image: Graphic abstract of the study: Methods, main results, and conclusion of the study are included.
Credit: ©Science China Press
Gynecologic cancer has become a major health concern among women. And gynecologic cancer may carry social and psychological sequelae with a relatively poor prognosis. This health crisis underlines the urgency of identifying risk factors. PM2.5 is recognized as a carcinogen, but its association with gynecologic cancer is contradicted by limited evidence. Moreover, as a complex mixture, PM2.5’s health effects depend greatly on its constituents and their proportions. Identification of hazardous constituents is crucial for developing targeted prevention strategies.
This study was a prospective cohort study conducted in Beijing to investigate the association of long-term exposure to PM2.5 with the incidence of gynecologic cancer, and further specify the key constituents. Participants were selected by cluster sampling from the National Urban Cancer Screening Program in Beijing (2013–2019). Morbidity data was collected through passive follow-up and obtained from the Beijing Cancer Registry System. A total of 85500 eligible participants were included, and 524 were identified with gynecologic cancer during a mean follow-up of 6.22 years. Five-year average concentrations of PM2.5 and its constituents, including carbon black (BC), ammonium (NH4+), nitrate (NO3−), organic matter (OM), and sulfate (SO42−), derived from the Tracking Air Pollution in China (TAP) dataset, were indicated as long-term exposure. The study utilized Cox proportional hazard models to explore the association between PM2.5 exposure and gynecologic cancer incidence. Quantile-based g-computation (Qgcomp) and SHapley Additive exPlanations (SHAP) models were used to assess the effect of each constituent.
The results of this study showed that exposure to PM2.5 was significantly associated with the incidence of gynecologic cancer, with a hazard ratio (HR) of 1.10 (95% CI: 1.00–1.22) with per standard deviation (SD) increment. The Qgcomp model highlighted BC and SO42− as the primary constituents, with weights of 61.6% and 35.9% in the positive direction, respectively. The SHAP model corroborated these results, as SO42− had the largest mean |SHAP| values of 0.0322 in the SHAP model, followed by BC (0.0270). These findings may carry a few implications for policy development to achieve more cost-effective reductions in air pollution.
In conclusion, the present study indicated that long-term exposure to PM2.5 was associated with gynecologic cancer incidence, with SO42− and BC playing the major roles.
Journal
Medicine Plus