{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:41:43Z","timestamp":1789771303980,"version":"4.0.1"},"reference-count":60,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Foundation of Jiangsu Hospital of Chinese Medicine","award":["Y24053"],"award-info":[{"award-number":["Y24053"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Air pollution is a recognized risk factor for colorectal cancer (CRC), but its specific impact in China, especially among older populations, remains underexplored.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used multivariable Cox models with restricted cubic splines to assess the dose\u2013response relationship between air pollution and CRC risk. Subgroup analyses by sex, residence (urban vs. rural) and pre-existing health conditions (hypertension, diabetes) were conducted. Mediation analysis assessed the indirect effects of smoking and alcohol on CRC risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Exposure to PM2.5, NO2 and SO2 was linked to increased CRC risk. For PM2.5, the hazard ratio (HR) for the highest exposure quartile was 2.35 (95% CI: 1.85\u20133.03) in urban residents and 1.93 (95% CI: 1.45\u20132.56) in rural residents. For NO2, the HR per 10\u2009\u00b5g\/m\u00b3 increase was 1.82 (95% CI: 1.56\u20132.12), and for SO2, it was 1.56 (95% CI: 1.31\u20131.85). Smoking mediated 14.03% of the effect of PM2.5 on CRC, while alcohol consumption mediated 5.12%. Subgroup analysis showed higher susceptibility in females (HR\u2009=\u20093.47, 95% CI: 2.63\u20134.63) compared to males (HR\u2009=\u20092.98, 95% CI: 2.25\u20133.79), and individuals with hypertension (HR\u2009=\u20092.67, 95% CI: 1.98\u20133.60) or diabetes (HR\u2009=\u20092.10, 95% CI: 1.55\u20132.86) were at significantly higher risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Long-term exposure to PM2.5, NO2 and SO2 significantly increases CRC risk in older Chinese adults, with smoking as a key mediator. Females, urban residents and those with hypertension or diabetes are especially vulnerable. Public health strategies should focus on reducing pollution in these high-risk groups.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/qjmed\/hcaf074","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T06:38:42Z","timestamp":1745476722000},"page":"501-513","source":"Crossref","is-referenced-by-count":5,"title":["Invisible foes: how air pollution and lifestyle conspire in the rise of colorectal cancer"],"prefix":"10.1093","volume":"118","author":[{"given":"Di","family":"Zhao","sequence":"first","affiliation":[{"name":"Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3824-4844","authenticated-orcid":false,"given":"Meng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing 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