Indoor air pollution and risk of lung cancer among Chinese female non-smokers. Cancer Causes Control. 2013;24:439-450. [PMID: 23314675 DOI: 10.1007/s10552-012-0130-8]

Comprehensive molecular profiling of advanced NSCLC using NGS: Prevalence of druggable mutations and clinical trial opportunities in the ATLAS study

BACKGROUND

In Spain, next-generation sequencing (NGS) is currently available in a limited number of specialized centers and remains inaccessible to a significant proportion of patients. The ATLAS study aims to explore the tumor molecular profile beyond known EGFR mutations and ALK translocations using NGS on tumor biopsy samples.

METHODS

Patients with EGFR-sensitizing mutations or ALK translocations were excluded. A total of 455 patients with advanced non-small cell lung cancer (NSCLC) were enrolled from 22 Spanish hospitals. DNA and RNA were extracted from formalin-fixed paraffin-embedded samples, and libraries were prepared using the Oncomine Focus Assay. The Trialing app was used to identify active clinical trials in Spain.

RESULTS

Mutations were detected in 65.7 % of the cases. Local pathology assessments detected druggable mutations in only 7.9 % of cases, while centralized NGS testing increased this detection rate to 25.9 %. The most prevalent druggable alteration was KRAS G12C (53.6 %), followed by MET amplification (8.1 %) and MET exon 14 skipping (7.3 %). Additionally, 34.5 % of patients had molecular alterations matching clinical trials, offering potential treatment opportunities. Women had a significantly higher probability of harbouring druggable mutations (36 % vs. 20.3 %, p < 0.001), including the KRAS G12C which was significantly more frequent in females (22.6 % vs. 10 %). KRAS mutations were more common in adenocarcinomas and increased with tumor differentiation grade (p < 0.001 and p = 0.049, respectively). Likewise, ALK translocations, EGFR mutations, BRAF V600E, MET exon 14 skipping, and RET/ROS1 fusions were mainly found in adenocarcinomas whereas copy number variations were more frequent in squamous carcinomas (28.6 % vs. 15.1 %; p = 0.003) and in men (22 % vs. 11.6 %; p = 0.008).

CONCLUSION

The ATLAS study demonstrates the utility of comprehensive NGS testing, which detects clinically relevant mutations in more than one-third of patients and may extend therapy options.

Estimated worldwide variation and trends in incidence of lung cancer by histological subtype in 2022 and over time: a population-based study

BACKGROUND

Lung cancer is the most common cancer worldwide, yet the current epidemiological profile of lung-cancer incidence by histological subtype is only partly understood. We aimed to assess geographical variation in incidence of lung cancer by subtype worldwide in 2022, geographical variation in adenocarcinoma incidence attributable to ambient particulate matter (PM) pollution worldwide in 2022, temporal trends in lung-cancer incidence by subtype from 1988 to 2017 in 19 countries, and generational changes.

METHODS

For this population-based study, we used data from the Global Cancer Observatory (GLOBOCAN) 2022, Cancer Incidence in Five Continents Volumes VII-XII, and members of the African Cancer Registry Network. To obtain national estimates of lung cancer in 2022 for the four main histological subtypes (ie, adenocarcinoma, squamous cell carcinoma [SCC], small-cell carcinoma, and large-cell carcinoma) by year, sex, and age group, we combined national estimates with representative, subsite-specific incidence proportions of lung cancer on the basis of recorded incidence data compiled in Cancer Incidence in Five Continents Volume XII and from members of the African Cancer Registry Network. We calculated country-specific, sex-specific, and age-specific proportions of and sex-specific and age-specific incidence rates per 100 000 people for all four histological subtypes. To account for differences in age composition between populations by country, we calculated age-standardised incidence rates (ASRs) per 100 000 people for lung cancer by subtype and sex at national and regional levels. We also quantified the burden of adenocarcinoma incidence attributable to ambient PM pollution for 179 countries in 2022. We conducted joinpoint regression and age-period-cohort analysis to assess temporal trends in ASRs in 19 countries by sex.

FINDINGS

In 2022, we estimated that there were 1 572 045 new cases of lung cancer worldwide among male individuals, of which 717 211 (45·6%) were adenocarcinoma, 461 171 (29·4%) were SCC, 180 063 (11·5%) were small-cell carcinoma, and 101 861 (6·5%) were large-cell carcinoma. In 2022, we estimated that there were 908 630 new cases of lung cancer worldwide among female individuals, of which 541 971 (59·7%) were adenocarcinoma, 155 598 (17·1%) were SCC, 87 902 (9·7%) were small-cell carcinoma, and 59 271 (6·5%) were large-cell carcinoma. Among male individuals, the highest ASRs were in east Asia for adenocarcinoma (27·12 [95% CI 27·04-27·21] per 100 000 people), east Europe for SCC (21·70 [21·51-21·89] per 100 000 people) and small-cell carcinoma (9·85 [9·72-9·98] per 100 000 people), and north Africa for large-cell carcinoma (4·33 [4·20-4·45] per 100 000 people). Among female individuals, the highest ASRs were in east Asia for adenocarcinoma (19·04 [18·97-19·11] per 100 000 people), north America for SCC (5·28 [5·21-5·35] per 100 000 people) and small-cell carcinoma (4·28 [4·21-4·35] per 100 000 people), and north Europe for large-cell carcinoma (2·87 [2·78-2·96] per 100 000 people). We estimated that 114 486 adenocarcinoma cases among male individuals and 80 378 adenocarcinoma cases among female individuals were attributable to ambient PM pollution worldwide in 2022, with ASRs of 2·35 (95% CI 2·33-2·36) per 100 000 male individuals and 1·46 (1·45-1·47) per 100 000 female individuals. Temporal trends in lung-cancer incidence by subtype and sex during 1988-2017 varied considerably across the 19 countries.

INTERPRETATION

Estimated geographical and temporal distribution of lung-cancer incidence varied across the four main subtypes worldwide. Our study highlights the need for future studies that identify possible causal factors that contribute to the changing risk patterns of lung cancer.

FUNDING

Natural Science Foundation of China Young Scientist Fund, Medical Scientific Research Foundation of Guangdong Province in China, and Young Innovative Talents Project of General Universities in Guangdong Province in China.

Update in Association between Lung Cancer and Air Pollution

A significant portion of newly diagnosed lung cancer cases occurs in populations exposed to air pollution. The World Health Organization has identified air pollution as a human carcinogen, prompting many countries to implement monitoring systems for ambient particulate matter (PM). PM is composed of a complex mixture of organic and inorganic particles, both solid and liquid, that are found in the air. Given the carcinogenic properties of PM and the high prevalence of lung cancer among exposed populations, exploring their connection and clinical implications is critical for effectively preventing lung cancer in this group. This review explores the relationship between ambient PM and lung cancer. Epidemiological studies have demonstrated a dose-response relationship between PM exposure and lung cancer risk. PM exposure induces oxidative stress, disrupts the body's redox balance, and causes DNA damage, which is a crucial factor in cancer development. Recent findings on the strong correlation between ambient PM and adenocarcinoma highlight the importance of understanding the specific molecular and pathological mechanisms underlying pollution-related lung cancer. In addition to efforts to control emission sources at the international level, a more individualized approach is essential for preventing PM-related lung cancer.

Lung cancer in young individuals; risk factors and epidemiology

Lung cancer remains a leading cause of cancer-related deaths globally, with an estimated 2.5 million new patients and 1.8 million deaths in 2022. While lung cancer predominantly affects older individuals, there is growing concern about the impact of lung cancer on younger generations, specifically adolescents and young adults (AYA) patients aged 15-39 years. Lung cancer in young individuals has several unique characteristics, such as sex preference, histological subtype, and frequency of somatic mutations in EGFR, ALK, and ROS1. In this article, we describe the risk factors for young patients with lung cancer in two aspects: internal and external predispositions. Although many researchers have focused on genetic predispositions, such as germline genetic alterations, genetic predispositions cannot fully explain the development of lung cancer in young patients. Therefore, we focused on external factors, such as viral infections. Younger patients generally have a better prognosis than older patients, and there is minimal difference in survival rates among advanced-stage young and older patients, which indicates the importance of early detection and intervention, regardless of age. The younger generation has fewer opportunities for radiography or computed tomography, and accidental detection during the examination of other diseases is extremely valuable and effective. Awareness-building activities for pediatricians and other specialists, such as general internal medicine specialists, are important for improving the outcomes of young patients with lung cancer.

Household air pollution as a determinant of health status: A study on older adults in Siliguri Municipal Corporation, India

Household air pollution (HAP), stemming from solid fuels, traditional cooking practices, and indoor pollutants like incense and mosquito oils, poses severe health risks, particularly for older adults. This study assesses the impact of HAP on self-reported health (SRH) among older adults in Siliguri municipal corporation, India. A cross-sectional survey of 400 older adults used multiple binary logistic regression to analyze HAP's impact on poor SRH. Solid fuel use, traditional cooking, lack of ventilation, and exposure to mosquito oil and family smoking were significantly linked to poorer health. Findings underscore the need for policy measures to reduce HAP through cleaner energy and ventilation improvements, aligning with SDG 7 goals to enhance the health of vulnerable populations.

Development of a prognostic prediction model for non-smoking lung adenocarcinoma based on pathological information and laboratory hematologic indicators: a multicenter study

Objective

To develop a simple and practical model to predict the prognostic survival of non-smoking patients with lung adenocarcinoma by combining general pathological information with laboratory hematologic indicators.

