Breast Cancer Incidence in Relation to Long-Term Low-Level Exposure to Air Pollution in the ELAPSE Pooled Cohort

Research output: Contribution to journalJournal articleResearchpeer-review

  • Ulla Arthur Hvidtfeldt
  • Jie Chen
  • Sophia Rodopoulou
  • Maciej Strak
  • Kees de Hoogh
  • Tom Bellander
  • Jørgen Brandt
  • Daniela Fecht
  • Francesco Forastiere
  • John Gulliver
  • Ole Hertel
  • Barbara H. Hoffmann
  • Klea Katsouyanni
  • Matthias Ketzel
  • Boel Brynedal
  • Karin Leander
  • Petter L.S. Ljungman
  • Patrik K.E. Magnusson
  • Gabriele Nagel
  • Göran Pershagen
  • Debora Rizzuto
  • Marie Christine Boutron-Ruault
  • Evangelia Samoli
  • Massimo Stafoggia
  • Roel Vermeulen
  • W. M.Monique Verschuren
  • Gudrun Weinmayr
  • Kathrin Wolf
  • Emanuel Zitt
  • Bert Brunekreef
  • Gerard Hoek
  • Ole Raaschou-Nielsen

BACKGROUND: Established risk factors for breast cancer include genetic disposition, reproductive factors, hormone therapy, and lifestyle-related factors such as alcohol consumption, physical inactivity, smoking, and obesity. More recently a role of environmental exposures, including air pollution, has also been suggested. The aim of this study, was to investigate the relationship between long-term air pollution exposure and breast cancer incidence. METHODS: We conducted a pooled analysis among six European cohorts (n = 199,719) on the association between long-term residential levels of ambient nitrogen dioxide (NO2), fine particles (PM2.5), black carbon (BC), and ozone in the warm season (O3) and breast cancer incidence in women. The selected cohorts represented the lower range of air pollutant concentrations in Europe. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level. RESULTS: During 3,592,885 person-years of follow-up, we observed a total of 9,659 incident breast cancer cases. The results of the fully adjusted linear analyses showed a HR (95% confidence interval) of 1.03 (1.00-1.06) per 10 μg/m³ NO2, 1.06 (1.01-1.11) per 5 μg/m³ PM2.5, 1.03 (0.99-1.06) per 0.5 10-5 m-1 BC, and 0.98 (0.94-1.01) per 10 μg/m³ O3. The effect estimates were most pronounced in the group of middle-aged women (50-54 years) and among never smokers. CONCLUSIONS: The results were in support of an association between especially PM2.5 and breast cancer. IMPACT: The findings of this study suggest a role of exposure to NO2, PM2.5, and BC in development of breast cancer.

Original languageEnglish
JournalCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Issue number1
Pages (from-to)105-113
Number of pages9
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
©2022 American Association for Cancer Research.

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