The impact of air pollution on lung cancer (LC) is difficult to detect in low-populated areas due to the potentially unfocused detection of pollutants and/or limited statistical power. This study identified and measured the harmful effect of pollution in small areas by considering the early onset of LC as a signature of pollution. This novel method requires a Bayesian standard curve calculated from the median age at LC onset and the corresponding median age of reference populations. Similar medians gathered from the area/s under investigation permits a probabilistic comparison with the standard curve. Statistically significant divergences can be interpreted as early or late LC onset. The method is exemplified in the Trieste municipality (northeast Italy) using data from the Friuli Venezia Giulia Cancer Registry (study population) and from the International Agency for Research on Cancer (reference population). Early LC onset has been observed near the pollution sources. Within 600 m of the iron foundry, onset ranged between 3.2 and 7.7 years earlier in men and between 11.7 and 16.8 years earlier in women. Near the shipyard, early onset was around 4 years in men and 7 years in women, while in the industrial area, early onset was 5 years in women only. Examining early LC onset may speed up the investigation of potential environmental hazards.
在人口稀少地区，由于污染物检测可能不够集中和/或统计效力有限，空气污染对肺癌的影响难以被察觉。本研究通过将肺癌早期发病视为污染标志，识别并测量了小范围区域内的污染危害效应。这一创新方法需要基于肺癌发病中位年龄与参照人群相应中位年龄计算贝叶斯标准曲线。从研究区域收集的类似中位数数据可与标准曲线进行概率比较，具有统计学意义的偏离可解读为肺癌的早发或晚发。本研究以意大利东北部的里雅斯特市为例，运用弗留利-威尼斯朱利亚癌症登记处（研究人群）和国际癌症研究机构（参照人群）的数据进行方法验证。结果显示在污染源附近观察到肺癌早发现象：距铸铁厂600米范围内，男性发病时间提前3.2至7.7年，女性提前11.7至16.8年；造船厂附近男性提前约4年，女性提前7年；工业区仅女性提前5年。通过检测肺癌早发现象，可加速潜在环境危害的调查进程。
Early Onset of Lung Cancer in Small Areas as a Signature of Point Pollution Sources
肿瘤(癌症)患者之家