Air Pollution May Shorten Lung Cancer Survival

Sandrah P. Eckel PhD Assistant Professor of Preventive Medicine USC Division of Biostatistics

Dr. Sandrah Eckel Interview with:
Sandrah P. Eckel PhD
Assistant Professor of Preventive Medicine
USC Division of Biostatistics What is the background for this study? What are the main findings?

Response: Lung cancer is the most common cancer and it is responsible for 1 in 5 cancer deaths. There is a growing body of evidence that ambient air pollution exposures are linked to lung cancer incidence and mortality, but the effect on survival of exposures after diagnosis are unclear. The International Agency for Research on Cancer recently classified ambient air pollution as carcinogenic. We reasoned that if air pollution drives lung cancer development, it could impact lung cancer progression—and shorten survival—through the same biological pathways.

We used 20 years of data on more than 300,000 newly diagnosed lung cancer cases from the California Cancer Registry and calculated average air pollution exposures at each patient’s residence from the date of diagnosis through the end of follow-up. We found that patients living in areas with higher pollution levels had shorter survival, particularly for patients who were diagnosed at an early stage and for those diagnosed at an early stage with adenocarcinoma histology. Interestingly, adenocarcinoma is the most common histological subtype of lung cancer in non-smokers. What should readers take away from your report?

Response: Smoking is the major risk factor for lung cancer, but ambient air pollution is another modifiable risk factor of interest. This study suggests that air pollution exposures after lung cancer diagnosis can impact how long a patient lives. What recommendations do you have for future research as a result of this study?

Response: The associations in this study are suggestive, but do not demonstrate a cause and effect. Our findings would be strengthened by replicating the results in other locations and with other study designs. Is there anything else you would like to add?

Response: The effects were most evident in patients diagnosed with early stage lung cancer. Given the increased emphasis on screening for early detection, there will be more patients diagnosed with early stage lung cancer and these are the patients for whom air pollution exposures after diagnosis appeared to have the largest impact. Thank you for your contribution to the community.


Sandrah P Eckel, Myles Cockburn, Yu-Hsiang Shu, Huiyu Deng, Frederick W Lurmann,Lihua Liu, Frank D Gilliland

Thorax thoraxjnl-2015-207927Published Online First: 4 August 2016 doi:10.1136/thoraxjnl-2015-207927

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on August 5, 2016 by Marie Benz MD FAAD