Exposure to radon and heavy particulate pollution and incidence of brain tumors

Author:

Palmer Joshua D1ORCID,Prasad Rahul N1,Cioffi Gino23ORCID,Kruchtko Carol4,Zaorsky Nicholas G4,Trifiletti Daniel M5ORCID,Gondi Vinai6,Brown Paul D7,Perlow Haley K1,Mishra Mark V8,Chakravarti Arnab1,Barnholtz-Sloan Jill S239,Ostrom Quinn T2101112

Affiliation:

1. Department of Radiation Oncology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Comprehensive Cancer Center , Columbus, Ohio , USA

2. Central Brain Tumor Registry of the United States, Hinsdale , Illinois , USA

3. Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute , Bethesda, Maryland , USA

4. Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University School of Medicine , Cleveland, Ohio , USA

5. Department of Radiation Oncology, Mayo Clinic Florida , Jacksonville, Florida , USA

6. Brain and Spine Tumor Center, Northwestern Medicine Cancer Center and Proton Center , Warrensville, Illinois , USA

7. Department of Radiation Oncology, Mayo Clinic , Rochester, Minnesota , USA

8. Department of Radiation Oncology, University of Maryland , Baltimore, Maryland , USA

9. Center for Biomedical Informatics and Information Technology (CBIIT), National Cancer Institute , Bethesda, Maryland , USA

10. Department of Neurosurgery, Duke University School of Medicine , Durham, North Carolina , USA

11. The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine , Durham, North Carolina , USA

12. Duke Cancer Institute, Duke University Medical Center , Durham, North Carolina , USA

Abstract

Abstract Background Global incidence for brain tumors varies substantially without explanation. Studies correlating radon exposure and incidence are inconclusive. Particulate pollution has been linked to increased tumor incidence. Particulates may disrupt the blood-brain barrier allowing intracranial exposure to oncogenic radon. We investigated the relationship between exposure to residential radon, particulate pollution, and brain tumor incidence in the United States (US). Methods County-level median radon testing results and annual air quality index values were obtained and divided into tertiles. Counties without both values were excluded. Four groups of counties were generated: high particulate/high radon (high/high), high/low, low/high, and low/low. Using incidence data from the Central Brain Tumor Registry of the US (provided by CDC’s National Program of Cancer Registries and NCI’s SEER), annual age-adjusted incidence rates (AAAIRs) by group were generated by behavior. Incidence rate ratios were calculated to examine for significant differences (α = .05). Poisson regression accounting for possible confounders was conducted. Results Counties with available data included 83% of the US population. High/high exposure was significantly associated with increased AAAIR of all non-malignant tumors (up to 26% higher, including most meningiomas) even after accounting for potential confounders. An increased AAAIR was noted for all malignant tumors (up to 10% higher), including glioblastoma, but was negated after accounting for demographic/socioeconomic differences. Conclusions We present the first report suggesting increased non-malignant brain tumor incidence in regions with high particulate and radon exposure. These findings provide insight into unexplained variation in tumor incidence. Future studies are needed to validate these findings in other populations.

Funder

Centers for Disease Control and Prevention

American Brain Tumor Association

Sontag Foundation

Novocure

Musella Foundation

National Brain Tumor Society

Pediatric Brain Tumor Foundation

Uncle Kory Foundation

Zelda Dorin Tetenbaum Memorial Fund

National Cancer Institute

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Neurology (clinical),Oncology

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