Abstract 836: Long-term particulate matter and mortality in cancer patients and survivors compared to general population
Authors: Shin Miyoun , Kim Ok-Jin , Choe Seung-Ah , Choi Yoon-Jung , Kim Ho , Lee Woojoo , Lee Ho , Kim Sun-Young 
Published: March 2024

Abstract
Background and Aim Exposure to particulate matter (PM) has been reported as a major environmental hazard to human health. Although many studies found the associations with mortality and its susceptibility in patients with diabetes and heart diseases, few studies paid attention to cancer. In addition, there were no studies that compared these associations in cancer patients and survivors with those in healthy people from the same population. The aim of this study is to compare the association between long-term exposure to PM with all-cause and cause-specific mortality between the general population and cancer patients and survivors both of which were selected from the same cohort in the Seoul Metropolitan Area (SMA), South Korea.
Methods Using the National Health Insurance Services-National Sample cohort, we selected the subjects who received health screening during 2005-2007, had full address information, and were aged 30-80 without severe disability. We defined cause-specific mortality based on the International Classification of Disease, 10th reversion from 2007 to 2015. Using a previously-validated prediction model, we estimated annual-average PM concentrations at participants’ district-level addresses and assessed individual long-term exposure as the average concentrations in the previous 5 years on each year during the follow-up. Then, we performed time-varying Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals (95%CI) per 10 ug/m3 increase in PM2.5 and PM10 adjusting for sociodemographic characteristics, family history of cancer, and health behaviors.
Results Our study population of 98,493 adults include 94,494 (95.9%) general population and 3,999 (4.1%) cancer patients and survivors in the SMA at baseline. In the general population, we observed the associations with deaths from all causes (PM2.5: HR=1.31, 95% CI: 1.10-1.55; PM10: 1.07, 1.00-1.15), non-accidental causes (PM2.5: 1.51, 1.24-1.84; PM10: 1.10, 1.02-1.20), and cardiopulmonary diseases (PM2.5: 1.57, 1.07-2.31); PM10: 1.22, 1.04-1.43). In contrast, although all HRs of all-cause and cause-specific mortality were not statistically significant, cancer patients and survivors showed much higher HRs for all-cancer and lung-cancer mortality (PM2.5: 1.57 and 1.99; PM10: 1.01 and 1.33) than those for all or other cause-specific mortality as well as those of cancer-related mortality in the general population.
Conclusions Our findings provided suggestive evidence of the different causes of deaths associated with long-term exposure to air pollution between the general population and cancer patients and survivors. While PM could behave as a risk factor of cardiopulmonary deaths in the general population, after diagnosed with cancer, exposure to PM may increase the risk of dying of cancer.
Citation Format: Miyoun Shin, Ok-Jin Kim, Seung-Ah Choe, Yoon-Jung Choi, Ho Kim, Woojoo Lee, Ho Lee, Sun-Young Kim. Long-term particulate matter and mortality in cancer patients and survivors compared to general population [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 836.