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DOI10.1002/cncr.30709
County-Level Cumulative Environmental Quality Associated With Cancer Incidence
Jagai, Jyotsna S.1; Messer, Lynne C.2; Rappazzo, Kristen M.3; Gray, Christine L.4,5; Grabich, Shannon C.4,5; Lobdell, Danelle T.3
发表日期2017-08-01
ISSN0008-543X
卷号123期号:15页码:2901-2908
英文摘要

BACKGROUND: Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains. METHODS: The EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with domain-specific indices and analyses were stratified by rural/urban status. RESULTS: Comparing the highest quintile/poorest environmental quality with the lowest quintile/best environmental quality for overall EQI, all-site county-level cancer incidence rate was positively associated with poor environmental quality overall (IRD, 38.55; 95% CI, 29.57-47.53) and for male (IRD, 32.60; 95% CI, 16.28-48.91) and female (IRD, 30.34; 95% CI, 20.47-40.21) subjects, indicating a potential increase in cancer incidence with decreasing environmental quality. Rural/urban stratified models demonstrated positive associations comparing the highest with the lowest quintiles for all strata, except the thinly populated/rural stratum and in the metropolitan/urbanized stratum. Prostate and breast cancer demonstrated the strongest positive associations with poor environmental quality. CONCLUSION: We observed strong positive associations between the EQI and all-site cancer incidence rates, and associations differed by rural/urban status and environmental domain. Research focusing on single environmental exposures in cancer development may not address the broader environmental context in which cancers develop, and future research should address cumulative environmental exposures. (c) 2017 American Cancer Society.


英文关键词all-site cancer;cumulative environmental exposures;air;water;land;built;sociodemographic
语种英语
WOS记录号WOS:000405826400016
来源期刊CANCER
来源机构美国环保署
文献类型期刊论文
条目标识符http://gcip.llas.ac.cn/handle/2XKMVOVA/61394
作者单位1.Univ Illinois, Sch Publ Hlth, Div Environm & Occupat Hlth Sci, Chicago, IL USA;
2.Portland State Univ, Coll Urban & Publ Affairs, Sch Community Hlth, Portland, OR 97207 USA;
3.US EPA, Natl Hlth & Environm Effects Res Lab, Chapel Hill, NC USA;
4.Univ N Carolina, Gillings Sch Global Publ Hlth, Chapel Hill, NC USA;
5.US EPA, Oak Ridge Inst Sci & Educ, Natl Hlth & Environm Effects Res Lab, Chapel Hill, NC USA
推荐引用方式
GB/T 7714
Jagai, Jyotsna S.,Messer, Lynne C.,Rappazzo, Kristen M.,et al. County-Level Cumulative Environmental Quality Associated With Cancer Incidence[J]. 美国环保署,2017,123(15):2901-2908.
APA Jagai, Jyotsna S.,Messer, Lynne C.,Rappazzo, Kristen M.,Gray, Christine L.,Grabich, Shannon C.,&Lobdell, Danelle T..(2017).County-Level Cumulative Environmental Quality Associated With Cancer Incidence.CANCER,123(15),2901-2908.
MLA Jagai, Jyotsna S.,et al."County-Level Cumulative Environmental Quality Associated With Cancer Incidence".CANCER 123.15(2017):2901-2908.
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