Fine particulate matter (PM) exposure has been associated with liver cancer incidence and mortality in a limited number of studies. We sought to evaluate this relationship for the first time in a U.S. cohort with historical exposure assessment. We used spatiotemporal prediction models to estimate annual average historical PM concentrations (1980–2015) at residential addresses of 499,729 participants in the NIH-AARP Diet and Health Study, a cohort in 6 states (California, Florida, Louisiana, New Jersey, North Carolina, and Pennsylvania) and 2 metropolitan areas (Atlanta, Georgia, and Detroit, Michigan) enrolled in 1995–1996 and followed up through 2017. We used a time-varying Cox model to estimate the association for liver cancer and the predominant histologic type, hepatocellular carcinoma (HCC), per 5 µg/m increase in estimated outdoor PM levels, incorporating a 5-year average, lagged 10 years prior to cancer diagnosis and adjusting for age, sex, race/ethnicity, education level and catchment state. We also evaluated PM interactions with hypothesized effect modifiers. We observed a non-significantly increased risk of liver cancer associated with estimated PM exposure (Hazard ratio [HR] = 1.05 [0.96–1.14], N = 1,625); associations were slightly stronger for HCC, (84 % of cases; HR = 1.08 [0.98–1.18]). Participants aged 70 or older at enrollment had an increased risk of liver cancer versus other age groups (HR = 1.50 [1.01–2.23]); p-interaction = 0.01) and risk was elevated among participants who did not exercise (HR = 1.81 [1.22–2.70]; p-interaction = 0.01). We found no evidence of effect modification by sex, smoking status, body mass index, diabetes status, or alcohol consumption (p-interaction > 0.05). Our findings in this large cohort suggest that residential ambient PM levels may be associated with liver cancer risk. Further exploration of the variation in associations by age and physical activity are important areas for future research.

中文翻译：

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NIH-AARP 饮食与健康研究中长期暴露于环境细颗粒物与肝癌风险

在有限的研究中，细颗粒物 (PM) 暴露与肝癌的发病率和死亡率相关。我们首次试图在美国队列中通过历史暴露评估来评估这种关系。我们使用时空预测模型来估计 NIH-AARP 饮食与健康研究中 499,729 名参与者居住地址的年平均历史 PM 浓度（1980 年至 2015 年），该研究涉及 6 个州（加利福尼亚州、佛罗里达州、路易斯安那州、新泽西州、北卡罗来纳州）和宾夕法尼亚州）和 2 个大都市区（佐治亚州亚特兰大和密歇根州底特律）于 1995 年至 1996 年入组并随访至 2017 年。我们使用时变 Cox 模型来估计肝癌与主要组织学类型的关联，考虑到 5 年平均值，估计室外 PM 水平每增加 5 µg/m2，肝细胞癌 (HCC) 的发生率就比癌症诊断前滞后 10 年，并根据年龄、性别、种族/族裔、教育水平和流域州进行调整。我们还评估了 PM 与假设的效应调节剂的相互作用。我们观察到，与估计的 PM 暴露相关的肝癌风险并未显着增加（风险比 [HR] = 1.05 [0.96–1.14]，N = 1,625）；与 HCC 的相关性稍强（84% 的病例；HR = 1.08 [0.98–1.18]）。与其他年龄组相比，入组时年龄为 70 岁或以上的参与者患肝癌的风险更高（HR = 1.50 [1.01–2.23]）； p 交互作用 = 0.01），不运动的参与者的风险升高（HR = 1.81 [1.22–2.70]；p 交互作用 = 0.01）。我们没有发现性别、吸烟状况、体重指数、糖尿病状况或饮酒量影响效果的证据（p 交互作用 > 0.05）。我们在这个大型队列中的研究结果表明，居住环境 PM 水平可能与肝癌风险相关。进一步探索年龄和身体活动之间的关联变化是未来研究的重要领域。