Ambient air pollution, cancer risk, and survival using an American Cancer Society prospective cohort

Outdoor air pollution is an established lung carcinogen. In this thesis, we examined associations of outdoor air pollution and incidence of cancers other than lung cancer, as well as the role of air pollution in lung cancer survival. Ambient air pollution data was linked to ~108,000 participants in the U.S. Cancer Prevention Study-II Nutrition cohort and updated in a time-varying manner annually during follow-up from 1992-2017. Associations with cancer incidence were examined. Coarse particulates and gaseous pollutant indicators were adversely associated with colorectal, cervical, kidney, melanoma skin cancers, as well as with incidence of several hematologic cancer subtypes. Although recent air pollution exposures were not adversely associated with lung cancer survival overall, some pollutants were associated with poorer survival in patients with early-stage disease. This thesis suggests that outdoor air pollution may be involved in development of some cancers beyond lung cancer. Findings with lung cancer survival should be evaluated in future research.