Is There an Association Between Ambient Air Pollution and Bladder Cancer Incidence? Analysis of 15 European Cohorts

Pedersen M 1 , Stafoggia M 2 , Weinmayr G 3 , Andersen ZJ 4 , Galassi C 5 , Sommar J 6 Show all authors , Forsberg B 6 , Olsson D 6 , Oftedal B 7 , Krog NH 7 , Aamodt G 8 , Pyko A 9 , Pershagen G 9 , Korek M 9 , De Faire U 9 , Pedersen NL 10 , Östenson CG 11 , Fratiglioni L 12 , Sørensen M 13 , Eriksen KT 13 , Tjønneland A 13 , Peeters PH 14 , Bueno-de-Mesquita B 15 , Vermeulen R 16 , Eeftens M 17 , Plusquin M 18 , Key TJ 19 , Jaensch A 9 , Nagel G 20 , Concin H 21 , Wang M 22 , Tsai MY 23 , Grioni S 24 , Marcon A 25 , Krogh V 24 , Ricceri F 26 , Sacerdote C 3 , Ranzi A 27 , Cesaroni G 28 , Forastiere F 28 , Tamayo I 29 , Amiano P 30 , Dorronsoro M 30 , Stayner LT 31 , Kogevinas M 32 , Nieuwenhuijsen MJ 32 , Sokhi R 33 , de Hoogh K 34 , Beelen R 35 , Vineis P 36 , Brunekreef B 37 , Hoek G 38 , Raaschou-Nielsen O 39

Affiliations 

  • 1 The Danish Cancer Society Research Center, Copenhagen, Denmark; Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. Electronic address: [email protected]
  • 2 Department of Epidemiology, Lazio Regional Health Service, Rome, Italy; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
  • 3 Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
  • 4 Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  • 5 Unit of Cancer Epidemiology, Città della Salute e della Scienza University Hospital and Center for Cancer Prevention, Turin, Italy
  • 6 Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
  • 7 Norwegian Institute of Public Health, Oslo, Norway
  • 8 Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway
  • 9 Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
  • 10 Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
  • 11 Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
  • 12 Aging Research Center, Department of Neurobiology Care Science and Society, Karolinska Institute, Stockholm, Sweden
  • 13 The Danish Cancer Society Research Center, Copenhagen, Denmark
  • 14 Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands; MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
  • 15 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, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 16 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, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  • 17 Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
  • 18 MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
  • 19 Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
  • 20 Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Agency for Preventive and Social Medicine, Bregenz, Austria
  • 21 Agency for Preventive and Social Medicine, Bregenz, Austria
  • 22 Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
  • 23 Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
  • 24 Epidemiology and Prevention Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • 25 Unit of Epidemiology & Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
  • 26 Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Unit of Epidemiology, Regional Health Service, Grugliasco, Italy
  • 27 Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia-Romagna, Modena, Italy
  • 28 Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
  • 29 Institute de Salut Global Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain; Universitat Pompeu Fabra, Barcelona, Spain
  • 30 Public Health Department of Gipuzkoa, BioDonostia Research Institute, San Sebastian, Spain; Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
  • 31 Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
  • 32 Institute de Salut Global Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
  • 33 Centre for Atmospheric and Instrumentation Research, University of Hertfordshire, Hatfield, UK
  • 34 Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
  • 35 Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; National Institute for Public Health (RIVM), Bilthoven, The Netherlands
  • 36 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, Turin, Italy
  • 37 Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  • 38 Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
  • 39 The Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
Eur Urol Focus, 2018 01;4(1):113-120.
PMID: 28753823 DOI: 10.1016/j.euf.2016.11.008

Abstract

BACKGROUND: Ambient air pollution contains low concentrations of carcinogens implicated in the etiology of urinary bladder cancer (BC). Little is known about whether exposure to air pollution influences BC in the general population.

OBJECTIVE: To evaluate the association between long-term exposure to ambient air pollution and BC incidence.

DESIGN, SETTING, AND PARTICIPANTS: We obtained data from 15 population-based cohorts enrolled between 1985 and 2005 in eight European countries (N=303431; mean follow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO2 and NOx), particulate matter (PM) with diameter <10μm (PM10), <2.5μm (PM2.5), between 2.5 and 10μm (PM2.5-10), PM2.5absorbance (soot), elemental constituents of PM, organic carbon, and traffic density at baseline home addresses using standardized land-use regression models from the European Study of Cohorts for Air Pollution Effects project.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and meta-analyses to estimate summary hazard ratios (HRs) for BC incidence.

RESULTS AND LIMITATIONS: During follow-up, 943 incident BC cases were diagnosed. In the meta-analysis, none of the exposures were associated with BC risk. The summary HRs associated with a 10-μg/m3 increase in NO2 and 5-μg/m3 increase in PM2.5 were 0.98 (95% confidence interval [CI] 0.89-1.08) and 0.86 (95% CI 0.63-1.18), respectively. Limitations include the lack of information about lifetime exposure.

CONCLUSIONS: There was no evidence of an association between exposure to outdoor air pollution levels at place of residence and risk of BC.

PATIENT SUMMARY: We assessed the link between outdoor air pollution at place of residence and bladder cancer using the largest study population to date and extensive assessment of exposure and comprehensive data on personal risk factors such as smoking. We found no association between the levels of outdoor air pollution at place of residence and bladder cancer risk.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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