Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Correlation Between Nitrogen Dioxide as an Air Pollution Indicator and Breast Cancer: a Systematic Review and Meta-Analysis

  • Keramatinia, Aliasghar (Cancer Research Center, Shahid Beheshti University of Medical Sciences) ;
  • Hassanipour, Soheil (Department of Epidemiology and Biostatistics, School of Public Health and Health Care Research Institute, Tehran University of Medical Sciences) ;
  • Nazarzadeh, Milad (Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences) ;
  • Wurtz, Morten (Department of Cardiology, Aarhus University Hospital) ;
  • Monfared, Ayad Bahadori (Department of Social Medicine, Medical School, Shahid Beheshti University of Medical Sciences) ;
  • Khayyamzadeh, Maryam (Cancer Research Center, Shahid Beheshti University of Medical Sciences) ;
  • Bidel, Zeinab (Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences) ;
  • Mhrvar, Narges (Cancer Research Center, Shahid Beheshti University of Medical Sciences) ;
  • Mosavi-Jarrahi, Alireza (Department of Social Medicine, Medical School, Shahid Beheshti University of Medical Sciences)
  • Published : 2016.02.05
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Abstract

Background: The aim of this systematic review was to study the relationship between exposure to nitrogen dioxide ($NO_2$) in the ambient air and breast cancer incidence. Materials and Methods: A systematic review was performed based on the MOOSE guideline for review of observational studies. We searched five online databases (PubMed, Science Direct, Google Scholar, EBSCO, and Scopus) from their conception to June 2014. A pooled estimate of the correlation between $NO_2$ exposure and breast cancer incidence was calculated using Pearson's correlation coefficient. Results: A total of 654 titles were retrieved in the initial search of the databases. Further refinement and screening of the retrieved studies produced a total of five studies from four countries. The studies included three ecological studies (aggregate level) and two individual based studies (one prospective cohort and the other one a case-control study). The ecological studies were pooled and the meta-analysis of correlation coefficient without z transformation showed a pooled estimate of r = 0.89 with 95% CI of 0.84 to 0.95. Using z transformation, the pooled r was 1.38 with 95%CI of 1.11 to 1.59. No significant heterogeneity between studies was observed. Following a sensitivity analysis and the removal of each study from pooled analysis we did not see any significant change in the pooled estimate. Conclusions: It was concluded that there is a tendency toward a weak association between exposure to $NO_2$ in ambient air and breast cancer at the individual level and a significant association at the aggregate level.

Keywords

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