Lung cancer caused by pollution?

Lung cancer caused by pollution?


Like a “hidden killer”, air pollutants can cause lung cancer in non-smokers via a mechanism revealed on Saturday in a study, which marks an “important step for science and society”, according to experts. 

Already implicated in climate change, fine particles – less than 2.5 microns, about the diameter of a hair – are responsible cancerous changes in airway cells, according to scientists from the Francis Crick Institute and University College London.

Present in exhaust gases, dust from vehicle brakes or fumes from fossil fuels, fine particles are “a hidden killer”, Charles Swanton of the Francis-Crick Institute, in charge of research, told AFP. present this research, not yet peer-reviewed, at the annual meeting of the European Society for Medical Oncology.

While air pollution has long been suspected, “we weren’t really sure if this pollution directly caused lung cancer, or how,” explained Professor Swanton.

The researchers first explored data from more than 460,000 residents of England, South Korea and Taiwan, and showed that exposure to increasing concentrations of fine particles was linked to an increased risk of lung cancer.

The major discovery is that of the mechanism by which these pollutants can trigger lung cancer in non-smokers.

By laboratory studies on mice, the researchers showed that the particles caused changes in two genes (EGFR and KRAS), already linked to lung cancer.

They then analyzed nearly 250 samples of healthy human lung tissue, never exposed to carcinogens from tobacco or heavy pollution. EGFR gene mutations appeared in 18% of the samples, KRAS alterations in 33%.

“On their own, these mutations are probably not enough to lead to cancer. But when you expose a cell to pollution, it probably stimulates some kind of “inflammatory” reaction, and if “the cell harbors a mutation, it will form cancer,” Professor Swanton sums up.

That's a “deciphering of the biological mechanism of what was an enigma”, but “quite confusing”, recognizes this chief medical officer of Cancer Research UK, the main funder of the study.

Traditionally, it was thought that the Exposure to carcinogenic factors, such as those from cigarette smoke or pollution, caused genetic mutations in the cells, making them tumorous and causing them to proliferate.

For Suzette Delaloge, director of the cancer prevention program at the Gustave-Roussy Institute, “it's quite revolutionary because we had practically no demonstration before of this alternative carcinogenesis”.

“This study is a fairly important step for science – and for society too, I hope,” the oncologist, who was responsible for discussing the study at the congress, told AFP. “This opens a great door for knowledge, but also for prevention”.

The next step will be to “understand why certain altered lung cells become cancerous after exposure to pollutants”, according to Pr Swanton.

This study confirms that reducing air pollution is also crucial for health , insist several researchers.

“We have the choice to smoke or not, but not the air we breathe. As probably five times more people are exposed to unhealthy levels of pollution than tobacco, this is a major global problem,” Professor Swanton said.

More than 90% of the world's population is exposed to what the WHO considers to be excessive levels of fine particulate pollutants.

This research also gives hope for new approaches to prevention and treatment.

To detect and prevent, Suzette Delaloge is considering several avenues, but “not for tomorrow”: “personal assessment of our exposure to pollutants”, detection – not yet possible – of the EGFR genetic mutation, etc.

For Tony Mok, from the University of Hong Kong, quoted in an ESMO press release, this research, “as intriguing as it is promising”, “allows us to consider one day looking for precancerous lesions in the lungs using imaging and then trying to treat them with drugs like interleukin inhibitors.”

Pr Swanton imagines “what molecular prevention could look like in the future cancer, with a pill, maybe every day, to reduce the risk of cancer in areas with ha ut risk”.