Methods

Cox univariate and multivariate analyses were used to identify the variable indicators. A Cox proportional hazards model was constructed based on the selected variables to compare survival outcomes between the high-and low-risk groups of non-smoking patients with lung adenocarcinoma and to validate the model's performance. Subsequently, a nomogram model was established to systematically evaluate the impact of selected variables on prognosis.

Results

Data of non-smoking patients with lung adenocarcinoma from four hospitals were retrospectively collected. We enrolled 1,172 patients, this includes 372 external validation data. Multivariate analysis identified six significant variables (P < 0.05): tumor TNM stage, tumor size, white blood cell count, neutrophil percentage, lymphocyte percentage, and hemoglobin level. We combined these six variables to build a model. The C-index of the training set is 0.811 (0.780-0.842), this value is 0.786 (0.737-0.835) in,test set and 0.810 (0.772-0.847) in validation set. The area under the curve (AUC) results of the predicted 3-years overall survival (OS) of the three data sets were 0.850, 0.819, and 0.860, respectively. These values for 5-years were 0.811, 0.771, and 0.849. Stratified analysis based on tumor staging showed that the model effectively distinguished outcomes (P < 0.0001). High-risk groups demonstrated significantly poorer prognosis compared to low-risk groups (P < 0.001).

Conclusion

The prognostic model based on tumor TNM stage, tumor size, white blood cell count, neutrophil percentage, lymphocyte percentage, and hemoglobin levels effectively predicted the prognosis of non-smoking patients with lung adenocarcinoma. Compared with the more studied blood markers at present, the indicators of our model do not need conversion, Our model provides a useful reference for personalized diagnosis and treatment in clinical practice.

Predictive performance of risk prediction models for lung cancer incidence in Western and Asian countries: a systematic review and meta-analysis

Numerous prediction models have been developed to identify high-risk individuals for lung cancer screening, with the aim of improving early detection and survival rates. However, no comprehensive review or meta-analysis has assessed the performance of these models across different sociocultural contexts. Therefore, this review systematically examines the performance of lung cancer risk prediction models in Western and Asian populations. PubMed and EMBASE were searched from inception through January 2023. Studies published in English that proposed a validated model on human populations with well-defined predictive performances were included. Two reviewers independently screened the titles and abstracts, and the Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess study quality. A random-effects meta-analysis was performed, and a 95% confidence interval (CI) for model performance was reported. Between-study heterogeneity was adjusted for using the Hartung-Knapp-Sidik-Honkman test. A total of 54 studies were included, with 42 from Western countries and 12 from Asian countries. Most Western studies focused on ever-smokers (19/42; 45.2%) and the general population (17/42; 40.5%), and only two Asian studies developed models exclusively for never-smokers. Across both Western and Asian prediction models, the three most consistently included risk factors were age, sex, and family cancer history. In 45.2% (19/42) of Western and 50.0% (6/12) of Asian studies, models incorporated both traditional risk factors and biomarkers. In addition, 14.8% (8/54) of the studies directly compared biomarker-based models with those incorporating only traditional risk factors, demonstrating improved discrimination. Machine-learning algorithms were applied in eight Western models and two Asian models. External validation of PLCOM2012 (AUC = 0.748; 95% CI: 0.719-0.777) outperformed other prediction models, such as Bach (AUC = 0.710; 95% CI: 0.674-0.745) and Spitz models (AUC = 0.698; 95% CI: 0.640-0.755). Despite showing promising results, the majority of Asian risk models in our study lack external validation. Our review also highlights a significant gap in prediction models for never-smokers. Future research should focus on externally validating existing Asian models or incorporating relevant Asian risk factors into widely used Western models (PLCOM2012) to better account for unique risk profiles and lung cancer progression patterns in Asian populations.

Lung Cancer Risk in Female School Cooks: A Nationwide Retrospective Cohort Study in the Republic of Korea

Background

Exposure to cooking fumes exposure likely increases the lung cancer risk in school cooks, but research on the incidence of lung cancer in school cooks is lacking. Therefore, this study aimed to examine a nationwide cohort of school cooks for lung cancer by linking three Korean social insurance databases to determine whether working as a school cook increases lung cancer risk.

Methods

A nationwide retrospective cohort of school cooks and clerks with lung cancer was established by linking Employment Insurance, Industrial Accident Compensation Insurance, and National Health Insurance Service databases. Covariates were matched using 1:1 propensity score matching (PSM) for school cooks and clerks. Age-standardized incidence and hazard ratios (HRs) for lung cancer were calculated using the Cox proportional hazards model. Fine-Gray subdistribution HRs were used for sensitivity analysis. After further categorization into never- and ever-smoked subcohorts, the same analyses were performed.

Results

Post PSM, we identified 76 cases of lung cancer in school cooks during 259,819 person-years of follow-up. The age-standardized incidence was 199.8 (95% confidence interval [CI]: 120.7-278.9) and 166.8 (95% CI: 95.8-237.7) for school cooks and clerks, respectively. The subdistribution HR for school cooks post PSM was 1.72 (95% CI: 1.14-2.60). In the never-smoked subcohort, the subdistribution HR for school cooks post PSM was 4.23 (95% CI: 2.36-7.58).

Conclusion

School cooks were at an elevated risk of developing lung cancer, likely due to exposure to cooking fumes, highlighting the need for improved ventilation and preventive measures in school kitchens to reduce lung cancer risk.

Fatty liver index and development of lung cancer: a nationwide cohort study

BACKGROUND/AIMS

This study aimed to evaluate the impact of steatotic liver disease severity on the cumulative incidence of lung cancer utilizing data from the Korea National Health Insurance Service (NHIS).

METHODS

This study examined the risk of lung cancer in the general population in conjunction with the incidence of steatotic liver disease. The study population consisted of 3,261,438 individuals aged 20 years or older who underwent a general health examination in 2009.

RESULTS

Individuals with fatty liver index (FLI) of 30-59 exhibited a 1.08-fold increased risk of lung cancer (95% CI: 1.04-1.11), while FLI ≥ 60 was associated with a 1.22-fold elevated risk of lung cancer (95% CI: 1.17-1.28) compared to those with FLI < 30. The risk varied with smoking status; in current smokers, the adjusted HR for the FLI 30-59 group was 1.05 (95% CI: 1.00-1.10), while that in the FLI ≥ 60 group was 1.11 (95% CI: 1.04-1.18). In never- or past-smokers, the adjusted HR for the FLI 30-59 group was 1.10, and that for the FLI ≥ 60 group was 1.31. Subgroup analysis revealed an incidence rate of 1.06 per 1,000 person-years in the consistently high FLI group compared to 1.15 in those with improved FLI. Improving FLI over time was associated with a 0.93-fold decrease in lung cancer risk.

CONCLUSION

Our study demonstrated a correlational relationship between lung cancer incidence and the severity of steatotic liver disease as measured by FLI.

The Association Between Indoor Air Pollution and Lung Cancer Risk in a Chinese Population

Though indoor air pollution (IAP) is associated with elevated lung cancer risk, an integrated measure is imperative to thoroughly investigate this association. The interplay between sex and IAP on lung cancer remains unclear. We conducted a population-based case-control study in Jiangsu Province, China, from 2003 to 2010, with 2871 lung cancer cases and 8019 controls. Exposures and covariates information were collected via in-person interviews using a standardized questionnaire. An integrated weighted risk score (WRS), accounting for the effect sizes of each source of IAP, was introduced. Unconditional logistic regression was employed to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs). Interactions between sex and IAP by tobacco smoking status were evaluated. Environmental tobacco smoking (ETS) (aOR = 1.54, 95% CI: 1.40, 1.69), poor ventilation (aOR = 1.18, 95% CI: 1.07, 1.30), and coal used for cooking (aOR = 1.27, 95% CI: 1.15, 1.41) were associated with lung cancer. Dose-response relationships between lung cancer and WRS were observed, with p for trend less than 0.001. aOR for individuals at the highest quartile of the WRS of IAP was 1.74 (95% CI: 1.52, 2.00) compared to the lowest quartile. The associations were more profound among never-smokers than ever-smokers. Females tended to be more vulnerable to IAP, and sex interacted with IAP beyond multiplicativity on the odds scale. IAP is associated with lung cancer, with a stronger impact among never-smokers. An interaction between IAP and sex was observed. These results underscore the importance of controlling IAP, especially ETS in order to reduce the risk of lung cancer.

Study of the microenvironment of the lung flora in female lung adenocarcinoma patients: from benign lesions to invasive lung adenocarcinomas

BACKGROUND

The number of female lung adenocarcinoma patients is increasing annually, but these patients are difficult to diagnose in the early stage without obvious clinical symptoms, leading to late-stage diagnoses and poor outcomes. Recent studies have shown that the lung microbiota is closely related to the occurrence and development of lung cancer, especially the characteristic changes in the lung microbiota of lung cancer patients, which opens a new research direction for the diagnosis and treatment of lung cancer. This study aimed to analyze the characteristics of the lung flora in different stages of female lung adenocarcinoma.

METHODS

16 S rRNA sequencing technology was used to analyze the alpha diversity, beta diversity, composition, and function of the pulmonary flora in female patients with benign lesions (n = 7), adenocarcinoma in situ (n = 16), microinvasive adenocarcinoma (n = 31), and invasive adenocarcinoma (n = 25).

RESULTS

Progression to invasive lung adenocarcinoma is correlated with reduced alpha diversity in the lung flora. Compared with the other stages, only the invasive adenocarcinoma stage had significant differences in the beta diversity of the lung flora. At the phylum and genus levels, the abundance of major flora species decreased significantly as the disease progressed to the invasive adenocarcinoma stage, whereas the abundance of Bacillus spp. increased significantly. The abundance of phenotypes with mobile elements, biofilm-forming ability, oxidative stress tolerance, parthenogenetic anaerobic properties, and pathogenicity was significantly greater in invasive adenocarcinomas. The abundance of metabolic pathways was significantly lower in invasive adenocarcinomas.

