Lung cancer is the leading cancer-related killer in the United States. The incidence varies geographically and may be affected by environmental pollutants. Our goal was to determine associations within time series for specific air pollutants and lung cancer cases over a 33-year period in Wayne County, Michigan, controlling for population change. Lung cancer data for Wayne County were queried from the Michigan Cancer Registry from 1985 to 2018. Air pollutant data were obtained from the United States Environmental Protection Agency from 1980 to 2018. Autoregressive distributed lag (ARDL) models were estimated to investigate time lags in years between specific air pollution levels and lung cancer development. A total of 58,866 cases of lung cancer were identified. The mean age was 67.8 years. Females accounted for 53 percent of all cases in 2018 compared to 44 percent in 1985. Three major clusters of lung cancer incidence were detected with the most intense clusters in downtown Detroit and the heavily industrialized downriver area. Sulfur dioxide (SO2) had the strongest statistically significant relationship with lung cancer, showing both short- and long-term effects (lag range, 1–15 years). Particulate matter (PM2.5) (lag range, 1–3 years) and nitrogen dioxide (NO2) (lag range, 2–4 years) had more immediate effects on lung cancer development compared to carbon monoxide (CO) (lag range, 5–6 years), hazardous air pollutants (HAPs) (lag range, 9 years) and lead (Pb) (lag range, 10–12 years), which had more long-term effects on lung cancer development. Areas with poor air quality may benefit from targeted interventions for lung cancer screening and reductions in environmental pollution.
肺癌是美国癌症相关死亡的首要原因。其发病率存在地域差异，并可能受环境污染物的影响。本研究旨在控制人口变化因素，分析密歇根州韦恩郡33年间特定空气污染物与肺癌病例的时间序列关联。肺癌数据来源于密歇根癌症登记系统（1985-2018年），空气污染物数据来自美国环境保护署（1980-2018年）。通过建立自回归分布滞后（ARDL）模型，探究特定空气污染水平与肺癌发病之间的时间滞后效应。研究共纳入58,866例肺癌病例，平均年龄67.8岁。2018年女性病例占比达53%（1985年为44%）。肺癌发病率呈现三个主要聚集区，其中底特律市中心和工业化程度较高的下游区域聚集程度最高。二氧化硫（SO2）与肺癌的统计学关联最为显著，同时存在短期和长期效应（滞后区间1-15年）。细颗粒物（PM2.5）（滞后区间1-3年）和二氧化氮（NO2）（滞后区间2-4年）对肺癌发病的影响较为直接；而一氧化碳（CO）（滞后区间5-6年）、有害空气污染物（HAPs）（滞后区间9年）和铅（Pb）（滞后区间10-12年）则表现出更长期的效应。空气质量较差的地区可通过实施针对性干预措施，加强肺癌筛查并降低环境污染水平。
Lung Cancer and Air Quality in a Large Urban County in the United States
肿瘤(癌症)患者之家