引用次数: 0
摘要
导言：美国国立卫生研究院（NIH）的 "我们所有人研究计划"（All of Us Research Program）已在全美招募了超过544,000名参与者，其种族/民族多样性前所未有，为研究各种暴露和疾病提供了机会。本文旨在研究 PM2.5 暴露与癌症风险之间的关联：这项工作是利用 "我们所有人 "研究人员工作台（All of Us Researcher Workbench）对来自 409,876 名 "我们所有人 "研究计划参与者的数据进行的。癌症病例的确定是通过电子健康记录数据和自我报告的个人病史问卷进行的。PM2.5暴露数据来自美国国家航空航天局地球观测系统数据和信息中心（NASA's Earth Observing System Data and Information Center），并使用参与者的三位数邮政编码前缀进行分配。多变量逻辑回归用于估算几率比（OR）和 95% 置信区间（CI）。广义加法模型（GAM）用于研究非线性关系：从参与者的电子病历数据中确定了 33,387 名参与者和 46,176 个癌症流行病例，从 18,133 名参与者的自我报告调查数据中确定了 20,297 个病例；电子病历和调查数据中均有 9,502 个癌症病例。2007 年至 2016 年的 PM2.5 平均水平为 8.90 μg/m3（最低 2.56，最高 15.05）。在对电子健康记录中的癌症病例进行分析时发现，与第一四分位数相比，第四四分位数暴露中乳腺癌（OR 1.17，95% CI 1.09-1.25）、子宫内膜癌（OR 1.33，95% CI 1.09-1.62）和卵巢癌（OR 1.20，95% CI 1.01-1.42）的几率增加。在GAM中，PM2.5浓度越高，患血癌、骨癌、脑癌、乳腺癌、结肠癌和直肠癌、内分泌系统癌症、肺癌、胰腺癌、前列腺癌和甲状腺癌的几率越高：我们发现了 PM2.5 与乳腺癌、卵巢癌和子宫内膜癌相关的证据。关于PM2.5对这些癌症风险的影响，以前的文献几乎没有证据，因此值得进一步研究。
Air quality and cancer risk in the All of Us Research Program.
Introduction: The NIH All of Us Research Program has enrolled over 544,000 participants across the US with unprecedented racial/ethnic diversity, offering opportunities to investigate myriad exposures and diseases. This paper aims to investigate the association between PM2.5 exposure and cancer risks.
Materials and methods: This work was performed on data from 409,876 All of Us Research Program participants using the All of Us Researcher Workbench. Cancer case ascertainment was performed using data from electronic health records and the self-reported Personal Medical History questionnaire. PM2.5 exposure was retrieved from NASA's Earth Observing System Data and Information Center and assigned using participants' 3-digit zip code prefixes. Multivariate logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI). Generalized additive models (GAMs) were used to investigate non-linear relationships.
Results: A total of 33,387 participants and 46,176 prevalent cancer cases were ascertained from participant EHR data, while 20,297 cases were ascertained from self-reported survey data from 18,133 participants; 9,502 cancer cases were captured in both the EHR and survey data. Average PM2.5 level from 2007 to 2016 was 8.90 μg/m3 (min 2.56, max 15.05). In analysis of cancer cases from EHR, an increased odds for breast cancer (OR 1.17, 95% CI 1.09-1.25), endometrial cancer (OR 1.33, 95% CI 1.09-1.62) and ovarian cancer (OR 1.20, 95% CI 1.01-1.42) in the 4th quartile of exposure compared to the 1st. In GAM, higher PM2.5 concentration was associated with increased odds for blood cancer, bone cancer, brain cancer, breast cancer, colon and rectum cancer, endocrine system cancer, lung cancer, pancreatic cancer, prostate cancer, and thyroid cancer.
Conclusions: We found evidence of an association of PM2.5 with breast, ovarian, and endometrial cancers. There is little to no prior evidence in the literature on the impact of PM2.5 on risk of these cancers, warranting further investigation.
期刊介绍：
Cancer Causes & Control is an international refereed journal that both reports and stimulates new avenues of investigation into the causes, control, and subsequent prevention of cancer. By drawing together related information published currently in a diverse range of biological and medical journals, it has a multidisciplinary and multinational approach.
The scope of the journal includes: variation in cancer distribution within and between populations; factors associated with cancer risk; preventive and therapeutic interventions on a population scale; economic, demographic, and health-policy implications of cancer; and related methodological issues.
The emphasis is on speed of publication. The journal will normally publish within 30 to 60 days of acceptance of manuscripts.
Cancer Causes & Control publishes Original Articles, Reviews, Commentaries, Opinions, Short Communications and Letters to the Editor which will have direct relevance to researchers and practitioners working in epidemiology, medical statistics, cancer biology, health education, medical economics and related fields. The journal also contains significant information for government agencies concerned with cancer research, control and policy.
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