Fine particulate matter (PM2.5) and ozone (O3) pollution are major risk factors for respiratory and cardiovascular disease and death. For survivors of testicular cancer, one of the most common and curable cancers occurring in young men, respiratory and cardiovascular conditions often arise shortly after their treatment ceases. These health conditions are attributed to the chemotherapies used to cure testicular cancer that also exhibit toxic effects on heart and lung tissue. Post-treatment exposure to air pollution among testicular cancer survivors may exacerbate previous damage from chemotherapy, leading to a higher risk for respiratory and cardiovascular problems. The effects of air pollution exposure on testicular cancer survivors, however, are unknown. To fill this knowledge gap, we will examine how air pollution is associated with respiratory and cardiovascular health care encounters among 1,293 testicular cancer survivors diagnosed between 1999 and 2017 who live in Utah, a state with severe air pollution problems. Using the nation?s only statewide population registry, the Utah Population Database (UPDB), we can link individual identifying information from statewide administrative data, statewide hospital and ambulatory surgery records, and outpatient medical records from Utah?s largest health systems to residential data on short-term air pollution exposure for both PM2.5 and O3. We will: 1) Investigate the association of short-term air pollution exposure with respiratory and cardiovascular health events among testicular cancer survivors, measured through statewide healthcare encounter data, and compare the risk between survivors and a cancer-free sample, and 2) Investigate treatments and health behaviors that may modify the relationship between air pollution exposure and respiratory and cardiovascular events among testicular cancer survivors. We will also assess how the relationship varies over time.
Both aims will use a case-crossover design to examine the effects of short-term pollution exposure on the risk for respiratory and cardiovascular-associated outpatient, urgent care, and emergency department visits and hospitalizations. We will also examine how risk differs among subgroups of survivors based on treatment (e.g., surgery alone vs. surgery and chemotherapy), smoking, time since diagnosis, race/ethnicity, and other factors. Because of the pervasiveness of air pollution in United States and the lack of data on how environmental pollutants affect vulnerable populations such as cancer survivors, this project represents a unique opportunity to determine whether air pollution is a risk factor for respiratory and cardiovascular health problems among testicular cancer survivors. Moreover, our findings will have implications for other populations of cancer survivors and can help inform cancer survivorship guidelines on reducing air pollution exposure.

Public Health Relevance

Cancer therapies can damage the lung and heart tissue of testicular cancer survivors, resulting in major health problems after therapy ends. Breathing air pollution also damages lung and heart tissue and may cause additional health problems among testicular cancer survivors. This study will examine how short-term air pollution exposure increases the risk for lung and heart problems in testicular cancer survivors and how risk may be modified for survivors who were treated with chemotherapy, and will provide new information on how to prevent health problems in cancer survivor populations.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Small Research Grants (R03)
Project #
1R03CA238957-01A1
Application #
9881961
Study Section
Special Emphasis Panel (ZCA1)
Program Officer
Dellavalle, Curt Tavis
Project Start
2020-09-08
Project End
2022-08-30
Budget Start
2020-09-08
Budget End
2022-08-30
Support Year
1
Fiscal Year
2020
Total Cost
Indirect Cost
Name
University of Utah
Department
Pediatrics
Type
Schools of Medicine
DUNS #
009095365
City
Salt Lake City
State
UT
Country
United States
Zip Code
84112