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Based on a 10\u2010year prospective cohort of 1184 newly diagnosed NPC patients, we comprehensively evaluated the potential causal links of ambient PM<jats:sub>2.5<\/jats:sub> and its chemical components including black carbon (BC), organic matter (OM), sulfate (SO<jats:sub>4<\/jats:sub><jats:sup>2\u2212<\/jats:sup>), nitrate (NO<jats:sub>3<\/jats:sub><jats:sup>\u2212<\/jats:sup>), and ammonium (NH<jats:sub>4<\/jats:sub><jats:sup>+<\/jats:sup>) with the recurrence risk of NPC using a marginal structural Cox model adjusted with inverse probability weighting. We observed 291 NPC patients experiencing recurrence during the 10\u2010year follow\u2010up and estimated a 33% increased risk of NPC recurrence (hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 1.02\u20131.74) following each interquartile range (IQR) increase in PM<jats:sub>2.5<\/jats:sub> exposure. Each IQR increment in BC, NH<jats:sub>4<\/jats:sub><jats:sup>+<\/jats:sup>, OM, NO<jats:sub>3<\/jats:sub><jats:sup>\u2212<\/jats:sup>, and SO<jats:sub>4<\/jats:sub><jats:sup>2\u2212<\/jats:sup> was associated with HRs of 1.36 (95%CI: 1.13\u20131.65), 1.35 (95%CI: 1.07\u20131.70), 1.33 (95%CI: 1.11\u20131.59), 1.32 (95%CI: 1.06\u20131.64), 1.31 (95%CI: 1.08\u20131.57). The elderly, patients with no family history of cancer, no smoking history, no drinking history, and those with severe conditions may exhibit a greater likelihood of NPC recurrence following exposure to PM<jats:sub>2.5<\/jats:sub> and its chemical components. Additionally, the effect estimates of the five components are greater among patients who were exposed to high concentration than in the full cohort of patients. Our study provides solid evidence for a potential relationship between long\u2010term exposure to PM<jats:sub>2.5<\/jats:sub> and its components and the risk of NPC recurrence.<\/jats:p>","DOI":"10.1002\/ijc.35047","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T05:54:37Z","timestamp":1718171677000},"page":"1558-1566","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Potential causal links of long\u2010term exposure to PM<sub>2.5<\/sub> and its chemical components with the risk of nasopharyngeal carcinoma recurrence: A 10\u2010year cohort study in South China"],"prefix":"10.1002","volume":"155","author":[{"given":"Xurui","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Medical Statistics, School of Health &amp; Research Center for Health Information &amp; Sun Yat\u2010sen Global Health Institute Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, School of Health &amp; 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