Fine Particulate Matter Air Pollution and Mortality among Pediatric, Adolescent, and Young Adult Cancer Patients.

Background: Air pollution is a carcinogen and causes pulmonary and cardiac complications. We examined the association of fine particulate matter pollution (PM _2.5 ) and mortality from cancer and all causes among pediatric, adolescent, and young adult (AYA) patients with cancer in Utah, a state with considerable variation in PM _2.5 .
Methods: We followed 2,444 pediatric (diagnosed ages 0-14) and 13,459 AYA (diagnosed ages 15-39) patients diagnosed in 1986-2015 from diagnosis to 5 and 10 years postdiagnosis, death, or emigration. We measured average monthly PM _2.5 by ZIP code during follow-up. Separate pediatric and AYA multivariable Cox models estimated the association of PM _2.5 and mortality. Among AYAs, we examined effect modification of PM _2.5 and mortality by stage while controlling for cancer type.
Results: Increases in PM _2.5 per 5 μg/m ³ were associated with cancer mortality in pediatric lymphomas and central nervous system (CNS) tumors at both time points, and all cause mortality in lymphoid leukemias [HR _5-year = 1.32 (1.02-1.71)]. Among AYAs, PM _2.5 per 5 μg/m ³ was associated with cancer mortality in CNS tumors and carcinomas at both time points, and all cause mortality for all AYA cancer types [HR _5-year = 1.06 (1.01-1.13)]. PM _2.5 ≥12 μg/m ³ was associated with cancer mortality among breast [HR _5-year = 1.50 (1.29-1.74); HR _10-year = 1.30 (1.13-1.50)] and colorectal cancers [HR _5-year = 1.74 (1.29-2.35); HR _10-year = 1.67 (1.20-2.31)] at both time points. Effect modification by stage was significant, with local tumors at highest risk.
Conclusions: PM _2.5 was associated with mortality in pediatric and AYA patients with specific cancers.
Impact: Limiting PM _2.5 exposure may be important for young cancer patients with certain cancers. See all articles in this CEBP Focus section, "Environmental Carcinogenesis: Pathways to Prevention."
(©2020 American Association for Cancer Research.)