| Title: | Air pollution and the risk of second primary lung cancer among lung cancer survivors: the prospective UK Biobank cohort study |
| Journal: | British Journal of Cancer |
| Published: | 27 Apr 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42045539/ |
| DOI: | https://doi.org/10.1038/s41416-026-03454-6 |
| URL: | https://www.nature.com/articles/s41416-026-03454-6.pdf |
Publication 17826
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BackgroundLung cancer survivors have a high risk of second primary lung cancer (SPLC). While air pollution is associated with the risk of initial primary lung cancer (IPLC), especially in never smokers, its effect on SPLC risk is unknown.MethodsWe identified 2439 IPLC patients from the UK Biobank, followed through 2017, linking baseline addresses to 2005-2007 annual average exposures of particulate matter (PM10) and nitrogen dioxide (NO2) from the EU-wide Land Use Regression model. Associations with SPLC risk were assessed using cause-specific Cox models adjusted for co-pollutants, socioeconomic factors, smoking, and tumour characteristics.ResultsOf 2439 IPLC patients, 92 (3.7%) developed SPLC over 6561 person-years. The 10-year cumulative incidence of SPLC was 3.98% (3.11-4.85%). A dose-response relationship was observed between PM10 and SPLC risk, with an adjusted hazard ratio (aHR) of 6.43 (2.38-17.32) in the highest vs. lowest (aHR = 1.69 [0.68-4.19]) quintile; a co-pollutant NO2 showed an aHR of 0.96 (0.93-0.99). The PM10 effect was pronounced in never-smoking (aHR = 2.26 [1.22-4.18]) vs. ever-smoking IPLC patients (aHR = 1.42 [1.21-1.68]) on the risk of non-small cell SPLC.InterpretationExposure to PM10 may increase SPLC risk in lung cancer survivors, highlighting the potential value of incorporating environmental factors into SPLC surveillance to identify high-risk individuals.</p>
10 Authors
- Eunji Choi
- Sophia Luo
- Victoria Y. Ding
- Anna Graber-Nadich
- Julie T. Wu
- Rita Popat
- Iona Cheng
- Joel W. Neal
- Heather A. Wakelee
- Summer S. Han
Enabling scientific discoveries that improve human health