Effect of ambient air pollution on the incidence of colorectal cancer among a diabetic population: a nationwide nested case–control study in Taiwan

Abstract

ObjectivesAn increasing number of studies had shown that air pollution exposure may aggravate blood glucose control in patients with diabetes, an independent risk factor for colorectal cancer (CRC) proposed by some researchers. This study aimed to investigate the impact of exposure to ambient particulate matter with aerodynamic diameters ≤2.5 μm (PM2.5) on the incidence of CRC among a diabetic population.DesignA nested case–control study.SettingA subset data retrieved from the Taiwan’s National Health Insurance Research Database.ParticipantsWe identified patients with newly diagnosed diabetes (n=1 164 962) during 1999–2013. Participants who had subsequently developed an incident of CRC were placed into the case group, while controls were matched to the cases at a 4:1 ratio by age, gender, date of diabetes diagnosis and the index date of CRC diagnosis.Methods and outcome measuresAll variables associated with the risk of CRC entered into a multinomial logistic regression model. The dose–response relationship between various average concentrations of PM2.5 exposure and the incidence of CRC was estimated by logistic regression.ResultsThe study included a total of 7719 incident CRC cases matched with 30 876 controls of random sampling. The mean annual concentration of PM2.5 was 35.3 µg/m3. After adjusting for potential confounders, a dose–response relationship was observed between the CRC risks and each interquartile increase of PM2.5 concentration (Q1–Q2: 1.03 (0.95–1.11), Q2–Q3: 1.06 (0.98–1.15), ≥Q3: 1.19 (1.10–1.28) in model 2. The adjusted ORs (95% CI) of CRC incidence for each 10 µg/m3 increment of PM2.5 was 1.08 (1.04–1.11). Moreover, a faster growing adapted Diabetes Complications Severity Index (aDCSI) score was noticed in CRC group compared with the controls, which also showed a significant association in our multivariate analysis (adjusted OR=1.28, 95% CI 1.18 to 1.38).ConclusionsLong-term exposure to high concentrations of PM2.5 may contribute to an increased incidence of CRC among diabetic populations.

Exposure to Outdoor Particulate Matter Air Pollution and Risk of Gastrointestinal Cancers in Adults: A Systematic Review and Meta-Analysis of Epidemiologic Evidence

“…The earliest of the 20 studies included was published in 2005 ( Table 3 ). 13 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 Baseline data collection began in 1982 to 2016, and follow-up periods ranged from 5 to 27 y. All included studies were retrospective or prospective cohort analyses except for one nested case–control study 48 and one time-series analysis with individual-level medical records, 47 and exposures were directly linked to individuals or geographic area (e.g., county, ZIP code).…”

“… 13 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 Baseline data collection began in 1982 to 2016, and follow-up periods ranged from 5 to 27 y. All included studies were retrospective or prospective cohort analyses except for one nested case–control study 48 and one time-series analysis with individual-level medical records, 47 and exposures were directly linked to individuals or geographic area (e.g., county, ZIP code). All included studies were conducted in the northern hemisphere: Asia, 13 , 40 , 44 , 46 , 47 , 48 , 51 Europe, 33 , 36 , 39 , 41 , 45 , 50 the United States, or Canada.…”

“…All included studies were retrospective or prospective cohort analyses except for one nested case–control study 48 and one time-series analysis with individual-level medical records, 47 and exposures were directly linked to individuals or geographic area (e.g., county, ZIP code). All included studies were conducted in the northern hemisphere: Asia, 13 , 40 , 44 , 46 , 47 , 48 , 51 Europe, 33 , 36 , 39 , 41 , 45 , 50 the United States, or Canada. 34 , 35 , 37 , 38 , 42 , 43 , 49 …”

“…Most studies had large sample sizes ( participants) and were rated as having sufficient population representation, but some were focused on a circumscribed geographic area. 13 , 33 , 36 , 37 , 38 , 40 , 42 , 47 , 48 , 49 , 51 …”

Manajemen Kanker Kolorektal

“…Hasil-hasil penelitian ini diharapkan dapat bermanfaat bagi para pemangku kebijakan, terutama di negara dengan sektor industri yang berkembang pesat, untuk tetap memerhatikan analisis dampak lingkungan dalam upaya mengendalikan risiko penyakit yang berkaitan dengan paparan polusi, termasuk kanker. [14][15][16][17][18]…”