@article { author = {Abdul Wahab, Sopian and Hassan, Astrid and Latif, Mohd Talib and Vadiveel, Yasheeny and Jeyabalan, Tamyenthini and Soo, Chun Ian and Abdul Hamid, Faisal and Yu-lin, Andrea Ban and Hassan, Tidi}, title = {Cluster Analysis Evaluating PM2.5, Occupation Risk and Mode of Transportation as Surrogates for Air-pollution and the Impact on Lung Cancer Diagnosis and 1-Year Mortality}, journal = {Asian Pacific Journal of Cancer Prevention}, volume = {20}, number = {7}, pages = {1959-1965}, year = {2019}, publisher = {West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.}, issn = {1513-7368}, eissn = {2476-762X}, doi = {10.31557/APJCP.2019.20.7.1959}, abstract = {Objective: Epidemiological studies have reported the close relationship between risk for lung cancers and air pollutionin particular, for non-smoking related lung cancers. However, most studies used residential address as proxies which maynot estimate accurately an individual’s air pollution exposure. Therefore, the aim of this study was to identify risk factorssuch as occupation and mode of transportation associated with lung cancer diagnosis and death. Methods: Subjectswith lung cancer (n=514) were evaluated both by chart reviews for clinical data and interviews to determine residentialaddress for ten years, main occupation and main mode of transportation. Annual particulate matter with diameter sizeless than 2.5 micrometre (PM2.5) concentration were calculated based on particulate matter with diameter size less than10 micrometre (PM10) data recorded by Malaysian Department of Environment. Logistic regression analysis, clusteranalysis and the Cox regression analysis were performed to the studied variables. Results: This study concurred withprevious studies that lung adenocarcinoma were diagnosed in predominantly younger, female non-smokers comparedto the other types of lung cancers. Lung adenocarcinoma subjects had annual PM2.5 that was almost twice higher thansquamous cell carcinoma, small cell carcinoma and other histological subtypes (p=0.024). Independent of smoking,the κ -means cluster analysis revealed two clusters in which the high risk cluster involves occupation risk with airpollution of more than four hours per day, main transportation involving motorcycle and trucks and mean annual PM2.5concentration of more than 30 based on residential address for more than ten years. The increased risk for the high-riskcluster was more than five times for the diagnosis of lung adenocarcinoma (OR=5.69, 95% CI=3.14-7.21, p<0.001).The hazard ratio for the high-risk cluster was 3.89 (95% CI=2.12-4.56, p=0.02) for lung adenocarcinoma mortality at1 year. Conclusion: High-risk cluster including PM2.5, occupation risk and mode of transportation as surrogates forair-pollution exposure was identified and highly associated with lung adenocarcinoma diagnosis and 1-year mortality.}, keywords = {PM 2.5,Occupation risk,Air pollution,Lung cancer}, url = {https://journal.waocp.org/article_88652.html}, eprint = {https://journal.waocp.org/article_88652_3a980bb128e0ff37e99ba762e83b0d3c.pdf} }