CONCLUSIONS

Invasive adenocarcinoma has a unique flora structure characterized by decreased flora diversity and abundance and an increase in specific flora (e.g., Bacillus). In terms of bacterial function, adaptability and pathogenicity increased, and metabolic pathway activity decreased.

Role of Nanoformulations in the Treatment of Lung Cancer

Lung cancer is the second deadliest disease in the world. A major portion of deaths related to cancer are due to lung cancer in both males and females. Interestingly, unbelievable advances have occurred in recent years through the use of nanotechnology and development in both the diagnosis and treatment of lung cancer. Due to their in vivo stability, the nanotechnology-based pharmacological system gained huge attractiveness, solubility, absorption from the intestine, pharmacological effectiveness, etc. of various anticancer agents. However, this field needs to be utilized more to get maximum results in the treatment of lung cancer, along with wider context medicines. In the present review, authors have tried to concentrate their attention on lung cancer`s difficulties along with the current pharmacological and diagnostic situation, and current advancements in approaches based on nanotechnology for the treatment and diagnosis of lung cancer. While nanotechnology offers these promising avenues for lung cancer diagnosis and treatment, it is important to acknowledge the need for careful evaluation of safety, efficacy, and regulatory approval. With continued research and development, nanotechnology holds tremendous potential to revolutionize the management of lung cancer and improve patient outcomes. The review also highlights the involvement of endocrine systems, especially estrogen in lung cancer proliferation. Some of the recent clinical trials and patents on nanoparticle-based formulations that have applications in the treatment and diagnosis of lung cancer are also discussed.

Indoor Air Quality in an Orthopedic Hospital from Romania

Inside hospitals, there is a trend of increasing levels of air pollutants. However, only the indoor air quality in operating theaters is carefully monitored. Therefore, we set the goal of this study to evaluate the indoor air quality in areas of an orthopedics department and to compare the indoor air quality indices that characterize these areas. We used a monitoring system based on the Internet of Things with uRADMonitor model A3 sensors, with which we prospectively measured indoor air quality in the facilities of the orthopedic emergency hospital of Targu Mures in Romania, between 1 February 2023, and 31 January 2024. The primary target pollutants investigated in the emergency room, outpatient room and ward were carbon dioxide (CO2), nitrogen dioxide (NO2), volatile organic compounds (VOCs) and particles with a diameter smaller than 2.5 μm (PM2.5). We compared the effectiveness of the intervention for emergency rooms where air purifiers were working or not. The concentrations of CO2, VOCs and PM2.5 were significantly higher in the emergency room than in the outpatient room or ward. The indoor air quality was worst in winter, when the CO2, NO2 and VOC concentrations were at their highest. Air purifiers can help reduce the concentration of PM2.5 in emergency rooms. Medical staff and patients in orthopedic hospitals, especially in emergency rooms, are frequently exposed to polluted ambient air, which can affect their health. Orthopedic medical practice guidelines should address issues relating to the protection of personnel through the application of measures to improve indoor air quality.

Examining multidimensional health poverty and determining factors among rural women of childbearing age in ningxia, china

BACKGROUND

The multidimensional health poverty afflicting rural women of reproductive age bears profound implications for the sustainable development of families, societies, and healthy villages. Elucidating vulnerable groups at risk of multidimensional health poverty and delineating its determinants can inform refinements and implementation of health-poverty alleviation policies.

METHODS

Based on the 2022 "Health Status and Health Service Utilization" survey data in rural Ningxia, China, this study analyzes the dimension of health status, capacity for health service utilization, health expenditure and security using the A-F dual-threshold method, logit model, and probit model. It comprehensively evaluates multidimensional health poverty and analyzes its determining factors among rural women of childbearing age.

RESULTS

With k set at 0.3, the health multidimensional poverty index, incidence, and intensity among rural women of reproductive age were 0.021, 0.053, and 0.392, respectively. Chronic illness, capacity for free gynecological examination utilization, health examination utilization, and borrowing due to illness contributed significantly to multidimensional health poverty. Risk factors for multidimensional health poverty among rural women of childbearing age include age, unemployment, family size, and lack of sanitary toilets. Protective factors include being married, educational level, non-farm or student occupation, receiving government support, separate housing and kitchen, owning a television and computer.

CONCLUSIONS

Even with the elimination of absolute poverty, the multidimensional health poverty situation among rural women remains important from a gender perspective. It is recommended to strengthen economic assistance and health service support for these groups, improve the level of rural health services from a gender perspective, and enhance housing structure and sanitation toilet usage in rural areas. Efforts should be made to narrow the digital divide in rural areas and promote digital health education. Pre-interventions on multidimensional health poverty can provide new pathways for the development, empowerment, and well-being of rural women of childbearing age.

Insights into uncovered public health risks. The case of asthma attacks among archival workers: a cross-sectional study

Objective

To ascertain the prevalence of asthma attacks among archivists and identify the associated occupational factors in this understudied professional population.

Methods

We conducted a cross-sectional, questionnaire-based study among 1,002 archival workers. A multiple logistic regression was conducted to identify the association between asthma attacks and occupational exposures. The Strobe Protocol was applied.

Results

999 workers were included in the final analysis with the asthma prevalence of 33.3%. Main factors associated with asthma attacks (OR [95% CI]) were the presence of chemically irritating odors (2.152 [1.532-3.024]), mold odors (1.747 [1.148-2.658]), and insects (1.409[1.041-1.907]). A significant synergistic effect was observed between chemical irritants and mold, the odds ratio was 7.098 (95% CI, 4.752-10.603).

Conclusion

There was a high prevalence of asthma attacks among archival workers, an under-studied population. Chemical irritants, molds and insects were associated with their asthma attacks. Notably, this study's data analysis has revealed a strong synergy (OR = 7.098) between chemical odors and molds in the workplace. While the existing international literature on this specific interaction remains somewhat limited, previous studies have already demonstrated the potential for chemical irritants, such as sulfur dioxide and ozone, to synergistically interact with inhalable allergens, including fungi, molds and dust mites. Consequently, this interaction seems to exacerbate asthma symptoms and perpetuate untreated exposure. Furthermore, in damp and damaged buildings, the presence of microbial components, such as cellular debris or spores released during fungal growth can trigger an inflammatory response, potentially served as a shared pathway for the development of asthma among individuals exposed to these hazardous factors.

[Results of Lung Cancer Screening with Low-dose Computed Tomography and Exploration of Risk Factors in Guangzhou]

BACKGROUND

Both of lung cancer incidence and mortality rank first among all cancers in China. Previous lung cancer screening trials were mostly selective screening for high-risk groups such as smokers. Non-smoking women accounted for a considerable proportion of lung cancer cases in Asia. This study aimed to evaluate the outcome of community-based mass screening in Guangzhou and identify the high-risk factors for lung cancer.

METHODS

Residents aged 40-74 years in Guangzhou were screened with low-dose computed tomography (LDCT) for lung cancer and the pulmonary nodules were classified and managed according to China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2018 version). The detection rate of positive nodules was calculated. Before the LDCT examination, residents were required to complete a "lung cancer risk factors questionnaire". The risk factors of the questionnaire were analyzed by least absolute shrinkage and selection operator (LASSO) penalized Logistic regression analysis.

RESULTS

A total of 6256 residents were included in this study. 1228 positive nodules (19.63%) and 117 lung cancers were confirmed, including 6 cases of Tis, 103 cases of stage I (accounting for 88.03% of lung cancer). The results of LASSO penalized Logistic regression analysis indicated that age ≥50 yr (OR=1.07, 95%CI: 1.06-1.07), history of cancer (OR=3.29, 95%CI: 3.22-3.37), textile industry (OR=1.10, 95%CI: 1.08-1.13), use coal for cooking in childhood (OR=1.14, 95%CI: 1.13-1.16) and food allergy (OR=1.10, 95%CI: 1.07-1.13) were risk factors of lung cancer for female in this district.

CONCLUSIONS

This study highlighted that numerous early stages of lung cancer cases were detected by LDCT, which could be applied to screening of lung cancer in women. Besides, age ≥50 yr, personal history of cancer, textile industry and use coal for cooking in childhood are risk factors for women in this district, which suggested that it's high time to raise the awareness of early lung cancer screening in this group.

Efficacy of treating bacterial bioaerosols with weakly acidic hypochlorous water: A simulation chamber study

The COVID-19 pandemic highlighted the dangers of airborne transmission and the risks of pathogen-containing small airborne droplet inhalation as an infection route. As a pathogen control, Weakly Acidic Hypochlorous Water (WAHW) is used for surface disinfection. However, there are limited assessments of air disinfection by WAHW against airborne pathogens like bioaerosols. This was an empirical study evaluating the disinfection efficacy of WAHW in an atmospheric simulation chamber system against four selected model bacteria. The strains tested included Staphylococcus aureus (SA), Escherichia coli (EC), Pseudomonas aeruginosa (PA), and Pseudomonas aeruginosa (PAO1). Each bacterial solution was nebulized into the chamber system as the initial step, and bioaerosol was collected into the liquid medium by a bio-sampler for colony forming units (CFU) determination. Secondly, the nebulized bacterial bioaerosol was exposed to nebulized double distilled water (DDW) as the control and nebulized 150 ppm of WAHW as the experimental groups. After the 3 and 30-min reaction periods, the aerosol mixture inside the chamber was sampled in liquid media and then cultured on agar plates with different dilution factors to determine the CFU. Survival rates were calculated by a pre-exposed CFU value as a reference point. The use of WAHW decreased bacterial survival rates to 1.65-30.15% compared to the DDW control. PAO1 showed the highest survival rates and stability at 3 min was higher than 30 min in all experiments. Statistical analysis indicated that bacteria survival rates were significantly reduced compared to the controls. This work verifies the bactericidal effects against Gram-positive/negative bioaerosols of WAHW treatment. As WAHW contains chlorine in the acid solution, residual chlorine air concentration is a concern and the disinfection effect at different concentrations also requires investigation. Future studies should identify optimal times to minimize the treated time range and require measurements in a real environment.

