title: Household air pollution and cancers other than lung: a meta-analysis.
abstract: Household air pollution (HAP) from solid fuel combustion contributes to 2.6% of the global burden of disease. HAP emissions are an established lung carcinogen; however, associations with other cancer sites have not been fully explored. We conducted a meta-analysis of 18 case-control studies. Using fixed-effects models, utilizing the adjusted odds ratios (OR) and 95% confidence intervals (95% CI) from each study, we evaluated the association between HAP and cervical neoplasia (663 cases and 1747 controls) and upper aero-digestive tract cancers (6022 cases and 15 325 controls). We found that HAP was associated with cervical neoplasia (OR = 6.46; 95% CI = 3.12-13.36; 4 studies); oral (OR = 2.44; 95% CI = 1.87-3.19; 4 studies; 1000 cases/3450 controls); nasopharyngeal (OR = 1.80; 95% CI = 1.42-2.29; 6 studies; 2231 cases/2160 controls); pharyngeal (OR = 3.56; 95% CI = 2.22-5.70; 4 studies; 1036 cases/3746 controls); and laryngeal (OR = 2.35; 95% CI = 1.72- 3.21; 5 studies; 1416 cases/4514 controls) cancers. The elevated risk for esophageal cancer (OR = 1.92; 95% CI = 0.82-4.49; 2 studies; 339 cases/1455 controls) was non-significant. HAP was associated with cervical neoplasia among studies that accounted for HPV infection (OR = 9.60; 95% CI = 3.79-24.32) and smoking (OR = 4.72; 95% CI = 1.84-12.07). Similarly, our observed associations between HAP and upper aero-digestive tract cancers remained significantly elevated when analyses were restricted to studies that controlled for smoking. No significant publication bias was detected. Our results suggest that the carcinogenic effect of HAP observed for lung cancer may extend to other cancers, including those of the cervix and the upper aero-digestive tract. Further research is needed to confirm these associations in prospective studies.
authors.affiliation: Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1309, Belfer, Bronx, New York, USA. sowmya.josyula@einstein.yu.edu.
authors.forename: Sowmya
authors.initials: S
authors.lastname: Josyula
authors.affiliation: Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1309, Belfer, Bronx, New York, USA. juan.lin@einstein.yu.edu.
authors.forename: Juan
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1309, Belfer, Bronx, New York, USA. xiaonan.xue@einstein.yu.edu.
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Xue
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. rothmann@mail.nih.gov.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Rothman
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. qingl@mail.nih.gov.
authors.forename: Qing
authors.initials: Q
authors.lastname: Lan
authors.affiliation: Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1309, Belfer, Bronx, New York, USA. thomas.rohan@einstein.yu.edu.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Rohan
authors.affiliation: Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1309, Belfer, Bronx, New York, USA. dean.hosgood@einstein.yu.edu.
authors.forename: H Dean
authors.initials: HD
authors.lastname: Hosgood
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects*; D016022:Case-Control Studies; D016001:Confidence Intervals; D006801:Humans; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D016017:Odds Ratio; D012307:Risk Factors