PM₂.₅ exposure and lung cancer mortality in Slovakia: gender differences and delayed effects

Background

Ambient air pollution, particularly fine particulate matter (PM₂.₅), is a major environmental risk factor for lung cancer. Despite improvements in air quality, long-term exposure remains a public health concern. This study examines the association between PM₂.₅ exposure and lung cancer mortality in Slovakia, focusing on gender and age-related differences.

Methods

This ecological study combines air quality data from the Slovak Hydrometeorological Institute with Global Burden of Disease mortality estimates for 2010–2023. Population exposure trends were assessed using the Indicator of Population Exposure (IPE). Associations were analysed using correlation, linear regression and lagged models. Temporal trends in mortality were quantified using annual average percentage change (AAPC).

Results

PM₂.₅ exposure declined from 24.4 μg/m³ (2010) to 15.2 μg/m³ (2023). Lung cancer mortality decreased overall from 30.7 to 25.3 per 100,000 (AAPC −1.5%), driven mainly by reductions in males (56.8 to 42.6; AAPC −2.2%), while female rates remained stable (12.6; AAPC 0%). A strong association between PM₂.₅ and mortality was observed overall (r = 0.95) and in males (r = 0.97), but not in females. Lagged analysis suggested delayed effects, with emerging associations in females.

Conclusions

Declining PM₂.₅ exposure is associated with reduced lung cancer mortality, particularly among men. Persistent gender differences and delayed effects highlight the importance of long-term environmental and public health strategies.

Key messages

• Lung cancer mortality in Slovakia is decreasing (AAPC −1.5%), mainly due to reductions in men.

• Gender differences and delayed effects of exposure underline the importance of long-term prevention policies.