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Air pollution and green spaces in relation to breast cancer risk among pre and postmenopausal women : A mega cohort from Catalonia
Terre-Torras, Isaura Recalde, Martina Díaz, Yesika de Bont, Jeroen Bennett, Matthew Aragón, María Cirach, Marta O'Callaghan-Gordo, Cristina Nieuwenhuijsen, Mark J. Duarte-Salles, Talita
Terre-Torras, Isaura
Recalde, Martina
Díaz, Yesika
de Bont, Jeroen
Bennett, Matthew
Aragón, María
Cirach, Marta
O'Callaghan-Gordo, Cristina
Nieuwenhuijsen, Mark J.
Duarte-Salles, Talita
Abstract
Background
The association between air pollution and green spaces with breast cancer risk stratified by menopausal status has not been frequently investigated despite its importance given the different impact of risk factors on breast cancer risk depending on menopausal status.
Objectives
To study the association between air pollution, green spaces and pre and postmenopausal breast cancer risk.
Methods
We conducted a population-based cohort study using electronic primary care records in Catalonia. We included women aged 17–85 years free of cancer at study entry between 2009 and 2017. Our exposures were particulate matter <2.5 μm (PM2.5) & <10 μm (PM10), nitrogen dioxide (NO2), normalized difference vegetation index (NDVI), and percentage of green spaces estimated at the census tract level. Breast cancer was identified with ICD-10 code C50. We estimated cause-specific hazard ratios (HR) for the relationship between each individual exposure and pre and postmenopausal breast cancer risk, using linear and non-linear models.
Results
Of the 1,054,180 pre and 744,658 postmenopausal women followed for a median of 10 years, 6,126 and 17,858 developed breast cancer, respectively. Among premenopausal women, only very high levels of PM10 (≥46 μg/m3) were associated with increased cancer risk (compared to lower levels) in non-linear models. Among postmenopausal women, an interquartile range increase in PM2.5 (HR:1.03; 95%CI:1.01–1.04), PM10 (1.03; 1.01–1.05), and NO2 (1.05; 1.02–1.08) were associated with higher cancer risk. NDVI was negatively associated with decreased cancer risk only among postmenopausal women who did not change residence during follow-up (0.84; 0.71–0.99) or who were followed for at least three years (0.82; 0.69–0.98).
Discussion
Living in areas with high concentrations of PM2.5, PM10, and NO2 increases breast cancer risk in postmenopausal women while long-term exposure to green spaces may decrease this risk. Only very high concentrations of PM10 increase breast cancer risk in premenopausal women.
Keywords
air pollution, green spaces, breast cancer, malignant neoplasm, urban environment
Date
2022
Type
Journal article
Journal
Environmental Research
Book
Volume
214
Issue
1
Page Range
1-11
Article Number
Article 113838
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled