Association between indoor air pollution and risk of oesophageal cancer: a Chinese population-based case–control study
Abstract
Abstract Introduction Oesophageal cancer is a highly lethal malignancy with geographic disparity and a heavy burden in developing countries. While smoking and alcohol are established risk factors, emerging evidence suggests that indoor air pollution (IAP) may also play a role through the inhalation of aerosols along the aerodigestive tract, but its relationship with oesophageal cancer remains poorly understood. Previous studies have focused on how IAP is associated with lung cancer, and evidence on oesophageal cancer is sparse, underpowered and inconclusive. Methods This population-based case–control study was conducted in the Jiangsu Province, China, from 2003 to 2010. We analysed 2969 cases and 8019 controls using unconditional logistic regression, adjusting for potential confounders. In addition to the six individual household air pollution sources, we also studied their combined effect by calculating the unweighted and weighted sum of these IAP sources to improve comparability. Furthermore, we conducted subgroup analyses by sex and smoking status, as well as by sex exclusively among non-smokers. Results In both the overall sample and subgroups, higher exposure to various individual or combined IAP sources was associated with a dose-response increase in oesophageal cancer risk (weighted risk score (WRS) semi-Bayesian (SB)-adjusted OR (aOR): 2.70; 95% CI 2.36 to 3.07). Solid fuels appeared to have the strongest association (SB-aOR: 1.76; 95% CI 1.56 to 1.98), followed by…
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