Estimates of the current and future burden of lung cancer attributable to PMin Canada.
Prev Med. 2019 05 ;122:91-99. PMID: 31078178
The International Agency for Research on Cancer has classified PM(fine particulate matter, PM) as a lung cancer carcinogen in humans. We estimated the proportion of lung cancer cases attributable to PMexposure in Canada in 2015, and future avoidable cancers over the period 2016-2042 under different future exposure scenarios. A meta-analysis was conducted to estimate the relative risk of lung cancer associated with PMthat was generalizable to Canada. A population-weighted Canadian distribution of residential PMexposure was estimated annually using ecological-level, satellite-derived PMdata for the period 1990 to 2009. Population attributable risks (PAR) were estimated for PMand applied to lung cancer incidence from the Canadian Cancer Registry. Potential impact fractions based on counterfactual scenarios for the year 2042 were estimated, along with cumulative preventable cases from 2016 to 2042. The relative risk of lung cancer associated with PMwas 1.09 (95% CI: 1.06-1.12) per an increase of 10 μg/m. The average population-weighted exposure to PMcorresponding to a 20-year exposure window from 1990 to 2009 was 8.3 μg/m. The PAR for PMwas estimated at 6.9%, accounting for 1739 attributable lung cancer cases in 2015. If patterns of decline in PMcontinue, over 3000 lung cancer cases could be prevented between 2016 and 2042. Exposure to PMcontributes to a considerable burden of lung cancer in Canada and policies aimed at sustaining outdoor PMdeclines are important for lung cancer prevention in Canada.