Investigating the Association Between Air Pollution Exposure and Oncotype DX Breast Cancer Recurrence Scores in Georgia between 2010–2017 Restricted; Files & ToC
Destin, Christy (Spring 2025)
Abstract
Breast cancer is the most commonly diagnosed cancer and the second most common cause of cancer-related mortality in the US. Similarly, air pollution (as measured by PM₂.₅ and NO₂) represents another public health crisis that contributes to poor health outcomes. Previous studies have suggested that ambient air pollution plays a role in the progression of breast cancer. Our study aimed to investigate whether high levels of air pollution were associated with an increased risk of a high Oncotype DX score among early-stage estrogen receptor (ER)-positive breast cancer patients diagnosed in Georgia between 2010 and 2017.
We used data from a Breast Investigation of Disparities in Georgia (BRIDGE) cohort, which is a cohort derived from the Georgia Cancer Registry (GCR), for information on breast cancer diagnoses. Information on air pollution data were compiled across the state of Georgia for the years 2000 to 2016. We identified 6,985 women to be included in the study. Patients were included if they identified as non-Hispanic Black or Non-Hispanic White, with stage I–III ER+ breast cancer and received an Oncotype DX test as part of their treatment work-up. Descriptive statics were performed to summarize the data across categories of Oncotype DX recurrence score groups. We used unadjusted and adjusted ordinal logistic regression models to assess the relationship between high levels of air pollution and the increased risk of high Oncotype Dx score.
We did not observe an association between PM2.5 or NO2 with increasing the Oncotype DX group in our study. In the unadjusted model, the odds ratio (OR) of the mean PM2.5 (per-5unit increase) was 1.19, with a 95% confidence interval (CI) 0.96 to 1.49. While the OR of the mean NO2 (per 5-unit increase) was 1.01, with a 95% CI 0.98 to 1.04 . The adjusted model adjusting for age, race and urban/rural status had a mean PM2.5 (per-5-unit increase) OR=1.01 with 95% CI= 0.77, 1.32. A 5-unit increase in NO2 exposure was associated with an OR of 0.98 95% CI: 0.95, 1.02 .
These findings show that we did not observe an association between ambient air pollution (PM₂.₅ and NO₂) exposure and high Oncotype DX scores. Further research will investigate if this association is modified by other individual-level and clinical factors.
Table of Contents
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File download under embargo until 15 May 2027 | 2025-04-24 10:18:12 -0400 | File download under embargo until 15 May 2027 |
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