Impact of Residential Concentration of PM2.5 Analyzed as Time-Varying Covariate on the Survival Rate of Lung Cancer Patients: A 15-Year Hospital-Based Study in Upper Northern Thailand

Nawapon Nakharutai, Patrinee Traisathit, Natthapat Thongsak, Titaporn Supasri, Pimwarat Srikummoon, Salinee Thumronglaohapun, Phonpat Hemwan and Imjai Chitapanarux
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Nawapon Nakharutai: Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
Patrinee Traisathit: Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
Natthapat Thongsak: Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
Titaporn Supasri: Atmospheric Research Unit, National Astronomical Research Institute of Thailand, Chiang Mai 50180, Thailand
Pimwarat Srikummoon: Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
Salinee Thumronglaohapun: Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
Phonpat Hemwan: Department of Geography, Faculty of Social Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
Imjai Chitapanarux: Northern Thai Research Group of Therapeutic Radiology and Oncology (NTRG-TRO), Divisions of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

IJERPH, 2022, vol. 19, issue 8, 1-13

Abstract: Air pollutants, especially particulate matter (PM) ≤ 2.5 µm (PM2.5) and PM ≤ 10 µm (PM10), are a major concern in upper northern Thailand. Data from a retrospective cohort comprising 9820 lung cancer patients diagnosed from 2003 to 2018 were obtained from the Chiang Mai Cancer Registry, and used to evaluate mortality and survival rates. Cox proportional hazard models were used to identify the association between the risk of death and risk factors including gender, age, cancer stage, smoking history, alcohol-use history, calendar year of enrollment, and time-updated PM2.5, PM10, NO 2 and O 3 concentrations. The mortality rate was 68.2 per 100 persons per year of follow-up. In a multivariate analysis, gender, age, cancer stage, calendar year of enrollment, and time-varying residential concentration of PM2.5 were independently associated with the risk of death. The lower the annually averaged PM2.5 and PM10 concentrations, the higher the survival probability of the patient. As PM2.5 and PM10 were factors associated with a higher risk of death, lung cancer patients who are inhabitant in the area should reduce their exposure to high concentrations of PM2.5 and PM10 to increase survival rates.

Keywords: lung cancer; mortality rate; PM2.5; PM10; survival rate (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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