Association between PM2.5 and mortality of stomach and colorectal cancer in Xi’an: a time-series study

Globally, fine particulate matter has been associated with several health problems including cancer. However, most studies focused mainly on lung cancer. Stomach and colorectal cancers play significant roles in increasing public health's cancer globally. This study focused on investigating a possible significant association between exposure to fine particulate matter (PM2.5) and mortality due to stomach and colorectal cancer in Xi'an from 2014 to 2016. Using time-series analysis, the study applied both single and multi-pollutant(s) approaches for investigations; PM2.5 was the pollutant of interest. Generalized additive model (GAM) was the core statistical method used with the addition of distributed lag model (DLM) to observe delayed effects. As a single pollutant, PM2.5 was significantly associated with stomach cancer mortality only RR (95%CI): 1.0003 (1.0001, 1.002). For the multi-pollutant analysis, PM2.5 combinations with NO2 were significantly associated with both stomach and colorectal cancer mortality RR (95%CI): 1.0103 (1.009, 1.021) and 1.054 (1.0324, 1.0667), respectively. Also, PM2.5 combination with O3 was significantly associated with colorectal cancer mortality, RR (95%CI): 1.0151 (1.0091, 1.0172), but no association was noted for combination with SO2. Though this study has reported significant associations, it will be beneficial for the public's health if more studies further investigate the relationship between exposure to PM2.5 and other cancer mortality.