Impact of air pollution on breast cancer incidence and mortality: a nationwide analysis in South Korea

Jeongeun Hwang,Beomseok Ko,Hahn Yi,Seunghyun Choi,Hyunjin Bae,Namkug Kim

doi:10.1038/s41598-020-62200-x

Jeongeun Hwang, Beomseok Ko + Show 4 more

Open Access

https://doi.org/10.1038/s41598-020-62200-x

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Abstract

Breast cancer is one of the major female health problems worldwide. Although there is growing evidence indicating that air pollution increases the risk of breast cancer, there is still inconsistency among previous studies. Unlike the previous studies those had case-control or cohort study designs, we performed a nationwide, whole-population census study. In all 252 administrative districts in South Korea, the associations between ambient NO2 and particulate matter 10 (PM10) concentration, and age-adjusted breast cancer mortality rate in females (from 2005 to 2016, Nmortality = 23,565), and incidence rate (from 2004 to 2013, Nincidence = 133,373) were investigated via multivariable beta regression. Population density, altitude, rate of higher education, smoking rate, obesity rate, parity, unemployment rate, breastfeeding rate, oral contraceptive usage rate, and Gross Regional Domestic Product per capita were considered as potential confounders. Ambient air pollutant concentrations were positively and significantly associated with the breast cancer incidence rate: per 100 ppb CO increase, Odds Ratio OR = 1.08 (95% Confidence Interval CI = 1.06–1.10), per 10 ppb NO2, OR = 1.14 (95% CI = 1.12–1.16), per 1 ppb SO2, OR = 1.04 (95% CI = 1.02–1.05), per 10 µg/m3 PM10, OR = 1.13 (95% CI = 1.09–1.17). However, no significant association between the air pollutants and the breast cancer mortality rate was observed except for PM10: per 10 µg/m3 PM10, OR = 1.05 (95% CI = 1.01–1.09).

Highlights

Breast cancer is one of the major female health problems worldwide
In multicollinearity analysis among the air pollutants, the NO2 and O3 concentrations were colinear with a correlation coefficient of −0.862
O3 concentrations were excluded from the multivariable model due to its lesser correlation (0.659) with the breast cancer incidence rate than that of NO2 concentrations (0.774)

Summary

Introduction

Breast cancer is one of the major female health problems worldwide. there is growing evidence indicating that air pollution increases the risk of breast cancer, there is still inconsistency among previous studies. Chen et al.[5] and Wei et al.[9] aggregated air pollutant emission data and age-adjusted breast cancer incidence rates in Surveillance, Epidemiology, and End Results Program of the United States National Cancer Institute that covered 199 counties and approximately 100,000 or less female population and found positive correlations. We performed an ecological study to investigate the associations between CO, NO2, SO2, O3, PM10, and breast cancer incidence and mortality rate, in the whole of the 252 administrative districts in South Korea.

Results

Conclusion