Grant Number:	1R01CA315618-01 Interpret this number
Primary Investigator:	Zeinomar, Nur
Organization:	Rutgers Biomedical And Health Sciences
Project Title:	Characterizing the Role of Air Pollution in Breast Cancer Prognosis and Survivorship
Fiscal Year:	2026

PROJECT SUMMARY Black women diagnosed with breast cancer (BC) experience higher mortality rates, greater cardiometabolic burden, and worse survivorship outcomes compared to White women. They are also more likely to live in areas with higher exposure to outdoor air pollution, which has been classified as carcinogenic in humans by the International Agency for Research on Cancer and is linked to inflammation, cardiotoxicity, impaired quality of life, cardiovascular disease, and mortality. Because exposure to air pollution is ubiquitous, unavoidable, and more prevalent in socioeconomically disadvantaged communities, it represents an important yet understudied contributor to differences in BC outcomes. Despite biological plausibility and emerging evidence, the long-term associations of air pollution with survival, patient-reported outcomes (PROs), and biomarkers of systemic health in Black BC survivors remain poorly understood. To address these gaps, we will leverage the Women’s Circle of Health Follow-Up Study (WCHFS), a well-characterized, population-based cohort of 1,900 Black BC survivors in New Jersey with detailed data on clinical characteristics, lifestyle, area-based factors, structural factors,, and biospecimens. This project will evaluate whether long-term residential outdoor air pollution exposure adversely impacts survival, PROs, and biomarkers of inflammation and cardiac injury in this disproportionately affected population. This study is designed to pursue three specific aims: (1) assess associations between cumulative residential air pollution exposure and BC-specific and all-cause survival; (2) evaluate relationships between air pollution and PROs, including health-related quality of life (HRQoL), fatigue, and sleep disturbance, measured approximately two years post-diagnosis; and (3) examine associations between air pollution and biomarkers of systemic inflammation (hsCRP, IL-6, IL-1β, TNF-α) and cardiac injury (hs-cTnT, NT-proBNP) measured two to three years post-diagnosis. Outdoor air pollution will be estimated from spatiotemporal models yielding predictions in 1km grids (particulate matter within 2.5 microns in diameter (PM2.5), nitrogen dioxide (NO2), particulate matter trace elements, and particulate matter components). These gridded estimates will be linked to residential address histories of study participants to examine time-varying exposure windows. We will apply advanced mixtures-based statistical approaches to evaluate the joint impacts of multiple pollutants and will evaluate effect modification of primary analyses by individual and neighborhood- level structural and area-based factors. By integrating air pollution exposures with clinical, epidemiologic, PRO, and biomarker information in a large, well-characterized cohort of Black BC survivors, this project will identify modifiable environmental contributors to differences in cancer outcomes. Findings will provide an evidence base to inform survivorship care, clinical guidelines, and public health strategies, with the long-term goal of improving outcomes for cancer survivors.





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