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

Research output: Contribution to journalJournal articleResearchpeer-review

  • Massimo Stafoggia
  • Gudrun Weinmayr
  • Claudia Galassi
  • Johan Sommar
  • Bertil Forsberg
  • David Olsson
  • Bente Oftedal
  • Norun H. Krog
  • Geir Aamodt
  • Andrei Pyko
  • Göran Pershagen
  • Michal Korek
  • Ulf De Faire
  • Nancy L. Pedersen
  • Claes-göran Östenson
  • Laura Fratiglioni
  • Mette Sørensen
  • Kirsten T. Eriksen
  • Petra H. Peeters
  • Bas Bueno-de-mesquita
  • Roel Vermeulen
  • Marloes Eeftens
  • Michelle Plusquin
  • Timothy J. Key
  • Andrea Jaensch
  • Gabriele Nagel
  • Hans Concin
  • Meng Wang
  • Ming-yi Tsai
  • Sara Grioni
  • Alessandro Marcon
  • Vittorio Krogh
  • Fulvio Ricceri
  • Carlotta Sacerdote
  • Andrea Ranzi
  • Giulia Cesaroni
  • Francesco Forastiere
  • Ibon Tamayo
  • Pilar Amiano
  • Miren Dorronsoro
  • Leslie T. Stayner
  • Manolis Kogevinas
  • Mark J. Nieuwenhuijsen
  • Ranjeet Sokhi
  • Kees De Hoogh
  • Rob Beelen
  • Paolo Vineis
  • Bert Brunekreef
  • Gerard Hoek
  • Ole Raaschou-nielsen

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 airpollution 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 = 303 431; meanfollow-up 14.1 yr). We estimated exposure to nitrogen oxides (NO2 and NOx), particulate matter (PM) with diameter <10 mm (PM10), <2.5 mm (PM2.5), between 2.5 and 10 mm (PM2.5–10), PM2.5 absorbance (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-mg/m3 increase in NO2 and 5-mg/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 placeof residence and bladder cancer risk.

Original languageEnglish
JournalEuropean Urology Focus
Issue number1
Pages (from-to)113-120
Number of pages8
Publication statusPublished - 2018

ID: 173751001