Impact of indoor air pollution from cooking fuel usage and practices on self-reported health among older adults in India: Evidence from LASI

This research aims to explore the impact of various components of Indoor air pollution (IAP) on the Self-Reported Health (SRH) of older adults in India. Using a sample of 27,090 from the Longitudinal Aging Study in India (LASI) Wave-1, a multiple binary logistic regression model was employed to identify specific risk factors associated with poor SRH among older adults. Adjusting for demographic, socioeconomic, and IAP-related components, it was revealed that IAP significantly contributes to poor SRH. The adjusted model indicated that individuals using solid cooking fuels face a higher risk of poor SRH compared to those using liquid fuels. Additionally, individuals not using electric chimneys and cooking near windows are associated with an elevated risk of poor SRH, highlighting the importance of adequate ventilation. Health risk factors, including lung disease, diabetes, cough, and depression, further contribute to poor SRH among older adults exposed to IAP. Overall, the study offers crucial insights for policymakers, healthcare professionals, and environmentalists to improve the well-being of the vulnerable older population in India.

Clinic information, pathological, and imaging characteristics in 2 058 surgical patients with lung cancer from a single center

OBJECTIVES

Lung cancer is characterized by its high incidence and case fatality rate. Factors related to population composition and cancer prevention programme policy have an effect on the incidence and diagnosis of lung cancer. This study aims to provide scientific support for early diagnosis and treatment of lung cancer by investigating the clinic information, pathological, and imaging characteristics of surgical patients with lung cancer.

METHODS

The data of 2 058 patients, who underwent surgery for lung cancer in the Department of Thoracic Surgery of Xiangya Hospital of Central South University from 2016 to 2019, were retrospectively collected to analyze changes in clinic information, pathological, and imaging characteristics.

RESULTS

From 2016 to 2019, the number of patients per year was 280, 376, 524, and 878, respectively. Adenocarcinoma (68.1%) was the most common pathological type of surgical patients with lung cancer. From 2016 to 2019, the proportion of adenocarcinoma was increased from 55.5% to 74.1%. The proportion lung cancer patients in stage IA was increased from 38.9% to 62.3%, and the proportion of patients who underwent sublobar resection was increased from 1.8% to 8.6%. The proportion of lymph node sampling was increased in 2019. Compared with the rate in 2016, the detection rate of nodules with diameter≤1 cm detected by CT before surgery in 2019 was significantly improved (2.0% vs 18.2%), and the detection rate of nodules with diameter>3 cm was decreased (34.7% vs 18.3%). From 2016 to 2019, the proportion of lesions with pure ground-glass density and partial solid density detected by CT was increased from 2.0% and 16.6% to 20.0% and 37.3%, respectively. The proportion of solid density was decreased from 81.4% to 42.7%.

CONCLUSIONS

The number of lung cancer surgery patients is rapidly increasing year by year, the proportion of CT-detected purely ground-glass density and partially solid density lesions are increasing, the proportion of patients with adenocarcinoma is rising, the proportion of early-stage lung cancer is increasing, smaller lung cancers are detected in earlier clinical stage leading to a more minimally invasive approach to the surgical methods.

[Effectiveness Evaluation of Low-dose Spiral Computed Tomography for Lung Cancer Screening in Minhang District of Shanghai]

BACKGROUND

Low-dose spiral computed tomography (LDCT) has been recommended for lung cancer screening in high-risk populations. However, evidence from Chinese populations was limited due to the different criteria for high-risk populations and the short-term follow-up period. This study aimed to evaluate the effectiveness in Chinese adults based on the Lung Cancer Screening Program in Minhang District of Shanghai initiated in 2013.

METHODS

A total of 26,124 subjects aged 40 years or above were enrolled in the Lung Cancer Screening Program during the period of 2013 and 2017. Results of LDCT examination, and screen-detected cancer cases in all participants were obtained from the Reporting System of the Lung Cancer Screening Program. The newly-diagnosed cases and their vital status up to December 31, 2020 were identified through a record linkage with the Shanghai Cancer Registry and the Shanghai Vital Statistics. Standardized incidence ratio (SIR) and 95%CI were calculated using the local population at ages of 40 or above as the reference. Proportions of early-stage cancer (stage 0-I), pathological types, and 5-year observed survival rates of lung cancer cases were estimated and compared between the cases derived from the screened and non-screened populations. Cox regression models were applied to evaluate the hazard ratio (HR) and 95%CI of LDCT screening with all-cause death of the lung cancer cases.

RESULTS

The crude and age-standardized incidence of lung cancer in screened population were 373.3 (95%CI: 343.1-406.1) and 70.3 per 100,000 person-years, respectively, with an SIR of 1.8 (95%CI: 1.6-1.9), which was observed to decrease with following-up time. The early-stage cancer accounted for 49.4% of all lung cancer cases derived from the screened population, significantly higher than 38.4% in cases from the non-screened population during the same period (P<0.05). The proportion of lung adenocarcinoma (40.7% vs 35.9%) and 5-year survival rate (53.7% vs 41.5%) were also significantly higher in the cases from the screened population (all P<0.05). LDCT screening was associated with 30% (HR=0.7, 95%CI: 0.6-0.8) reduced all-cause deaths of the cases.

CONCLUSIONS

The participants of the screening program are at high-risk of lung cancer. LDCT favors the early-detection of lung cancer and improves 5-year survival of the screened cases, indicating a great potential of LDCT in reducing the disease burden of lung cancer in Chinese populations.

Shrinking the battlefield in cancer therapy: Nanotechnology against cancer stem cells

Cancer remains one of the leading causes of mortality worldwide, presenting a significant healthcare challenge owing to the limited efficacy of current treatments. The application of nanotechnology in cancer treatment leverages the unique optical, magnetic, and electrical attributes of nanomaterials to engineer innovative, targeted therapies. Specifically, manipulating nanomaterials allows for enhanced drug loading efficiency, improved bioavailability, and targeted delivery systems, reducing the non-specific cytotoxic effects characteristic of conventional chemotherapies. Furthermore, recent advances in nanotechnology have demonstrated encouraging results in specifically targeting CSCs, a key development considering the role of these cells in disease recurrence and resistance to treatment. Despite these breakthroughs, the clinical approval rates of nano-drugs have not kept pace with research advances, pointing to existing obstacles that must be addressed. In conclusion, nanotechnology presents a novel, powerful tool in the fight against cancer, particularly in targeting the elusive and treatment-resistant CSCs. This comprehensive review delves into the intricacies of nanotherapy, explicitly targeting cancer stem cells, their markers, and associated signaling pathways.

Air Pollution and Lung Cancer: A Review by International Association for the Study of Lung Cancer Early Detection and Screening Committee

INTRODUCTION

The second leading cause of lung cancer is air pollution. Air pollution and smoking are synergistic. Air pollution can worsen lung cancer survival.

METHODS

The Early Detection and Screening Committee of the International Association for the Study of Lung Cancer formed a working group to better understand issues in air pollution and lung cancer. These included identification of air pollutants, their measurement, and proposed mechanisms of carcinogenesis. The burden of disease and the underlying epidemiologic evidence linking air pollution to lung cancer in individuals who never and ever smoked were summarized to quantify the problem, assess risk prediction models, and develop recommended actions.

RESULTS

The number of estimated attributable lung cancer deaths has increased by nearly 30% since 2007 as smoking has decreased and air pollution has increased. In 2013, the International Agency for Research on Cancer classified outdoor air pollution and particulate matter with aerodynamic diameter less than 2.5 microns in outdoor air pollution as carcinogenic to humans (International Agency for Research on Cancer group 1) and as a cause of lung cancer. Lung cancer risk models reviewed do not include air pollution. Estimation of cumulative exposure to air pollution exposure is complex which poses major challenges with accurately collecting long-term exposure to ambient air pollution for incorporation into risk prediction models in clinical practice.

CONCLUSIONS

Worldwide air pollution levels vary widely, and the exposed populations also differ. Advocacy to lower sources of exposure is important. Health care can lower its environmental footprint, becoming more sustainable and resilient. The International Association for the Study of Lung Cancer community can engage broadly on this topic.

Vaping, Environmental Toxicants Exposure, and Lung Cancer Risk

Lung cancer (LC) is the second-most prevalent tumor worldwide. According to the most recent GLOBOCAN data, over 2.2 million LC cases were reported in 2020, with an estimated new death incident of 1,796,144 lung cancer cases. Genetic, lifestyle, and environmental exposure play an important role as risk factors for LC. E-cigarette, or vaping, products (EVPs) use has been dramatically increasing world-wide. There is growing concern that EVPs consumption may increase the risk of LC because EVPs contain several proven carcinogenic compounds. However, the relationship between EVPs and LC is not well established. E-cigarette contains nicotine derivatives (e.g., nitrosnornicotine, nitrosamine ketone), heavy metals (including organometal compounds), polycyclic aromatic hydrocarbons, and flavorings (aldehydes and complex organics). Several environmental toxicants have been proven to contribute to LC. Proven and plausible environmental carcinogens could be physical (ionizing and non-ionizing radiation), chemicals (such as asbestos, formaldehyde, and dioxins), and heavy metals (such as cobalt, arsenic, cadmium, chromium, and nickel). Air pollution, especially particulate matter (PM) emitted from vehicles and industrial exhausts, is linked with LC. Although extensive environmental exposure prevention policies and smoking reduction strategies have been adopted globally, the dangers remain. Combined, both EVPs and toxic environmental exposures may demonstrate significant synergistic oncogenicity. This review aims to analyze the current publications on the importance of the relationship between EVPs consumption and environmental toxicants in the pathogenesis of LC.

Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019

Objective

This study aimed to explore the global burden of early-onset cancer based on the Global Burden of Disease (GBD) 2019 study for 29 cancers worldwid.

Methods and analysis

Incidence, deaths, disability-adjusted life years (DALYs) and risk factors for 29 early-onset cancer groups were obtained from GBD.

Results

Global incidence of early-onset cancer increased by 79.1% and the number of early-onset cancer deaths increased by 27.7% between 1990 and 2019. Early-onset breast, tracheal, bronchus and lung, stomach and colorectal cancers showed the highest mortality and DALYs in 2019. Globally, the incidence rates of early-onset nasopharyngeal and prostate cancer showed the fastest increasing trend, whereas early-onset liver cancer showed the sharpest decrease. Early-onset colorectal cancers had high DALYs within the top five ranking for both men and women. High-middle and middle Sociodemographic Index (SDI) regions had the highest burden of early-onset cancer. The morbidity of early-onset cancer increased with the SDI, and the mortality rate decreased considerably when SDI increased from 0.7 to 1. The projections indicated that the global number of incidence and deaths of early-onset cancer would increase by 31% and 21% in 2030, respectively. Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers.

Conclusion

Early-onset cancer morbidity continues to increase worldwide with notable variances in mortality and DALYs between areas, countries, sex and cancer types. Encouraging a healthy lifestyle could reduce early-onset cancer disease burden.

Where there are fumes, there may be lung cancer: a systematic review on the association between exposure to cooking fumes and the risk of lung cancer in never-smokers

PURPOSE

Lung cancer in never-smokers (LCINS) is the seventh leading cause of cancer, and exposure to cooking fumes has recently emerged as a potential risk factor. This systematic review is the first to summarize and evaluate the relationship between exposure to cooking fumes and the risk of LCINS.

METHODS

This study conducted an online literature search of PubMed, CINAHL, and PsychInfo databases. Inclusion criteria were original research articles published in English, that assessed the relationship between exposure to cooking fumes and the risk of lung cancer between 1 January 2012 and 6 December 2022, and that included never-smokers.

RESULTS

Thirteen case-control studies and three prospective cohort studies, focusing mostly on women with LCINS, met the inclusion criteria. Seven case-control studies reported an association between exposure to cooking oil fumes and an increased risk of LCINS. Two case-control studies found that using a fume extractor was associated with a decreased risk of LCINS. In other case-control studies, coal use was linked to an increased risk of LCINS, and participants who did not use a ventilator in their kitchens had a higher risk for LCINS. Poor ventilation [Adjusted Hazard Ratio (AHR) = 1.49; 95% CI: 1.15, 1.95] and poor ventilation in combination with coal use (AHR = 2.03; 95% CI: 1.35, 3.05) were associated with an increased risk for LCINS in one prospective cohort study.

CONCLUSION

The evidence reviewed underscores the need to develop culturally-tailored interventions that improve access to affordable and clean fuel through engaging relevant stakeholders.

Path planning for percutaneous lung biopsy based on the loose-Pareto and adaptive heptagonal optimization method

Lung cancer has is highly prevalent worldwide and is the leading cause of cancer-related deaths. In the clinic, a biopsy sample of the lesion is taken to determine whether a lung mass is benign or malignant. CT-guided percutaneous lung biopsy is a minimally invasive intervention and is commonly used to diagnose lung cancer. Path planning before surgery plays a crucial role in percutaneous lung biopsy. Traditionally, path planning for lung biopsy is performed manually by physicians based on CT images of the patient, which demands knowledge and extensive clinical experience of the operating physicians. In this work, a computer-assisted path planning system for percutaneous lung biopsy is proposed based on clinical objectives. Five constraints are presented to remove unqualified skin entry points and determine a feasible entry region based on clinical criteria. Inspired by the Pareto principle and the concept of geometric weighting, the loose-Pareto and adaptive heptagonal optimization (LPHO) method is introduced to plan the optimal puncture path. CT images of 29 patients were collected from Zigong First People's Hospital. Retrospective experiments and test experiments were conducted to evaluate the effectiveness of the algorithm. The planning paths obtained using the proposed method were clinically feasible for 89.7% of patients, demonstrating the applicability and robustness of the system in surgical path planning for lung biopsy.

A new filterless indoor air purifier for particulate matter and bioaerosol based on heterogeneous condensation

Using an indoor air purifier is an important solution for improving indoor air quality and protecting people from the harmful effects of air pollution on their health. The filter air purifiers can remove particulate matter including bioaerosols, but their filter media can cause secondary pollution. To fulfill this need, a new filterless indoor air purifier, the Cloud-Air-Purifying (CAP) air purifier, is presented in this study. Using heterogeneous condensation and supergravity technology, the CAP air purifier grows and collects fine particles, while rapidly disinfecting bioaerosols with chemical disinfection and ultraviolet (UV) disinfection. Furthermore, the purifying performance of the CAP air purifier was tested in a simulated cabin. The results showed the clean air delivery rate (CADR) of the CAP air purifier was approximately 150 m³/h, and the effective coefficient was 0.93. The CAP air purifier was highly efficient in purifying fine particulate matter, 93% for PM₁₀ and 91% for particle size of 0.5-1 μm in 60 min, which was 13-58 times more than natural decay. The reason for the efficient removal of fine particles is that they can condense and grow in water vapor supersaturated environment and be collected in a supergravity field. Moreover, the CAP air purifier has significant bactericidal effects on bioaerosols. It achieved a disinfection efficiency of 99.99997% by decreasing bioaerosols from 10⁸ CFU/m³ to less than 30 CFU/m³ in only 20 min when particle purification in combination with UV disinfection and disinfectant (ClO₂). Furthermore, ClO₂ release concentrations, noise, and power consumption were investigated for application purposes, with results showing that they were within acceptable limits. The study presents an innovative idea and design for preventing airborne microorganisms and particulate matter through heterogeneous condensation technology.

Effects of quercetin on emissions of aldehydes from heated docosahexaenoic acid (DHA)-fortified soybean oil

Home cooking has been considered as an indoor pollution problem since cooking oil fumes contain various toxic chemicals such as aldehydes. Fortifying edible oils with docosahexaenoic acid (DHA) has been applied to enhance the nutritional value of oils. This study designed a frying simulation system and examined the effect of oil type, DHA fortification, heating time, and addition of natural antioxidant on the emissions of aldehydes from heated oils. Results showed that linseed oil had the highest total aldehyde emissions, followed by soybean oil, peanut oil, and palm oil. Fortifying soybean oil with DHA increased the toxic aldehydes emitted. Quercetin, a flavonoid, significantly reduced aldehydes emitted from DHA-fortified soybean oil (by up to 39.80%) to levels similar to those of normal soybean oil. Further analysis showed that DHA-fortified soybean oil with quercetin had a significantly higher DHA and unsaturated fatty acids (UFAs) content than the control oil at each heating time point. The result indicated that quercetin inhibited emissions of aldehydes, at least in part, by protecting UFAs from oxidation. Collectively, quercetin could be used as a natural additive in DHA-fortified and normal cooking oils to reduce aldehyde emissions, indoor air pollution, and preserve functional DHA and other UFAs.

Cancer situation in China: what does the China cancer map indicate from the first national death survey to the latest cancer registration?

BACKGROUND

Over the past four decades, the Chinese government has conducted three surveys on the distribution of causes of death and built cancer registration. In order to shine a new light on better cancer prevention strategies in China, we evaluated the profile of cancer mortality over the forty years and analyzed the policies that have been implemented.

METHODS

We described spatial and temporal changes in both cancer mortality and the ranking of major cancer types in China based on the data collected from three national surveys during 1973-1975, 1990-1992, 2004-2005, and the latest cancer registration data published by National Central Cancer Registry of China. The mortality data were compared after conversion to age-standardized mortality rates based on the world standard population (Segi's population). The geographical distribution characteristics were explored by marking hot spots of different cancers on the map of China.

RESULTS

From 1973 to 2016, China witnessed an evident decrease in mortality rate of stomach, esophageal, and cervical cancer, while a gradual increase was recorded in lung, colorectal, and female breast cancer. A slight decrease of mortality rate has been observed in liver cancer since 2004. Lung and liver cancer, however, have become the top two leading causes of cancer death for the last twenty years. From the three national surveys, similar profiles of leading causes of cancer death were observed among both urban and rural areas. Lower mortality rates from esophageal and stomach cancer, however, have been demonstrated in urban than in rural areas. Rural areas had similar mortality rates of the five leading causes of cancer death with the small urban areas in 1973-1975. Additionally, rural areas in 2016 also had approximate mortality rates of the five leading causes with urban areas in 2004-2005. Moreover, stomach, esophageal, and liver cancer showed specific geographical distributions. Although mortality rates have decreased at most of the hotspots of these cancers, they were still higher than the national average levels during the same time periods.

