Mitigating air pollution’s impact on lung cancer in a large-scale longitudinal study: The unexplored potential of dietary interventions

Background

Lung cancer remains a leading cause of cancer-related deaths globally, influenced by environmental and lifestyle factors. However, evidence on the impact of multiple air pollutants is limited. Moreover, their combined effect of air pollutants and dietary patterns on lung cancer remains unclear.

Methods

This study used UK Biobank data to assess the impact of mixed air pollutants (PM₁₀, PM_2.5, NO₂, NO_x, and SO₂) on lung cancer risk, with pollution scores based on weighted regression coefficients. Diet quality was measured using the Mediterranean Diet-based Healthy Diet Score. Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95 % confidence intervals (CIs).

Results

Our analysis included 327,147 participants with 3705 incident lung cancer cases. Higher exposure to air pollutants significantly increased lung cancer risk (HR: 1.41, 95 % CI: 1.34–1.48 per interquartile range (IQR) increase in air pollution score). Per IQR increase, HRs (95 % Cis) for individual pollutants were as follows: PM₁₀,1.25(1.19–1.32), PM_2.5, 1.50(1.41–1.59), NO₂, 1.35(1.29–1.42), NO_x, 1.29(1.24–1.34), and SO₂, 1.20(1.15–1.26). Conversely, a higher healthy diet score was associated with lower lung cancer risk, with each IQR increase corresponding to an HR of 0.88 (95 % CI: 0.85–0.90). The combination of high air pollution and an unhealthy diet showed synergistic effects (synergy index: 1.40, 95 % CI: 1.11–1.76), further elevating lung cancer risk.

Conclusions

Poor dietary habits exacerbate the adverse effects of long-term air pollution exposure on lung cancer risk. Public health interventions promoting dietary improvements and reducing air pollution are critical for lung cancer prevention.