Work

Residential greenspace exposure and prognosis of nasopharyngeal carcinoma in a large cohort: the role of PM2.5

Year: 2026

Type: article

Abstract: Background: Fine particulate matter (PM2.5) is a recognized risk factor for nasopharyngeal carcinoma (NPC); however, how PM2.5 exposure influences NPC prognosis and whether its effects on mortality are mediated through disease progression remain insufficiently understood.Methods: We conducted a hospital-based cohort study including 7,780 patients with NPC at Sun Yat-sen University Cancer Center. Individual-level PM2.5 exposure was assessed across multiple exposure windows. Cox proportional hazards models and Fine-Gray competing risk models were used to evaluate the associations of PM2.5 (per 10 μg/m3 increase) with NPC outcomes. Multi-state models were further employed to capture dynamic disease progression processes and to evaluate how PM2.5 influenced transition. Dose-response relationships were reported for each quartile.Findings: Higher PM2.5 exposure was significantly associated with increased risks of death, recurrence, and metastasis, with the strongest associations observed for the 1-year exposure window preceding the event (Specific-death: HR=1.49, 95% CI: 1.33-1.66; Recurrence: HR=1.95, 95% CI: 1.82-2.08; Metastasis: HR=2.13, 95% CI: 1.94-2.33). Multi-state models indicated that PM2.5 exposure accelerated disease progression and increased mortality. Short-term exposure raised the risk of direct death, whereas long-term exposure had a stronger effect on transitions to recurrence or metastasis and subsequent mortality.Interpretation: In this large NPC cohort, PM2.5 exposure was associated with reduced survival, largely mediated through increased recurrence and distant metastasis. Reducing air pollution may complement conventional therapies to improve outcomes in NPC patients.

Source: npj Clean Air

DOI: 10.1038/s44407-026-00106-0