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Overall environmental quality and cancer incidence
Jagai, J., L. Messer, K. Rappazzo, C. Gray, S. Grabich, AND D. Lobdell. Overall environmental quality and cancer incidence. Society for Epidemiologic Research, Denver, CO, June 16 - 19, 2015.
This abstract demonstrates the utility of the Environmental Quality Index in assessing environmental exposures related to cancer incidence.
Cancer is associated with individual ambient environmental exposures such as fine particulate matter and arsenic in drinking water. However, the role of the overall ambient environment is not well-understood. To estimate cumulative environmental exposures, an Environmental Quality Index (EQI) for 2000-2005 was constructed representing five environmental domains (air, water, land, built and sociodemographic) for each U.S. county (n=3141). Annual county-level, age-adjusted, cancer incidence rates (per 100,000) for 2006-2010 from Surveillance, Epidemiology, and End Results Program (SEER) were linked to the EQI. Sex stratified random intercept fixed slope linear models, for EQI quintiles and cancer incidence, were estimated, adjusting for county percentage of ever-smoked. Incidence rate differences (95% CI) comparing highest quintile/worst environmental quality to lowest quintile/best quality are reported. All cause cancer was positively associated with EQI in both sexes (males: 32.6 (16.3,48.9), females: 36.4(27.6,45.3)). Models were also stratified by four rural-urban continuum codes (RUCC) ranging from metropolitan urbanized (RUCC1) to rural (RUCC4). We observed positive associations between all cause cancer and EQI for most strata for males (RUCC1: 27.0(11.3,42.7); RUCC2: 11.3(-18.1,40. 7), RUCC3: 25.7(3.9,47.5), RUCC4: -12.1(-50.7,26.4)) and across all strata for females (RUCC1: 30.0(17.2,42.8); RUCC2: 28.5(14.4,42.7), RUCC3: 16.3(2.1,30.5), RUCC4: 1.5(0.8,3.0)). The strongest associations were seen in the most urbanized areas for both sexes. In addition, we assessed associations with the primary cancer types for both sexes, lung, breast, prostate, and colorectal cancers. Associations by individual environmental domains (i.e., air, water, land, etc.) will also be presented. These results suggest that cumulative environmental exposure is associated with cancer risk, and associations vary by urbanicity. This abstract does not necessarily reflect EPA policy.