Title: The effects of air pollution on mortality and clinicopathological features of esophageal cancer
Abstract: // Xiaochen Huang 1, * , Shanghui Guan 1, * , Jiangfeng Wang 1 , Linli Zhao 1 , Yibin Jia 1 , Zilong Lu 2 , Cuiping Yin 3 , Shengsi Yang 1 , Qingxu Song 1 , Lihui Han 1 , Cong Wang 1 , Jingyi Li 1 , Wei Zhou 1 , Xiaolei Guo 2 and Yufeng Cheng 1 1 Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China 2 Department of Noncommunicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan 250014, Shandong, China 3 Department of Rehabilitation, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China * These authors have contributed equally to this work and should be considered as co-first authors Correspondence to: Yufeng Cheng, email: [email protected] Xiaolei Guo, email: [email protected] Keywords: air pollution, PM 10 , esophageal cancer, mortality, clinicopathological features Received: December 15, 2016 Accepted: March 27, 2017 Published: April 20, 2017 ABSTRACT This study aimed to estimate the associations between air pollution and esophageal cancer. In the ecologic cross-sectional study, correlation analyses were made between city-level mean concentrations of particulate matter less than 10μm in aerodynamic diameter (PM 10 ), SO 2 , NO 2 and city-level age-standardized mortality rates of esophageal cancer in Shandong Province, China. PM 10 ( p =0.046) and NO 2 ( p =0.03) both had significant linear correlations with esophageal cancer mortality rates. After introducing smoking as a risk factor in models of multiple linear regression analyses, PM 10 was still an independent risk factor that increased esophageal cancer mortality rates. This study further compared clinicopathological features of 1,255 eligible esophageal squamous cell carcinoma patients by dividing them into different pollution level groups. There was statistically significant difference in gender distributions ( p =0.02) between groups after subgroup analysis. Female patients accounted for a higher proportion in the high PM 10 level group than in the low PM 10 level group. It suggested that females were more sensitive to higher PM 10 level pollution. The features that manifested the degree of malignancy of esophageal cancer, including primary tumor invasion, regional lymph nodes metastasis, histological grade, stage, lymph-vascular invasion and tumor size demonstrated no statistically significant difference between groups.