Socioeconomic Evaluation of Breast Cancer Attributable to Benzo[a]pyrene (BaP), Nitrogen Dioxide (NO2), and Polychlorinated Biphenyls 153 (PCB-153) Air Pollutants
Author(s)
Lionel Perrier, PhD1, Delphine Praud, PhD1, Magali Morelle, MSc1, Isabelle Soerjomataram, MD, PhD2, Pietro Salizzoni, Ing3, Elodie Faure, ¨PhD4, Gianluca Severi, PhD4, Francesca Romana Mancini, PhD4, Leny Grassot, PhD1, Thomas Coudon, PhD1, Béatrice Fervers, MD, PhD1;
1Cancer Centre Leon Berard, Lyon, France, 2International Agency for Research on Cancer (IARC), Lyon, France, 3Ecole Centrale de Lyon, Lyon, France, 4Gustave Roussy, Villejuif, France
1Cancer Centre Leon Berard, Lyon, France, 2International Agency for Research on Cancer (IARC), Lyon, France, 3Ecole Centrale de Lyon, Lyon, France, 4Gustave Roussy, Villejuif, France
Presentation Documents
OBJECTIVES: Breast cancer (BC) is the most common cancer in women worldwide. Exposure to air pollutants is suggested to increase BC risk. The aim of the present study was to estimate the fraction of BC attributable to the Benzo[a]pyrene (BaP), nitrogen dioxide (NO2), and polychlorinated biphenyls 153 (PCB-153) and the economic impact in France.
METHODS: Data from the XENAIR nested case-control study of 5222 BC cases and 5222 matched controls were used. Annual atmospheric concentration levels of BaP, NO2, and PCB-153 from 1990 to the index date (date of case diagnosis), were estimated using cases and controls’ geocoded residential addresses. We quantified the proportion of BC attributable to each air pollutant using the comparative risk assessment approach, multiplied this to incidence and mortality estimates from the Global Burden of Disease study. Medical costs were obtained from the French national health data system (SNDS) and intangible costs were estimated by calculating the value of statistical life year.
RESULTS: Estimated attributable fractions were 2.49% (threshold: 0.4 ng/3), 8.90% (threshold: 10 µg/m3), 13.70% (If patients were exposed since 1990 as they were in 2010) for BaP, NO2, and PCB-153, respectively. This amounts to 1,055, 3,772, 5,806 cases of breast cancer annually in France or 251, 899, 1,383 deaths from breast cancer for BaP, NO2, and PCB-153, respectively. The total cost of BC attributable to air pollutants (in €2018) were €734,130,385 for BaP, €2,624,000,170 for NO2, €4,039,191,273 for PCB-153. Healthcare expenditures, intangible morbidity costs, and intangible mortality costs represented 7, 13, and 80% of the total cost. One-way sensitivity analyses showed that the most sensitive parameter on costs was the estimated attributable fraction, while healthcare expenditures per case had the lowest impact.
CONCLUSIONS: Studies have reported major impact of pollution on morbidity and deaths from cancer. Additionally, this study reports major healthcare costs attributable to three air pollutants.
METHODS: Data from the XENAIR nested case-control study of 5222 BC cases and 5222 matched controls were used. Annual atmospheric concentration levels of BaP, NO2, and PCB-153 from 1990 to the index date (date of case diagnosis), were estimated using cases and controls’ geocoded residential addresses. We quantified the proportion of BC attributable to each air pollutant using the comparative risk assessment approach, multiplied this to incidence and mortality estimates from the Global Burden of Disease study. Medical costs were obtained from the French national health data system (SNDS) and intangible costs were estimated by calculating the value of statistical life year.
RESULTS: Estimated attributable fractions were 2.49% (threshold: 0.4 ng/3), 8.90% (threshold: 10 µg/m3), 13.70% (If patients were exposed since 1990 as they were in 2010) for BaP, NO2, and PCB-153, respectively. This amounts to 1,055, 3,772, 5,806 cases of breast cancer annually in France or 251, 899, 1,383 deaths from breast cancer for BaP, NO2, and PCB-153, respectively. The total cost of BC attributable to air pollutants (in €2018) were €734,130,385 for BaP, €2,624,000,170 for NO2, €4,039,191,273 for PCB-153. Healthcare expenditures, intangible morbidity costs, and intangible mortality costs represented 7, 13, and 80% of the total cost. One-way sensitivity analyses showed that the most sensitive parameter on costs was the estimated attributable fraction, while healthcare expenditures per case had the lowest impact.
CONCLUSIONS: Studies have reported major impact of pollution on morbidity and deaths from cancer. Additionally, this study reports major healthcare costs attributable to three air pollutants.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH21
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Oncology