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Statistical approaches to analyse the combined effect of seven air pollutants and breast cancer risk: a case–control study nested in the French E3N-Generations cohort

Title: Statistical approaches to analyse the combined effect of seven air pollutants and breast cancer risk: a case–control study nested in the French E3N-Generations cohort
Authors: Giampiccolo, Camille; Fervers, Béatrice; Coudon, Thomas; Praud, Delphine; Vigneron, Arnaud; Grassot, Lény; Mercoeur, Benoît; Faure, Elodie; Frenoy, Pauline; Génard-Walton, Maximilien; Couvidat, Florian; Severi, Gianluca; Romana Mancini, Francesca; Roy, Pascal; Amadou, Amina
Contributors: Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE); Université Claude Bernard Lyon 1 (UCBL); Université de Lyon-Université de Lyon-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS); Unité Ad Hoc INSERM 000008 "Radiations : Défense, Santé, Environnement" Lyon (Inserm U1296); Centre Léon Bérard Lyon -Université Lumière - Lyon 2 (UL2)-Service de Santé des Armées-Institut National de la Santé et de la Recherche Médicale (INSERM); Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL); Centre Léon Bérard Lyon -Université Claude Bernard Lyon 1 (UCBL); Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Centre de recherche en épidémiologie et santé des populations (CESP); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse; AP-HP. Université Paris Saclay-AP-HP. Université Paris Saclay-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay; Épidémiologie et recherches translationnelles sur les maladies rénales et cardiovasculaires (EPREC) (U1018 (Équipe 5)); AP-HP. Université Paris Saclay-AP-HP. Université Paris Saclay-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse; Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB); Établissement Français du Sang Auvergne-Rhône-Alpes Lyon (EFS Auvergne-Rhône-Alpes - Lyon); Établissement Français du Sang La Plaine Saint-Denis (EFS)-Établissement Français du Sang La Plaine Saint-Denis (EFS)-CHU de Grenoble-Alpes - Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA); Institut National de l'Environnement Industriel et des Risques (INERIS); Università degli Studi di Firenze = University of Florence = Université de Florence (UniFI); Hospices Civils de Lyon (HCL); Ministère de l'enseignement supérieur, de la recherche et de l'innovation; ANR-10-COHO-0006,E4N,Etude Epidémiologique des Enfants de femmes de l'Education Nationale(2010)
Source: ISSN: 1741-7015.
Publisher Information: CCSD; BioMed Central
Publication Year: 2026
Collection: Université de Versailles Saint-Quentin-en-Yvelines: HAL-UVSQ
Subject Terms: Cohort; Cohort study; Air pollution; Statistical analysis; Pollutant; Air pollutants; Breast cancer; [SDE]Environmental Sciences
Description: International audience ; Background: Air pollution is a complex mixture of closely correlated pollutants, making it challenging to assess both the overall mixture effect and to isolate the individual impact of each pollutant on breast cancer (BC) risk. This study assessed the effect of exposure to a mixture of seven correlated air pollutants (benzo[a]pyrene, cadmium, dioxins, polychlorinated biphenyl 153 (PCB153), nitrogen dioxide (NO2), particulate matter (PM2.5 and PM10)) on BC risk.Methods: The study was based on a case-control study nested within the French E3N-Generations cohort (5222 incident BC cases/5222 matched controls). Annual average concentrations of each pollutant were estimated using the CHIMERE chemistry-transport model, based on participants' residential addresses from 1990 to the index date. Bayesian kernel machine regression (BKMR) and quantile G-computation (QGC) were used to evaluate the joint effect of the pollutant mixture, individual pollutant contributions, and potential interactions.Results: In all women, the BKMR model showed an increasing trend in BC risk associated with a joint increase in exposure to the seven pollutants. Among individual pollutants, NO₂, PCB153, and PM showed the strongest positive dose-response associations. The QGC model also found a significant association between the pollutant mixture and BC risk (odds ratio (OR) = 1.12; 95% confidence interval (CI) = 1.02-1.24) per quartile increase in the mixture.Conclusions: This study provides evidence of a positive association between exposure to a mixture of seven air pollutants and the risk of BC for the two statistical approaches. NO2 contributed most significantly to the overall effect, followed by PCB153 and PM. These findings underscore the necessity of evaluating combined pollutant mixtures in risk assessment, identifying high-risk subpopulations, and designing targeted preventive strategies.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/41593633; PUBMED: 41593633; PUBMEDCENTRAL: PMC12924484
DOI: 10.1186/s12916-026-04653-x
Availability: https://hal.science/hal-05503034; https://hal.science/hal-05503034v1/document; https://hal.science/hal-05503034v1/file/s12916-026-04653-x.pdf; https://doi.org/10.1186/s12916-026-04653-x
Rights: https://creativecommons.org/licenses/by-nc-nd/4.0/ ; info:eu-repo/semantics/OpenAccess
Accession Number: edsbas.FF6B0F13
Database: BASE