AIRCARE (Air Pollution and Cancer Research Ecosystem): Center for Advanced Research on Environmental Health and Lung Cancer Risk

In India, lung cancer is the 2nd most common in males and 4th overall in cancer incidence with 81,784 new cases and 75,031 deaths with a 5-year prevalence of 1,13,990 as per GLOBOCAN 2022. Air pollution, particularly fine particulate matter (PM2.5), has been identified as a significant risk factor for lung cancer in never-smokers. India is showing an increasing incidence of lung cancer and there is a need to understand air pollution given many cities in India have been reported to be the most polluted in the world. Evidence of causal associations between PM2.5 and an increased likelihood of lung cancer with underlying biological mechanisms are now fully known. Current evidence focuses on individual pollutants, overlooking potential interactions among multiple risk factors that could amplify lung cancer risks. There is paucity of data on vulnerability of groups like children, older adults, and individuals with pre-existing health conditions, who may face disproportionate risks from poor air quality. The long-term effects of chronic exposure to air pollutants and their cumulative contribution to lung cancer risk remain understudied. Centre for Advanced Research on AIRCARE is essential to bridge these research gaps, providing a holistic understanding of air pollution's role in lung cancer to plan prevention and policy strategies. The study will be conducted at AIIMS, Delhi, and areas in Delhi and NCR with varying levels of PM 2.5 exposure and will encompass regions with diverse socio-economic profiles and industrial activities to capture the heterogeneity of exposure and risk. Subjects and controls will be enrolled to ensure a suitable representation of various demographic, socio-economic and air pollution exposure parameters. A subset of the cohort will be selected for genotyping, focusing on individuals with extreme exposure levels and/or lung cancer cases and controls for genetic interaction studies.