Abstract
PURPOSE: This study aims to examine the association between exposure to major ambient air pollutants and the incidence and mortality of lung cancer and some nonlung cancers. METHODS: This meta-analysis used PubMed and EMBASE databases to access published studies that met the eligibility criteria. Primary analysis investigated the association between exposure to air pollutants and cancer incidence and mortality. Study quality was assessed using the Newcastle Ottawa Scale. Meta-analysis was conducted using R software. RESULTS: The meta-analysis included 61 studies, of which 53 were cohort studies and eight were case-control studies. Particulate matter 2.5 mm or less in diameter (PM(2.5)) was the exposure pollutant in half (55.5%), and lung cancer was the most frequently studied cancer in 59% of the studies. A pooled analysis of exposure reported in cohort and case-control studies and cancer incidence demonstrated a significant relationship (relative risk [RR], 1.04 [95% CI, 1.02 to 1.05]; I(2), 88.93%; P < .05). A significant association was observed between exposure to pollutants such as PM(2.5) (RR, 1.08 [95% CI, 1.04 to 1.12]; I(2), 68.52%) and nitrogen dioxide (NO(2)) (RR, 1.03 [95% CI, 1.01 to 1.05]; I(2), 73.52%) and lung cancer incidence. The relationship between exposure to the air pollutants and cancer mortality demonstrated a significant relationship (RR, 1.08 [95% CI, 1.07 to 1.10]; I(2), 94.77%; P < .001). Among the four pollutants, PM(2.5) (RR, 1.15 [95% CI, 1.08 to 1.22]; I(2), 95.33%) and NO(2) (RR, 1.05 [95% CI, 1.02 to 1.08]; I(2), 89.98%) were associated with lung cancer mortality. CONCLUSION: The study confirms the association between air pollution exposure and lung cancer incidence and mortality. The meta-analysis results could contribute to community cancer prevention and diagnosis and help inform stakeholders and policymakers in decision making.