CONCLUSIONS

Building up a strong primary public health system especially among rural areas may be one critical step to reduce cancer burden in China.

The Introduction of Low-Dose CT Imaging and Lung Cancer Overdiagnosis in Chinese Women

BACKGROUND

Overdiagnosis of lung cancer by low-dose CT (LDCT) screening has raised concerns globally. LDCT screening has been used widely in employee health examinations in China since 2011.

RESEARCH QUESTION

Has the increasing use of LDCT in low-risk populations in China led to lung cancer overdiagnosis?

STUDY DESIGN AND METHODS

A total of 34,152 incident cases of and 27,208 deaths resulting from lung cancer in a population of approximately 3 million were derived from the Cancer Surveillance of Shanghai between 2002 and 2017. Changes in stage-specific and histologic type-specific incidence and mortality and incidence rate ratio (IRR) relative to the base year 2002 or to the period 2002 through 2005 were calculated by sex and were used to evaluate potential overdiagnosisve of lung cancer.

RESULTS

In men, both age-adjusted incidence of and mortality as a result of lung cancer decreased significantly up to 2008 and thereafter remained stable; in women, the incidence increased rapidly from 2011 (annual percentage change, 11.98%; 95% CI, 9.57%-14.45%), whereas the mortality declined persistently. The upward trend of incidence mainly was observed in lung adenocarcinoma in both sexes, with a sharper increase from 2012 through 2017. In men, the incidence of early-stage cancer increased 6.9 per 100,000 (95% CI, 5.1-8.7 per 100,000) and was accompanied by 5.5 per 100,000 (95% CI, -9.2 to -1.7 per 100,000) decline in late-stagecancer from 2002 through 2017. In women, early-stage incidence rose 16.1 per 100,000 (95% CI, 14.0-18.3 per 100,000), but no significant decline in late-stage cancer was found (absolute difference, -0.6 per 100,000; 95% CI, -2.8 to 1.7 per 100,000). The IRR was highest in most recent period and increased most in young women, mainly for early-stage cancer or lung adenocarcinoma.

INTERPRETATION

The results provide evidence at a population level for lung cancer overdiagnosis in Chinese women resulting from increasing LDCT screening in the low-risk populations. Criteria for LDCT screening and management of screening-detected nodules need to be addressed fully for expanded application of LDCT screening in China.

Do Storage Conditions Affect Collected Cookstove Emission Samples? Implications for Field Studies

Cookstove emissions are a significant source of indoor air pollution in developing countries and rural communities world-wide. Considering that many research sites for evaluating cookstove emissions and interventions are remote and require potentially lengthy periods of particulate matter (PM) filter sample storage in sub-optimal conditions (e.g., lack of cold storage), an important question is whether samples collected in the field are stable over time. To investigate this, red oak was burned in a natural-draft stove, and fine PM (PM2.5) was collected on polytetrafluoroethylene filters. Filters were stored at either ambient temperature or more optimal conditions (-20°C or -80°C) for up to 3 months and extracted. The effects of storage temperature and length on stability were evaluated for measurements of extractable organic matter (EOM), PM2.5, and polycyclic aromatic compound (PAC) levels in the filter extracts. A parallel, controlled laboratory condition was also evaluated to further explore sources of variability. In general, PM2.5 and EOM in both simulated field and laboratory samples were similar regardless of the storage condition or duration. The extracts were also analyzed by gas chromatography to quantify 22 PACs and determine similarities and/or differences between the conditions. PAC levels were a more sensitive stability measure in differentiating between storage conditions. The findings suggest that measurements are relatively consistent across storage duration/temperatures for filter samples with relatively low EOM levels. This study aims to inform protocols and filter storage procedures for exposure and intervention research conducted in low- and middle-income countries where studies may be budget- and infrastructure-limited.

Incidence and Risk of Lung Cancer in Tuberculosis Patients, and Vice Versa: A Literature Review of the Last Decade

Background

The incidence and risk of both lung cancer (LC) and tuberculosis (TB) are increasing rapidly. These two diseases frequently exist together and can influence the incidence and risk of each other. The aim of the current review was to summarize the incidence and risk of LC in TB patients, and vice versa, short out research gap, and contemplate future research perspectives. Methodology. PubMed and Scopus databases, and Google Scholar search engine were searched for epidemiological studies that investigated the incidence and risk of TB and LC, published since January 2011 to April 2022, and written in English. We used the searching keyword "tuberculosis" combined with "lung cancer" and associated medical subject heading (MeSH) to retrieve eligible research articles. We retrieved information's regarding the diagnosis of TB and LC, confounders, the associations of TB and LC, and incidence and risks of each other.

Results

We found higher incidence rate and risks (1.64 to 6 times higher) of LC in TB patients in comparison to non-TB participants. However, the incidence rate and risks of TB in LC patients were comparatively low. Male patients were exhibited higher risks than female. The medical comorbidities, smoking habits, and age can also influence the associations and risks of LC in TB patients or vice versa.

Conclusion

Our summarized studies might suggest that existing active TB may increase the incidence and risk of LC. However, large prospective cohort study is warranted to explore the real scenario worldwide.

KBTBD7 promotes non-small cell lung carcinoma progression by enhancing ubiquitin-dependent degradation of PTEN

The Kelch repeat and BTB domain containing 7 (KBTBD7) was first cloned in 2010. Its function as a transcriptional activator and a substrate adaptor during the ubiquitination process was soon found. KBTBD7 was shown to be involved in excessive inflammation after myocardial infarction, brain development, and neurofibromin stability. However, studies on the role of KBTBD7 in solid tumors, especially lung cancer, are still lacking. Therefore, in this study, we investigate the role of KBTBD7 in non-small cell lung cancer (NSCLC). Immunohistochemical staining of 102 paired NSCLC and peritumoral normal specimens indicated that KBTBD7 was highly expressed in NSCLC tissues and positively correlated with the histological type, P-TNM stage, lymph node metastasis, and tumor size. KBTBD7 was also well-expressed in NSCLC cell lines, and downregulation of KBTBD7 resulted in inhibition of NSCLC cell proliferation and invasion. Further investigation showed that KBTBD7 enhanced ubiquitin-dependent degradation of PTEN, thus activating EGFR/PI3K/AKT signaling and promoting NSCLC cell proliferation and invasion by regulating CCNE1, CDK4, P27, ZEB-1, Claudin-1, ROCK1, MMP-9, and E-cadherin protein levels. Our results indicate that KBTBD7 may be a potential therapeutic target for the treatment of NSCLC.

Lifestyle, Epstein-Barr virus infection, and other factors could impede nasopharyngeal cancer survivorship: a five-year cross-sectional study in North Eastern India

Nasopharyngeal Carcinoma (NPC) is one of the leading cancers in India's north-eastern (NE) region affecting a section of the population each year. A proportion of the NPC cases are observed to recur even after therapy, indicating the involvement of other factors. We aimed to explore the NPC and Epstein-Barr virus (EBV) burden in the NE region and investigate the prognostic factors for the NPC patients' poor survival and recurrence. NPC patients' information was obtained from different state hospitals between 2014 and 2019. PCR and Sanger sequencing were performed to detect EBV types. Statistical analysis, including forest plot analysis, Kaplan-Mayer survival plot, Log-rank test, cox hazard regression, and Aalen's additive regression model, were performed to determine prognostic factors for the NPC patients' lower survival and recurrence. We observed an increased incidence of NPC and EBV infection in the past five years. Step-wise statistical analyses pointed out that variable such as non-professionals (B = 1.02, HR = 2.8, 95%CI = 1.5,4.9) workers (B = 0.92, HR = 2.5, 95%CI = 1.4,4.4), kitchen cum bedroom (B = 0.61, HR = 1.8, 95%CI = 1.2,2.8), mosquito repellent (B = 0.60, HR = 1.7, 95%CI = 1.1,2.7), nasal congestion (B = 0.60, HR = 1.8, 95%CI = 1.2,2.8), lower haemoglobin level (B = 0.92, HR = 2.5, 95%CI = 1.3,4.9), tumor stage IV (B = 2.8, HR = 1.8, 95%CI = 1.6,14.3), N2 (B = 1.4, HR = 4.0, 95%CI = 1.8,9.1), N3 (B = 1.9, HR = 6.4, 95%CI = 2.8,15.3), and M+ (B = 2.02, HR = 7.5, 95%CI = 4.1,13.7) revealed significant correlation with NPC patients' poor prognosis (p < 0.05). The presence of viral factors also showed a significant association with NPC patients' decreased survival. We concluded that factors related to day-to-day life with EBV infection could be the individual predictor for NPC incidence, lower survival, and disease recurrence.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13337-022-00789-5.

A review of critical residential buildings parameters and activities when investigating indoor air quality and pollutants

Indoor air in residential dwellings can contain a variety of chemicals, sometimes present at concentrations or in combinations which can have a negative impact on human health. Indoor Air Quality (IAQ) surveys are often required to characterize human exposure or to investigate IAQ concerns and complaints. Such surveys should include sufficient contextual information to elucidate sources, pathways, and the magnitude of exposures. The aim of this review was to investigate and describe the parameters that affect IAQ in residential dwellings: building location, layout, and ventilation, finishing materials, occupant activities, and occupant demography. About 180 peer-reviewed articles, published from 01/2013 to 09/2021 (plus some important earlier publications), were reviewed. The importance of the building parameters largely depends on the study objectives and whether the focus is on a specific pollutant or to assess health risk. When considering classical pollutants such as particulate matter (PM) or volatile organic compounds (VOCs), the building parameters can have a significant impact on IAQ, and detailed information of these parameters needs to be reported in each study. Research gaps and suggestions for the future studies together with recommendation of where measurements should be done are also provided.

