Air Pollution and Lung Cancer - The IASLC Position Statement

Air Pollution and Lung Cancer - The IASLC Position Statement

Press Release
Apr 22, 2022
Joan H. Schiller
Christine D. Berg
Stephen Lam
Charu Aggarwal
Eric Bernicker
Paolo Boffetta
Milena Cavic
Jonathon Dowell
Regan Duffy
Ivy Elkins
David Gerber
Rudolf M. Huber
Samuel A. Kareff
Stephen Liu
Corey Langer, MD
Laura Mezquita
Renelle Myers
Jacquelyn E. Nixon
Kurt Oettel
Sandeep Patel
Nathan Penell
M. Patricia Rivera
Upal Basu Roy
Rachel Sanborn
David Spigel
Anne Traynor
Vamsi Velcheti
Howard (Jack) West
Jun Zhang

Lung cancer is a complicated disease with many causes. Among them are tobacco smoke, radon, and asbestos. However, one largely overlooked cause is the relationship between air pollution and lung cancer.

There have been numerous basic, translational, and epidemiological studies demonstrating that air pollution causes approximately 14% of lung cancer cases  worldwide.1   A substantial body of evidence regarding air pollution and risk of mortality comes from survival studies of cohorts that evaluated air pollution-mortality associations while controlling for important risk factors.1 Several epidemiological studies have shown that people living in areas with high air pollution are more likely to die of lung cancer than those who do not, including people who have never smoked.2 3 4  

Outdoor air pollution and its major component, particulate matter, have been rated as Group 1 carcinogens by the International Agency for Research on Cancer.5 Although many components of outdoor ambient air pollution are harmful to one’s health, one of the worst culprits is Particulate Matter 2.5 (PM2.5). Chronic, persistent exposure to PM2.5 can exacerbate such diseases as chronic obstructive pulmonary disease and can cause lung cancer, even in people who have never smoked. Each 10µ/m3 increase in PM2.5 is estimated to be associated with a 14% increase in lung cancer mortality.6 Additionally, the increase in the number of hot days from the accumulation of atmospheric greenhouse gases can lead to an increase in ground-level ozone, increasing smog, decreasing air quality, and exacerbation of respiratory illnesses.

The International Association for the Study of Lung Cancer is the world’s largest professional organization dedicated to the prevention and treatment of lung cancer. As an international organization of lung cancer professionals and advocates serving people in both developed and developing countries, and vulnerable individuals living in areas with heavy air pollution, we support advocacy for clean air, and urge all health care organizations and relevant legislative bodies to support the IASLC policy statement.

IASLC:

  • Urges all relevant local, national, and international legislative bodies to restrict air emission targets to the lowest levels as recommended by the World Health Organization7
  • Encourages health organizations to advocate for reducing fossil fuel emissions and for clean, sustainable energy
  • Encourages collaboration among health organizations on climate advocacy and environmental sustainability
  • Encourages health organizations to disinvest themselves from fossil fuel companies.
  • Supports further research into the pathophysiological and carcinogenetic effects of PM2.5 and other pollutants on human health
  • Urges all health care organizations to lower their carbon footprint at national and international meetings by encouraging virtual participation and decreasing the amount of paper and waste generated by industry and non-industrial partners.
References
  • 1. a. b. Vohra K, Vodonos A, Schwartz J, et al: Global mortality from outdoor fine particle pollution generated by fossil fuel combustion: Results from GEOS-Chem. Environ Res 195:110754, 2021
  • 2. Berg C, Schiller J: World Conference on Lung Cancer 2021
  • 3. Turner MC, Andersen ZJ, Baccarelli A, et al: Outdoor air pollution and cancer: An overview of the current evidence and public health recommendations. CA Cancer J Clin, 2020
  • 4. Coleman NC, Burnett RT, Higbee JD, et al: Cancer mortality risk, fine particulate air pollution, and smoking in a large, representative cohort of US adults. Cancer Causes Control 31:767-776, 2020
  • 5. Loomis D, Grosse Y, Lauby-Secretan B, et al: The carcinogenicity of outdoor air pollution. Lancet Oncol 14:1262-3, 2013
  • 6. Pope CA, Thun MJ, Namboodiri MM, et al: Particulate air pollution as a predictor of mortality in a prospective study of U.S. adults. Am J Respir Crit Care Med 1995;151:669-74.
  • 7. World Health Organization (WHO). Ambient (outdoor) air pollution (includes WHO Air quality guideline values). 21 September 2021. https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-… (accessed 03/19/2022).

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About the Authors

Joan H. Schiller

University of Virginia, Adjunct Professor
Lung Cancer Research Foundation

Christine D. Berg

Oncology Screening Consultant

Stephen Lam

BC Cancer & the University of British Columbia

Charu Aggarwal

MD, MPH
University of Pennsylvania

Eric Bernicker

MD
Houston Methodist Hospital Cancer Center

Paolo Boffetta

MD, MPH
Stony Brook Cancer Center

Milena Cavic

Institute for Oncology and Radiology of Serbia

Jonathon Dowell

MD
UT Southwestern Medical Center

Regan Duffy

MD, MPH
Providence Cancer Center

Ivy Elkins

MBA
EGFResisters

David Gerber

MD
UT Southwestern Medical Center

Rudolf M. Huber

University of Munich

Samuel A. Kareff

University of Miami Sylvester Comprehensive Cancer Center/Jackson Memorial Hospital

Stephen Liu

MD
Georgetown University

Corey Langer, MD

University of Pennsylvania

Laura Mezquita

Hospital Clinic of Barcelona

Renelle Myers

BC Cancer & the University of British Columbia

Jacquelyn E. Nixon

Citizens for Radioactive Radon Reduction

Kurt Oettel

MD
Gunderson Clinic

Sandeep Patel

MD
University of California, San Diego

Nathan Penell

MD, PhD
Cleveland Clinic

M. Patricia Rivera

MD
University Of North Carolina

Upal Basu Roy

PhD, MPH
LUNGevity Foundation

Rachel Sanborn

MD
Earle A. Chiles Research Institute, Providence Cancer Institute

David Spigel

Sarah Cannon Research Institute

Anne Traynor

MD
University of Wisconsin, Madison

Vamsi Velcheti

MD
New York University

Howard (Jack) West

MD
City of Hope Comprehensive Cancer Center

Jun Zhang

University of Kansas Medical Center