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Andersen ZJ, Stafoggia M, Weinmayr G, Pedersen M, Galassi C, Jørgensen JT, Oudin A, Forsberg B, Olsson D, Oftedal B, Aasvang GM, Aamodt G, Pyko A, Pershagen G, Korek M, De Faire U, Pedersen NL, Östenson CG, Fratiglioni L, Eriksen KT, Tjønneland A, Peeters PH, Bueno-de-Mesquita B, Plusquin M, Key TJ, Jaensch A, Nagel G, Lang A, Wang M, Tsai MY, Fournier A, Boutron-Ruault MC, Baglietto L, Grioni S, Marcon A, Krogh V, Ricceri F, Sacerdote C, Migliore E, Tamayo-Uria I, Amiano P, Dorronsoro M, Vermeulen R, Sokhi R, Keuken M, de Hoogh K, Beelen R, Vineis P, Cesaroni G, Brunekreef B, Hoek G, Raaschou-Nielsen O. Long-Term Exposure to Ambient Air Pollution and Incidence of Postmenopausal Breast Cancer in 15 European Cohorts within the ESCAPE Project. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:107005. [PMID: 29033383 PMCID: PMC5933325 DOI: 10.1289/ehp1742] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 08/04/2017] [Accepted: 08/12/2017] [Indexed: 05/23/2023]
Abstract
BACKGROUND Epidemiological evidence on the association between ambient air pollution and breast cancer risk is inconsistent. OBJECTIVE We examined the association between long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in European women. METHODS In 15 cohorts from nine European countries, individual estimates of air pollution levels at the residence were estimated by standardized land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE) and Transport related Air Pollution and Health impacts – Integrated Methodologies for Assessing Particulate Matter (TRANSPHORM) projects: particulate matter (PM) ≤2.5μm, ≤10μm, and 2.5–10μm in diameter (PM2.5, PM10, and PMcoarse, respectively); PM2.5 absorbance; nitrogen oxides (NO2 and NOx); traffic intensity; and elemental composition of PM. We estimated cohort-specific associations between breast cancer and air pollutants using Cox regression models, adjusting for major lifestyle risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. RESULTS Of 74,750 postmenopausal women included in the study, 3,612 developed breast cancer during 991,353 person-years of follow-up. We found positive and statistically insignificant associations between breast cancer and PM2.5 {hazard ratio (HR)=1.08 [95% confidence interval (CI): 0.77, 1.51] per 5 μg/m3}, PM10 [1.07 (95% CI: 0.89, 1.30) per 10 μg/m3], PMcoarse[1.20 (95% CI: 0.96, 1.49 per 5 μg/m3], and NO2 [1.02 (95% CI: 0.98, 1.07 per 10 μg/m3], and a statistically significant association with NOx [1.04 (95% CI: 1.00, 1.08) per 20 μg/m3, p=0.04]. CONCLUSIONS We found suggestive evidence of an association between ambient air pollution and incidence of postmenopausal breast cancer in European women. https://doi.org/10.1289/EHP1742.
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Affiliation(s)
- Zorana J Andersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Azienda Sanitaria Locale Roma 1 (ASL RM1), Rome, Italy
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Marie Pedersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Claudia Galassi
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Jeanette T Jørgensen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anna Oudin
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - David Olsson
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | | | - Geir Aamodt
- Norwegian Institute of Public Health, Oslo, Norway
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ulf De Faire
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology Care Science and Society, Karolinska Institute, Stockholm, Sweden
| | | | - Anne Tjønneland
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Petra H Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Bas Bueno-de-Mesquita
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Michelle Plusquin
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Andrea Jaensch
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Alois Lang
- Vorarlberg Cancer Registry, Agency for Preventive and Social Medicine (aks, Bregenz, Austria
| | - Meng Wang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Ming-Yi Tsai
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Agnes Fournier
- Centre de recherche en Épidémiologie et Santé des Populations (CESP) "Health across Generations", Institut national de la santé et de la recherche médicale (Inserm), Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Marie-Christine Boutron-Ruault
- Centre de recherche en Épidémiologie et Santé des Populations (CESP) "Health across Generations", Institut national de la santé et de la recherche médicale (Inserm), Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Laura Baglietto
- Centre de recherche en Épidémiologie et Santé des Populations (CESP) "Health across Generations", Institut national de la santé et de la recherche médicale (Inserm), Université Paris-Saclay, Villejuif, France
- Institut Gustave Roussy, Villejuif, France
| | - Sara Grioni
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione Istituto di ricovero e cura a carattere scientifico (IRCCS) Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione Istituto di ricovero e cura a carattere scientifico (IRCCS) Istituto Nazionale dei Tumori, Milan, Italy
| | - Fulvio Ricceri
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
- Unit of Epidemiology, Regional Health Service Azienda Sanitaria Locale Torino 3 (ASL TO3), Grugliasco, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Ibon Tamayo-Uria
- ISGlobal Institute de Salut Global Barcelona, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Miren Dorronsoro
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
- Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain
| | - Roel Vermeulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ranjeet Sokhi
- Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, Hatfield, UK
| | - Menno Keuken
- Netherlands Organization for Applied Scientific Research, Utrecht, Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
- Molecular and Epidemiology Unit, Human Genetics Foundation (HuGeF), Torino, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Azienda Sanitaria Locale Roma 1 (ASL RM1), Rome, Italy
| | - Bert Brunekreef
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - Gerard Hoek
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
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