Trends of cancer incidence among Chinese older adults from 2005 to 2016: A log-linear regression and age-period-cohort analysis

Background

To study the corresponding strategies for controlling cancer in older adults aged 60 and above in China, a comprehensive assessment of disease burden is required. Therefore, we will introduce the cancer epidemiological characteristics of older adults in China over a recent 12 year period.

Methods

The age-period-cohort model was constructed using the cancer incidence data from the Chinese Cancer Registry Annual Report published in 2008-2019. The annual change percentage (APC) was estimated by log-linear regression to reflect the time trend. The data from the GLOBOCAN 2020 database was selected for worldwide comparative analysis.

Results

The cancer incidence in older adults aged 60 and above in China showed a decreasing trend (APC = -0.73%, P = 0.009). The urban/rural ratio of cancer incidence increased from 0.94 to 1.07 (t = 3.52, P < 0.05), while the sex ratio (male/female) showed a significant decreasing trend only in rural areas (t = -6.77, P < 0.05), and the ratio decreased from 2.02 to 1.72. The results of the age-period-cohort model showed that the cancer incidence increased with age in both males and females, urban and rural areas. The RR of period effect increased from 2005 to 2010, then decreased from 2010 to 2015, and the downward trend was more obvious. The RR of the later-born cohort was lower than that of the earlier-born cohort in rural areas. Lung, gastric, colorectal, esophageal, liver, and breast cancers were common cancers in Chinese older adults. Lung cancer incidence ranked first in males, and it decreased with time in the 75-79 and 80-84 age groups (APC_{75 - 79} = -1.10%, APC_{80 - 84} = -0.88%, all P < 0.05). Breast cancer incidence ranked first among female in the 60-64 age group and showed an increasing trend (APC_{60 - 64} = 1.52%, P < 0.05).

Conclusions

The cancer incidence in Chinese older adults aged 60 and above showed a decreasing trend, but it was still at a relatively high level. The key targets of prevention and treatment should be males, urban areas, younger people, older adults aged 60-69, lung, gastrointestinal, and breast cancers in the future.

Prevalence of lung cancer in chronic obstructive pulmonary disease: A systematic review and meta-analysis

Background

There is growing evidence that chronic obstructive pulmonary disease (COPD) can increase the risk of lung cancer, which poses a serious threat to treatment and management. Therefore, we performed a meta-analysis of lung cancer prevalence in patients with COPD with the aim of providing better prevention and management strategies.

Methods

We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library databases from their inception to 20 March 2022 to collect studies on the prevalence of lung cancer in patients with COPD. We evaluated the methodological quality of the included studies using the tool for assessing the risk of bias in prevalence studies. Meta-analysis was used to determine the prevalence and risk factors for lung cancer in COPD. Subgroup and sensitivity analyses were conducted to explore the data heterogeneity. Funnel plots combined with Egger’s test were used to detect the publication biases.

Results

Thirty-one studies, covering 829,490 individuals, were included to investigate the prevalence of lung cancer in patients with COPD. Pooled analysis demonstrated that the prevalence of lung cancer in patients with COPD was 5.08% (95% confidence interval [CI]: 4.17–6.00%). Subgroup analysis showed that the prevalence was 5.09% (95% CI: 3.48–6.70%) in male and 2.52% (95% CI: 1.57–4.05%) in female. The prevalence of lung cancer in patients with COPD who were current and former smokers was as high as 8.98% (95% CI: 4.61–13.35%) and 3.42% (95% CI: 1.51–5.32%); the incidence rates in patients with moderate and severe COPD were 6.67% (95% CI: 3.20–10.14%) and 5.57% (95% CI: 1.89–16.39%), respectively, which were higher than the 3.89% (95% CI: 2.14–7.06%) estimated in patients with mild COPD. Among the types of lung cancer, adenocarcinoma and squamous cell carcinoma were the most common, with incidence rates of 1.59% (95% CI: 0.23–2.94%) and 1.35% (95% CI: 0.57–3.23%), respectively. There were also differences in regional distribution, with the highest prevalence in the Western Pacific region at 7.78% (95% CI: 5.06–10.5%), followed by the Americas at 3.25% (95% CI: 0.88–5.61%) and Europe at 3.21% (95% CI: 2.36–4.06%).

Conclusions

This meta-analysis shows that patients with COPD have a higher risk of developing lung cancer than those without COPD. More attention should be given to this result in order to reduce the risk of lung cancer in these patients with appropriate management and prevention.

Systematic review registration

International prospective register of systematic reviews, identifier CRD42022331872.

Expression and clinical significance of CD31, CD34, and CD105 in pulmonary ground glass nodules with different vascular manifestations on CT

Blood vessel passage on CT exerts a vital part in early diagnosis as well as treatment of carcinoma of the lungs. Intratumoral microvascular density (iMVD) has gradually become the focus of research on biological behavior, appearance, and evolution of malignant tumors nowadays. The aim of this paper was to verify whether there is a correlation between the iMVD and the vascular morphology of ground glass nodules (GGNs). A total of 109 patients with pulmonary GGN were classified into three groups (I,II, and III) according to the vascular morphology on CT, and their expression of CD31-, CD34-, and CD105-labeled iMVD was detected by the streptoavidin–biotin method, statistically analyzing the iMVD values of each group. The expression of CD31, CD34, and CD105 in different lung tissues was significantly different, with remarkably higher iMVD in lung cancer tissues than in adjacent normal lung tissues. In the imaging sort of types I, II, and III according to the means of vascular passage, the iMVD expression of CD31, CD34, and CD105 was significantly different between groups. These data suggest that the presence and the abnormal morphology of vessels seen within GGNs indicate the occurrence and progression of lung cancer in pathology. It offers a strong theoretical foundation for early diagnosis of carcinoma of the lungs, thus providing a more precise clinical diagnosis and prognosis of early-stage lung cancer.

Polyurethane Foam Face Masks as a Dosimeter for Quantifying Personal Exposure to Airborne Volatile and Semi-Volatile Organic Compounds

Airborne volatile organic compounds (VOCs) and semi-volatile organic compounds (SVOCs) are commonly quantitated by collecting the analytes on solid sorbent tubes or passive air samplers, followed by solvent extraction and instrumental analysis, or by grab bag/canister measurements. We report herein a user-friendly sampling method by breathing through polyurethane foam (PUF) face masks to collect airborne VOCs and SVOCs for chemical analysis. Specifically, dibasic esters, phthalate esters, polycyclic aromatic hydrocarbons, linalool, and nicotine trapped on PUF masks were quantitated by gas chromatography-mass spectrometry analysis as model VOCs and SVOCs. Results showed that the amount of these model VOCs and SVOCs trapped on PUF masks is proportional to the exposure duration. After cross-validation by parallel sampling using XAD-2 packed sorbent tubes, the method was used to quantitate VOCs and SVOCs in a variety of indoor and outdoor environments with varying air concentrations of analytes, temperature, humidity, and wind speed. Because air pollution is considered a major cause of many human diseases and premature deaths and the developed PUF mask sampling method showed high trapping efficiencies for both VOCs and SVOCs, it is believed that the developed sampling method will find wide application in assessing air pollution-associated disease risks with possible extension to more classes of VOCs and SVOCs when coupled with suitable instrumental detection methods.

Lung Cancer in the Course of COPD-Emerging Problems Today

Tobacco smoking remains the main cause of tobacco-dependent diseases like lung cancer, chronic obstructive pulmonary disease (COPD), in addition to cardiovascular diseases and other cancers. Whilst the majority of smokers will not develop either COPD or lung cancer, they are closely related diseases, occurring as co-morbidities at a higher rate than if they were independently triggered by smoking. A patient with COPD has a four- to six-fold greater risk of developing lung cancer independent of smoking exposure, when compared to matched smokers with normal lung function. The 10 year risk is about 8.8% in the COPD group and only 2% in patients with normal lung function. COPD is not a uniform disorder: there are different phenotypes. One of them is manifested by the prevalence of emphysema and this is complicated by malignant processes most often. Here, we present and discuss the clinical problems of COPD in patients with lung cancer and against lung cancer in the course of COPD. There are common pathological pathways in both diseases. These are inflammation with participation of macrophages and neutrophils and proteases. It is known that anticancer immune regulation is distorted towards immunosuppression, while in COPD the elements of autoimmunity are described. Cytotoxic T cells, lymphocytes B and regulatory T cells with the important role of check point molecules are involved in both processes. A growing number of lung cancer patients are treated with immune check point inhibitors (ICIs), and it was found that COPD patients may have benefits from this treatment. Altogether, the data point to the necessity for deeper analysis and intensive research studies to limit the burden of these serious diseases by prevention and by elaboration of specific therapeutic options.

Organic pollutant exposure and health effects of cooking emissions on kitchen staff in food services

This study was conducted to determine the exposure and health risk to cooking fumes of a total of 88 volunteer kitchen staff aged between 18 and 65 years working in five different kitchens in Ankara. Gas- and particle-phase polycyclic aromatic hydrocarbons (PAHs), and volatile organic compound (VOCs) concentrations were evaluated in the indoor air of 5 kitchens. Serum malondialdehyde (MDA) and superoxide dismutase (SOD) levels were analyzed to determine the oxidative damage as a result of the exposure to cooking fumes among the cooks and waiters. Significant positive relationships were found between serum MDA levels of the hot kitchen workers and indoor chrysene (Chr), indeno(1,2,3-c,d)pyrene (Ind), and total VOC levels. Although the carcinogenic risks estimated for the exposed population were between the acceptable/tolerable levels, the hazard quotient (HQ) estimated for the exposure to indoor benzene exceeded the safe level. The results of the study revealed that exposure to organic pollutants in indoor air may be a risk factor for the development of oxidative stress, especially in hot kitchen workers. The importance of efficient ventilation in the kitchen has been pointed out to reduce health risks caused by cooking fumes.

