Solid fuel use for heating and risks of breast and cervical cancer mortality in China.
Breast cancer
Cervical cancer
Heating
Indoor air pollution
Solid fuels
Journal
Environmental research
ISSN: 1096-0953
Titre abrégé: Environ Res
Pays: Netherlands
ID NLM: 0147621
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
09
03
2020
revised:
14
04
2020
accepted:
23
04
2020
pubmed:
8
5
2020
medline:
21
11
2020
entrez:
8
5
2020
Statut:
ppublish
Résumé
Carcinogens released from indoor burning of solid fuels are believed to enter the bloodstream and to be metabolized in breast and cervical tissues. Little evidence exists about the relationship of solid fuel use from heating with breast and cervical cancer. To examine the association of solid heating fuel use with breast and cervical cancer mortality. This study included female participants aged 30-79 years who were enrolled in the China Kadoorie Biobank during 2004-2008 from 10 diverse regions across China. During a 10.2-year median follow-up, 177 breast cancer deaths and 113 cervical cancer deaths were documented. Multivariable Cox regression models yielded adjusted hazard ratios (HRs) for the associations of self-reported long-term heating fuel exposure with two cancer deaths. Stratified analyses were used to assess effect modification. We included 236,116 participants for breast cancer analyses and 228,795 for cervical cancer analyses. Compared with non-solid fuel use, the fully adjusted HRs of cervical cancer deaths were 1.75 (0.91-3.38) for wood use, 2.23 (1.09-4.59) for mixed fuel (coal and wood) use. No evident relationship was observed for breast cancer deaths. Cervical cancer risk increased with the duration of solid fuel use (P for trend = 0.041). Elevated cervical cancer risk was observed in post-menopausal women (HR 2.01, 1.01-4.03), not in pre-menopausal women (HR 0.77, 0.56-2.31) (P for heterogeneity = 0.004); and in those aged ≥50 years (HR 2.56, 1.17-5.86), not in those aged < 50 years (HR 0.69, 0.26-1.84) (P < 0.001). Indoor solid fuel combustion for heating may be associated with a higher risk for cervical cancer death, but not for breast cancer. The strength of the association increased with the duration of exposure and was modified by age and menopause status.
Sections du résumé
BACKGROUND
Carcinogens released from indoor burning of solid fuels are believed to enter the bloodstream and to be metabolized in breast and cervical tissues. Little evidence exists about the relationship of solid fuel use from heating with breast and cervical cancer.
OBJECTIVES
To examine the association of solid heating fuel use with breast and cervical cancer mortality.
METHODS
This study included female participants aged 30-79 years who were enrolled in the China Kadoorie Biobank during 2004-2008 from 10 diverse regions across China. During a 10.2-year median follow-up, 177 breast cancer deaths and 113 cervical cancer deaths were documented. Multivariable Cox regression models yielded adjusted hazard ratios (HRs) for the associations of self-reported long-term heating fuel exposure with two cancer deaths. Stratified analyses were used to assess effect modification.
RESULTS
We included 236,116 participants for breast cancer analyses and 228,795 for cervical cancer analyses. Compared with non-solid fuel use, the fully adjusted HRs of cervical cancer deaths were 1.75 (0.91-3.38) for wood use, 2.23 (1.09-4.59) for mixed fuel (coal and wood) use. No evident relationship was observed for breast cancer deaths. Cervical cancer risk increased with the duration of solid fuel use (P for trend = 0.041). Elevated cervical cancer risk was observed in post-menopausal women (HR 2.01, 1.01-4.03), not in pre-menopausal women (HR 0.77, 0.56-2.31) (P for heterogeneity = 0.004); and in those aged ≥50 years (HR 2.56, 1.17-5.86), not in those aged < 50 years (HR 0.69, 0.26-1.84) (P < 0.001).
CONCLUSION
Indoor solid fuel combustion for heating may be associated with a higher risk for cervical cancer death, but not for breast cancer. The strength of the association increased with the duration of exposure and was modified by age and menopause status.
Identifiants
pubmed: 32380244
pii: S0013-9351(20)30471-0
doi: 10.1016/j.envres.2020.109578
pii:
doi:
Substances chimiques
Coal
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
109578Subventions
Organisme : Wellcome Trust
ID : 212946/Z/18/Z
Pays : United Kingdom
Organisme : Cancer Research UK
ID : 29186
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12026/2
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00017/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U137686851
Pays : United Kingdom
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.