Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE)
Ole Raaschou-Nielsen, Zorana J Andersen, Rob Beelen, Evangelia Samoli, Massimo Stafoggia, Gudrun Weinmayr, Barbara Hoffmann, Paul Fischer,
Mark J Nieuwenhuijsen, Bert Brunekreef, Wei W Xun, Klea Katsouyanni, Konstantina Dimakopoulou, Johan Sommar, Bertil Forsberg, Lars Modig,
Anna Oudin, Bente Oftedal, Per E Schwarze, Per Nafstad, Ulf De Faire, Nancy L Pedersen, Claes-Göran Östenson, Laura Fratiglioni, Johanna Penell,
Michal Korek, Göran Pershagen, Kirsten T Eriksen, Mette Sørensen, Anne Tjønneland, Thomas Ellermann, Marloes Eeftens, Petra H Peeters,
Kees Meliefste, Meng Wang, Bas Bueno-de-Mesquita, Timothy J Key, Kees de Hoogh, Hans Concin, Gabriele Nagel, Alice Vilier, Sara Grioni,
Vittorio Krogh, Ming-Yi Tsai, Fulvio Ricceri, Carlotta Sacerdote, Claudia Galassi, Enrica Migliore, Andrea Ranzi, Giulia Cesaroni, Chiara Badaloni,
Francesco Forastiere, Ibon Tamayo, Pilar Amiano, Miren Dorronsoro, Antonia Trichopoulou, ChristinaBamia, Paolo Vineis*, Gerard Hoek*
Background Ambient air pollution is suspected to cause lung cancer. We aimed to assess the association between
long-term exposure to ambient air pollution and lung cancer incidence in European populations.
Methods This prospective analysis of data obtained by the European Study of Cohorts for Air Pollution Effects used
data from 17 cohort studies based in nine European countries. Baseline addresses were geocoded and we assessed air
pollution by land-use regression models for particulate matter (PM) with diameter of less than 10 µm (PM10), less than
2·5 µm (PM2·5), and between 2·5 and 10 µm (PMcoarse), soot (PM2·5absorbance), nitrogen oxides, and two traffic indicators.
We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random
effects models for meta-analyses.
Findings The 312944 cohort members contributed 4013131 person-years at risk. During follow-up (mean 12·8 years),
2095 incident lung cancer cases were diagnosed. The meta-analyses showed a statistically significant association between
risk for lung cancer and PM10 (hazard ratio [HR] 1·22 [95% CI 1·03–1·45] per 10 µg/m³). For PM2·5 the HR was 1·18
(0·96–1·46) per 5 µg/m³. The same increments of PM10 and PM2·5 were associated with HRs for adenocarcinomas of the
lung of 1·51 (1·10–2·08) and 1·55 (1·05–2·29), respectively. An increase in road traffic of 4000 vehicle-km per day within
100 m of the residence was associated with an HR for lung cancer of 1·09 (0·99–1·21). The results showed no association
between lung cancer and nitrogen oxides concentration (HR 1·01 [0·95–1·07] per 20 µg/m³) or traffic intensity on the
nearest street (HR 1·00 [0·97–1·04] per 5000 vehicles per day).
Interpretation Particulate matter air pollution contributes to lung cancer incidence in Europe.
Funding European Community’s Seventh Framework Programme.