Air pollution: A culprit of lung cancer

Air pollution is a global health problem, especially in the context of rapid economic development and the expansion of urbanization. Herein, we discuss the harmful effects of outdoor and indoor pollution on the lungs. Ambient particulate matters (PMs) from industrial and vehicle exhausts is associated with lung cancer. Workers exposed to asbestos, polycyclic aromatic hydrocarbons (PAHs), and toxic metals are also likely to develop lung cancer. Indoors, cooking fumes, second-hand smoke, and radioactive products from house decoration materials play roles in the development of lung cancer. Bacteria and viruses can also be detrimental to health and are important risk factors in lung inflammation and cancer. Specific effects of lung cancer caused by air pollution are discussed in detail, including inflammation, DNA damage, and epigenetic regulation. In addition, advanced materials for personal protection, as well as the current government policies to prevent air pollution, are summarized. This review provides a basis for future research on the relationship between lung cancer and air pollution.

A protective role of autophagy in fine airborne particulate matter-induced apoptosis in LN-229 cells

Air pollution is a public health threat and global epidemiological studies have shown that ambient air pollutants are closely related to various poor health conditions, including neurodegenerative diseases. Here, we evaluated the toxic effects and the underlying mechanisms of fine airborne particulate matter (PM2.5) on human glioblastoma LN-229 cells. Our results showed that exposure of LN-229 cells to PM2.5 (≥ 200 μg/mL) significantly reduced cell viability. PM2.5 exposure increased autophagy, apoptosis, and ROS production in the cells. Pre-treatment with a ROS scavenger, catalase, or depletion of mtDNA (ρ0 cells) abolished PM2.5-induced autophagy and apoptosis. PM2.5 exposure also activated MAPK signals in cells, which were blocked by catalase pre-treatment or mtDNA depletion. Furthermore, inhibition of JNK, but not ERK1/2 or p38, attenuated PM2.5-induced autophagy and apoptosis in cells. Finally, suppression of autophagy with Bafilomycin A1 or Beclin 1 siRNA exacerbated PM2.5-induced apoptosis, indicating a protective role of autophagy against PM2.5-induced apoptosis. Our results demonstrated that exposure of LN-229 cells to PM2.5 caused autophagy and apoptosis through PM2.5-induced ROS generation, mainly by mitochondria, and JNK activation. Autophagy may have a transient protective response in PM2.5-induced apoptosis. These findings have important implications for understanding the potential neurotoxicity of PM2.5.

Human Papillomavirus Is Associated With Adenocarcinoma of Lung: A Population-Based Cohort Study

Background

Recent trends in the incidence of lung cancer have been reported despite the decreasing rate of smoking. Lung cancer is ranked among the top causes of cancer-related deaths. The ratio of adenocarcinoma to squamous cell carcinoma, as well as the ratio of women to men, is still increasing. Human papillomavirus (HPV) has been discovered in lung cancer tissues and blood specimens, particularly in Eastern countries. However, the association between HPV infection and lung adenocarcinoma remains unclear.

Methods

This population-based cohort study was conducted using data from Taiwan's single-payer national health insurance and cancer registry databases. Data on HPV infection, cancer, sex, age, comorbidities, urbanization, and occupation were collected. The cumulative incidence rates were generated using Kaplan–Meier curves and log-rank tests. COX regression analysis was used to estimate the hazard ratios of factors associated with cancer occurrence. We used data from 2007 and 2015. The cases were matched with sex and age in a 1:2 manner with 939,874 HPV+ and 1,879,748 HPV– individuals, respectively.

Results

The adjusted hazard ratios [95% confidence interval (CI)] for HPV infection in all lung cancers were 1.539 (1.436–1.649), male lung cancer 1.434 (1.312–1.566), female lung cancer 1.742 (1.557–1.948), squamous cell carcinoma (SCC) 1.092 (0.903–1.320), male SCC 1.092 (0.903–1.320), female SCC 0.949 (0.773–1.164), adenocarcinoma 1.714 (1.572–1.870), male adenocarcinoma 1.646 (1.458–1.858), and female adenocarcinoma 1.646 (1.458–1.858). The highest adjusted hazard ratio for lung cancer was chronic obstructive pulmonary disease (COPD) 1.799 (1.613–2.007), followed by male sex 1.567 (1.451–6.863) and HPV infection. The highest adjusted hazard ratio for adenocarcinoma was HPV infection 1.714 (1.572–1.870), followed by COPD 1.300 (1.102–1.533), and for SCC, male sex 5.645 (4.43–3.37), followed by COPD 2.528 (2.002–3.192).

Conclusion

Our study showed that HPV infection was associated with the occurrence of adenocarcinoma of the lung in both men and women but was not associated with SCC of the lung.

Trends of cancer mortality in Xi'an City, China: 2005-2020

PURPOSE

Describe and predict the malignant tumor deaths in Xi'an so as to provide evidence for the government to formulate the prevention and treatment plans.

METHODS

Overall malignant tumor death in Xi'an in the past 16 years was described. The multi-decrease life table was used to calculate cumulative mortality risk by cause and life expectancy reduction years by cause of malignant tumors in 2020. The join point regression models were used to analyze the change trend of standard mortality of malignant tumors in Xi'an from 2005 to 2020. The appropriate gray models were selected to predict the death of malignant tumors in Xi'an in the next decade.

RESULTS

The mortality of total malignant tumors in Xi'an showed that men are higher than women and the elderly are higher than other groups. As for 2020, lung cancer had the highest risk of death for both men and women, while leukemia had the highest life expectancy reduction years by cause. From 2005 to 2020, standardized mortality of majority malignant tumors showed downward trends, which were particularly obvious in recent years. The prediction results of several major malignant tumors showed that in the next decade, the mortality of most malignant tumors had downward trends, but combined with the increase of population in the future, the number of malignant tumor deaths in Xi'an will continue to increase.

CONCLUSIONS

Malignant tumors in Xi'an have decreasing mortality trends in recent years, and effective measures to prevent and treat tumors should be strengthened in the future.

Mediterranean Diet Patterns in Relation to Lung Cancer Risk: A Meta-Analysis

Background

We systematically quantified the currently inconclusive association between Mediterranean diet patterns and the risk of lung cancer.

Methods

We searched the PubMed, Cochrane, Database of Abstracts of Reviews of Effects (DARE) and Web of Science electronic databases to identify relevant articles published before October 2021. We used the Newcastle–Ottawa scale to assess the quality of the published research and a random-effects model to estimate the aggregate hazard ratios and 95% CIs. As a result of significant heterogeneity, we performed subgroup analysis, meta-regression analysis, and sensitivity analysis. Where data were available, we also performed a dose–response analysis.

Results

Nine articles were included in the meta-analysis. The meta-analysis showed that there was a significant negative correlation between Mediterranean diet patterns and the risk of lung cancer in the general population with a hazard ratio of 0.82, a 95% CI of 0.74–0.92, and a high heterogeneity (I² = 59.9%, P < 0.05). As a result of the significant heterogeneity, we conducted subgroup analysis, meta-regression analysis, and sensitivity analysis and found that the study design was the source of the heterogeneity. Subgroup analysis and sensitivity analysis showed that the final results did not change very much, the sensitivity was low and the results were relatively stable. The dose–response relationship showed that, based on the lowest Mediterranean diet score (0 points), for every three-point increase, the risk of lung cancer was reduced by 9%.

Conclusion

The evidence in this meta-analysis shows that there is a significant negative correlation between Mediterranean diet patterns and the risk of lung cancer, suggesting that Mediterranean diets are a protective factor in lung cancer.

Indoor solid fuel use and renal function among middle-aged and older adults: A national study in rural China

Solid fuel use is the main source of indoor air pollution, especially in rural areas of developing countries. Nevertheless, the evidence linking indoor solid fuel use and renal function is very limited. Therefore, we investigated the association between indoor solid fuel use and renal function among middle-aged and older adults in rural China. Cystatin C (CysC) concentration of each participant was used to calculate the estimated glomerular filtration rate (eGFR). We used the baseline data to investigate the associations between solid fuel use for cooking and heating and eGFR through a linear-mixed effects model. Then, we applied the generalized linear-mixed effects model with binary distribution to examine the relationship between renal function decline and cooking fuel switching from 2011 to 2015. A total of 4959 participants were included at baseline, and 3536 participants were included in the follow-up analysis. Compared to participants who used clean fuel for both cooking and heating, the eGFR was significantly lower among participants who cooked with solid fuel and heated with clean fuel (β: -2.81; 95% CI: -5.53, -0.09). In the follow-up analysis, the risks of renal function decline for participants using solid fuel for cooking were significantly higher in males (OR: 2.74; 95% CI: 1.68, 4.49), smokers (OR: 5.70; 95% CI: 2.82, 11.55), and drinkers (OR: 7.11; 95% CI: 3.15, 16.02) compared to females, non-smokers, and non-drinkers. Moreover, 45-65 years aged participants (OR: 0.54; 95% CI: 0.33, 0.89) and non-drinkers (OR: 0.61; 95% CI: 0.41, 0.92) who switched from solid to clean cooking fuel had a lower risk of renal function decline. In conclusion, our findings show that household solid fuel use is likely to be an important risk factor for renal function decline in rural China. And switching to cleaner fuel may provide significant public health benefits.