Grant Number:	1R03CA238957-01A1 Interpret this number
Primary Investigator:	Kirchhoff, Anne
Organization:	University Of Utah
Project Title:	Identifying the Role of Air Pollution in the Lung and Heart Health Outcomes of Testicular Cancer Survivors
Fiscal Year:	2020

PROJECT SUMMARY ABSTRACT 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.





None