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Exposure to outdoor air pollution, wildfires, and cancer survival in the United States.

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Title: Exposure to outdoor air pollution, wildfires, and cancer survival in the United States.
Authors: VoPham T; Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA. Electronic address: trang@fredhutch.org., Liu T; Department of Geography, University of British Columbia, Vancouver, British Columbia, Canada., Cortez M; Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA., Karasaki S; Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA., Falkenberg NF; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Zewdie HY; Department of Epidemiology, University of Washington, Seattle, WA, USA., Lin J; Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA., Nondin C; Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA., Chao SLS; Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA., Knowlton T; Plume Labs by AccuWeather, Paris, France., Quennehen B; Plume Labs by AccuWeather, Paris, France., Mendoza JA; Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA; Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, University of Washington, Seattle, WA, USA., Ioannou GN; Division of Gastroenterology, Department of Medicine, Veterans Affairs Puget Sound Healthcare System and University of Washington, Seattle, WA, USA., Berry K; Research and Development, Veterans Affairs Puget Sound Healthcare System, Seattle, WA, USA., Adamkiewicz G; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Li CI; Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA., Hart JE; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Hospital and Harvard Medical School, Boston, MA, USA.
Source: Cancer epidemiology [Cancer Epidemiol] 2025 Oct; Vol. 98, pp. 102899. Date of Electronic Publication: 2025 Jul 29.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101508793 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1877-783X (Electronic) Linking ISSN: 18777821 NLM ISO Abbreviation: Cancer Epidemiol Subsets: MEDLINE
Imprint Name(s): Original Publication: Amsterdam : Elsevier
MeSH Terms: Air Pollution*/adverse effects , Air Pollution*/statistics & numerical data , Neoplasms*/mortality , Neoplasms*/etiology , Neoplasms*/epidemiology , Environmental Exposure*/adverse effects , Environmental Exposure*/statistics & numerical data , Wildfires*/statistics & numerical data , Cancer Survivors*/statistics & numerical data, Humans ; United States/epidemiology ; Female ; Male ; Middle Aged ; Particulate Matter/adverse effects ; Particulate Matter/analysis ; SEER Program/statistics & numerical data ; Aged ; Adult ; Ozone/analysis ; Ozone/adverse effects ; Air Pollutants/adverse effects ; Nitrogen Dioxide/analysis ; Nitrogen Dioxide/adverse effects
Abstract: Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for this journal and was not involved in the editorial review or the decision to publish this article.
Background: Climate change has led to an increase in wildfires, a major source of air pollution, which may be particularly harmful to individuals diagnosed with cancer. The objective of this study was to examine the relationships of air pollution and wildfires with mortality risk among cancer survivors.
Methods: Surveillance, Epidemiology, and End Results (SEER) cancer registries provided information on 7,051,014 patients diagnosed with cancer from 2000 to 2021 in the United States. Cox regression was used to calculate adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) for the associations between exposures to particulate matter < 2.5 µm (PM 2.5 ), nitrogen dioxide (NO 2 ), ozone (O 3 ), and wildfires (estimated using high-resolution geospatial datasets) with all-cause and cause-specific mortality risk.
Results: There were 3,452,593 deaths, including 2,369,364 from cancer, 525,409 from cardiopulmonary, and 557,820 from other causes. Among cancer survivors, higher exposure to PM 2.5 and wildfires (but not NO 2 or O 3 ) were associated with increased risk for all-cause, cancer, and other mortality. The association between PM 2.5 and cancer mortality was stronger in counties more heavily impacted by wildfires (HR per 10 μg/m 3 in counties with ≥ median 0.39 wildfires per year: 1.17, 95 % CI 1.04-1.33) vs. no wildfires (HR 1.06, 95 % CI 0.97-1.15) (p interaction = 0.0064).
Conclusions: Among patients diagnosed with cancer, PM 2.5 air pollution, particularly in areas heavily impacted by wildfires, is associated with increased risk for mortality.
(Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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Grant Information: K01 DK125612 United States DK NIDDK NIH HHS; P30 ES000002 United States ES NIEHS NIH HHS; T32 CA094880 United States CA NCI NIH HHS
Contributed Indexing: Keywords: Air pollution; Cancer epidemiology; Cancer mortality; Cancer survival; Environmental epidemiology; PM(2.5); Wildfires
Substance Nomenclature: 0 (Particulate Matter)
66H7ZZK23N (Ozone)
0 (Air Pollutants)
S7G510RUBH (Nitrogen Dioxide)
Entry Date(s): Date Created: 20250730 Date Completed: 20250909 Latest Revision: 20250911
Update Code: 20250911
PubMed Central ID: PMC12341480
DOI: 10.1016/j.canep.2025.102899
PMID: 40737820
Database: MEDLINE
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