title: The burden of lung cancer mortality attributable to fine particles in China.
abstract: Although studies have examined the associations between fine particles (PM2.5) and lung cancer mortality in US and European countries, the evidence is still limited for China. In addition, no study has provided estimates of spatial variation in lung cancer mortality attributable to PM2.5in China. In this study, we quantified the associations between lung cancer mortality and PM2.5, using a spatiotemporal model with observed data of lung cancer mortality from 75 communities from the National Cancer Registration of China from 1990 to 2009 and the annual concentrations of PM2.5at 0.5°×0.5° spatial resolution. We also estimated lung cancer mortality burden attributable to PM2.5in China, with predicted county level lung cancer deaths in 2005. We found that the PM2.5-lung cancer mortality associations were non-linear, with thresholds of 40μg/m3overall, 45μg/m3for male, 42μg/m3for female, 45μg/m3for those aged 30-64years, 48μg/m3for those aged 65-74years, and 40μg/m3for those aged 75years and more, above which the relative risks were 1.08 (95% CI: 1.07, 1.09), 1.07 (95% CI: 1.05, 1.08), 1.12 (95% CI: 1.1, 1.14), 1.05 (95% CI: 1.04, 1.07), 1.07 (95% CI: 1.06, 1.09), and 1.14 (95% CI: 1.12, 1.16) respectively. There were 51,219 (95% CI: 45,745-56,512) lung cancer deaths attributed to PM2.5in 2005, with attributable fractions of 13.7% (95% CI: 12.23-15.11%) overall, 10.01% (95% CI: 8.37-11.58%) for men, 18.06% (95% CI: 15.81-20.18%) for women, 8.35% (95% CI: 6.07-10.51%) for those aged 65-74years, 9.73% (95% CI: 7.6-11.75%) for those aged 65-74years, 21.7% (95% CI: 19.27-23.99%) for those aged 75years or more. In conclusion, assuming a causal relation a reduction in exposure levels of PM2.5below thresholds would avert a substantial number of deaths from lung cancer in China.
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia. Electronic address: y.guo1@uq.edu.au.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Guo
authors.affiliation: National Office for Cancer Prevention and Control, National Cancer Center, Chinese Academy of Medical Sciences, Cancer Hospital, Beijing, China.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Zeng
authors.affiliation: National Office for Cancer Prevention and Control, National Cancer Center, Chinese Academy of Medical Sciences, Cancer Hospital, Beijing, China.
authors.forename: Rongshou
authors.initials: R
authors.lastname: Zheng
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Li
authors.affiliation: School of Public Health, Curtin University, Perth, Australia.
authors.forename: Gavin
authors.initials: G
authors.lastname: Pereira
authors.affiliation: State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Qiyong
authors.initials: Q
authors.lastname: Liu
authors.affiliation: National Office for Cancer Prevention and Control, National Cancer Center, Chinese Academy of Medical Sciences, Cancer Hospital, Beijing, China. Electronic address: chenwq@cicams.ac.cn.
authors.forename: Wanqing
authors.initials: W
authors.lastname: Chen
authors.affiliation: School of Public Health, Curtin University, Perth, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Huxley
mesh_terms: D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D052638:Particulate Matter / Q000032:analysis*
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: Air pollution; Attributable fraction; Attributable risk; Fine particles; Lung cancer mortality; Spatial age-period-cohort study