County‐level cumulative environmental quality associated with cancer incidence

Jagai, Jyotsna S.; Messer, Lynne C.; Rappazzo, Kristen M.; Gray, Christine L.; Grabich, Shannon C.; Lobdell, Danelle T.

doi:10.1002/cncr.30709

Cited by 47 publications

(30 citation statements)

References 37 publications

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“…Such exposures include urban air pollution, particularly diesel exhaust, water pollution, pesticides in food, ionizing radiation and work-related chemicals [2]. Using the same SEER county cancer incidence data (2006-2010), Jagai and colleagues found a strong association between all-site cancer incidence and a measure of overall environmental quality, the Environmental Quality Index (which, developed by the U.S. EPA, combines measures of environmental quality in five domains: air, water, land, built environment and sociodemographic factors) [19].…”

Section: Discussionmentioning

confidence: 99%

Cancer rates not explained by smoking: a county-level analysis

et al. 2020

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Background: Debates over the importance of "lifestyle" versus "environment" contributions to cancer have been going on for over 40 years. While it is clear that cigarette smoking is the most significant cancer risk factor, the contributions of occupational and environmental carcinogens in air, water and food remain controversial. In practice, most cancer prevention messaging focuses on reducing cigarette smoking and changing other personal behaviors with little mention of environmental chemicals, despite widespread exposure to many known carcinogens. To inform decision-making on cancer prevention priorities, we evaluated the potential impact of smoking cessation on cancer rates. Methods: Using cancer incidence data from 612 counties in the SEER database, and county-level smoking prevalences, we investigated the impact of smoking cessation on incidence for 12 smoking-related cancer types, 2006-2016. A multilevel mixed-effects regression model quantified the association between county-level smoking prevalence and cancer incidence, adjusting for age, gender and variability over time and among counties. We simulated complete smoking cessation and estimated the effects on county-level cancer rates. Results: Regression models showed the expected strong association between smoking prevalence and cancer incidence. Simulating complete smoking cessation, the incidence of the 12 smoking-related cancer types fell by 39.8% (54.9% for airways cancers; 28.9% for non-airways cancers). And, while the actual rates of smoking-related cancers from 2006 to 2016 declined (annual percent change (APC) = − 0.8, 95% CI = − 1.0 to − 0.5%), under the scenario of smoking elimination, the trend in cancer incidence at these sites was not declining (APC = − 0.1, 95% CI = − 0.4 to + 0.1%). Not all counties were predicted to benefit equally from smoking elimination, and cancer rates would fall less than 10% in some counties. Conclusions: Smoking prevention has produced dramatic reductions in cancer in the US for 12 major types. However, we estimate that eliminating smoking completely would not affect about 60% of cancer cases of the 12 smoking-related types, leaving no improvement in the incidence trend from 2006 to 2016. We conclude that cancer prevention strategies should focus not only on lifestyle changes but also the likely contributions of the full range of risk factors, including environmental/occupational carcinogens.

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Section: Discussionmentioning

confidence: 99%

Cancer rates not explained by smoking: a county-level analysis

et al. 2020

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“…The EQI was constructed to describe the ambient county-level environmental conditions to which residents are exposed [ 17 , 18 ] and was designed to represent simultaneous exposure to several different potential sources of environmental factors. Previously, the EQI has been applied to estimate associations between the cumulative environmental quality and preterm birth, cancer incidence, and non-accidental mortality in the U.S. [ 19 , 26 , 27 ].…”

Section: Methodsmentioning

confidence: 99%

Effect Modification by Environmental Quality on the Association between Heatwaves and Mortality in Alabama, United States

Jian

Gohlke

2017

IJERPH

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Background: Previous studies have shown that heatwaves are associated with increased mortality. However, it remains unclear whether the associations between heatwaves and mortality are modified by the environmental quality. Methods: We used the United States (US) Environmental Protection Agency’s Environmental Quality Index (EQI) and its five domain indices (air, water, land, built, and sociodemographic) to represent the cumulative environmental quality. We applied a time-stratified case-crossover design to analyze the disparities in the association between heatwaves and non-accidental deaths (NAD) among counties with different environmental qualities, in metropolitan areas in Alabama (AL), United States. Results: We found significant associations between heatwaves and NAD and a significant effect modification of this relationship by EQI. There were higher odds ratios in counties with the worst cumulative environmental qualities compared to counties with the best cumulative environmental qualities. For example, the percent change in odds ratio (mean and (95% CI)) between heatwave days and non-heatwave days was −10.3% (−26.6, 9.6) in counties with an overall EQI of 1 (the best overall environment) and 13.2% (4.9, 22.2) in counties with an overall EQI of 3 (the worst overall environment). Among the five domains, air quality had the strongest effect modification on the association. Conclusion: Our findings provide evidence that the associations between heatwaves and NAD vary among areas with different environmental qualities. These findings suggest that integration of air quality and heatwave warning systems may provide greater protection to public health.

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“…Spatial heterogeneity of exposure occurs when there is an uneven distribution of various concentrations of chemicals and exposures within a given spatial area, and it has been a problem in studies of exposures to airborne contaminants. 12,14 When the population was organized by population geography, spatial heterogeneity of exposure has caused problems in studies looking at agricultural exposures and birth defects, 15,16 environmental movement of contaminants and neural tube defects, 17 urban environment exposures and cancer incidence, 18 and iodine exposure and thyroid cancer. 19 We propose that environmental assessment of contaminant exposure via natural waters can best be dealt with when the watershed is used as the defining geospatial boundary.…”

Section: Relationship Between Watershed Boundaries and Population Geomentioning

confidence: 99%

Using Watershed Boundaries to Map Adverse Health Outcomes: Examples From Nebraska, USA

Corley

Bartelt–Hunt

Rogan

et al. 2018

Environ�Health�Insights

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In 2009, a paper was published suggesting that watersheds provide a geospatial platform for establishing linkages between aquatic contaminants, the health of the environment, and human health. This article is a follow-up to that original article. From an environmental perspective, watersheds segregate landscapes into geospatial units that may be relevant to human health outcomes. From an epidemiologic perspective, the watershed concept places anthropogenic health data into a geospatial framework that has environmental relevance. Research discussed in this article includes information gathered from the literature, as well as recent data collected and analyzed by this research group. It is our contention that the use of watersheds to stratify geospatial information may be both environmentally and epidemiologically valuable.

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County‐level cumulative environmental quality associated with cancer incidence

Cited by 47 publications

References 37 publications

Cancer rates not explained by smoking: a county-level analysis

Cancer rates not explained by smoking: a county-level analysis

Effect Modification by Environmental Quality on the Association between Heatwaves and Mortality in Alabama, United States

Using Watershed Boundaries to Map Adverse Health Outcomes: Examples From Nebraska, USA

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