Chen Ee Low, Sean Loke, Ga Eun Pang, Ben Sim, Valerie Shiwen Yang
Psychological outcomes in patients with rare cancers: a systematic review and meta-analysis
EClinicalMedicine
fine particulate matter pm25 exposure associated liver cancer incidence mortality limited number studies sought evaluate relationship first time us cohort historical exposure assessment used spatiotemporal prediction models estimate annual average historical pm25 concentrations 19802015 residential addresses 499729 participants nihaarp diet health study cohort 6 states california florida louisiana new jersey north carolina pennsylvania 2 metropolitan areas atlanta georgia detroit michigan enrolled 19951996 followed 2017 used timevarying cox model estimate association liver cancer predominant histologic type hepatocellular carcinoma hcc per 5 gm3 increase estimated outdoor pm25 levels incorporating 5year average lagged 10 years prior cancer diagnosis adjusting age sex raceethnicity education level catchment state also evaluated pm25 interactions hypothesized effect modifiers observed nonsignificantly increased risk liver cancer associated estimated pm25 exposure hazard ratio hr 105 096114 n 1625 associations slightly stronger hcc 84 cases hr 108 098118 participants aged 70 older enrollment increased risk liver cancer versus age groups hr 150 101223 pinteraction 001 risk elevated among participants exercise hr 181 122270 pinteraction 001 found evidence effect modification sex smoking status body mass index diabetes status alcohol consumption pinteraction 005 findings large cohort suggest residential ambient pm25 levels may associated liver cancer risk exploration variation associations age physical activity important areas future research