{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T00:26:51Z","timestamp":1794270411209,"version":"4.9.0"},"reference-count":76,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Liver cancer (LC) is a leading cause of global cancer mortality, with established risk factors including viral hepatitis, alcohol use and metabolic disorders. Emerging evidence suggests air pollution may contribute to hepatocarcinogenesis, but a comprehensive synthesis of this association is lacking. This systematic review and meta\u2010analysis evaluates the relationship between long\u2010term air pollution exposure and LC incidence and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following PRISMA guidelines, we searched PubMed\/MEDLINE, Embase, Web of Science and Scopus through July 2025. Observational studies reporting adjusted effect estimates (HR\/RR\/OR) for LC outcomes associated with PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , PM\n                      <jats:sub>10<\/jats:sub>\n                      , NO\n                      <jats:sub>2<\/jats:sub>\n                      or other pollutants were included. Random\u2010effects meta\u2010analyses assessed pollutant\u2010specific risks per standardised increments (1\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      for PM\n                      <jats:sub>2.5<\/jats:sub>\n                      ; 10\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      for NO\n                      <jats:sub>2<\/jats:sub>\n                      , etc.). Heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) assessment, subgroup (geography, study design) and sensitivity analyses were performed. The protocol for this study was registered on PROSPERO (CRD420251082568).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 23 included studies (11 incidence, 12 mortality), PM\n                      <jats:sub>2.5<\/jats:sub>\n                      exposure (per 1\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      ) was significantly associated with increased LC incidence (HR\u2009=\u20091.020, 95% CI: 1.01\u20131.03) and mortality (HR\u2009=\u20091.02, 95% CI: 1.01\u20131.04). NO\n                      <jats:sub>2<\/jats:sub>\n                      (per 10\u2009\u03bcg\/m\n                      <jats:sup>3<\/jats:sup>\n                      ) showed stronger incidence risks (HR\u2009=\u20091.16, 95% CI: 1.04\u20131.28) but non\u2010significant mortality associations (HR\u2009=\u20091.06, 95% CI: 0.91\u20131.22). Subgroup analyses revealed higher PM\n                      <jats:sub>2.5<\/jats:sub>\n                      \u2010associated risks in studies with prospective design and those with higher median follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Long\u2010term exposure to PM\n                      <jats:sub>2.5<\/jats:sub>\n                      and NO\n                      <jats:sub>2<\/jats:sub>\n                      is associated with elevated LC risk, independent of traditional etiologies. These findings underscore air pollution as an environmental carcinogen for LC and advocate for stricter air quality controls. Regional variations highlight the need for targeted interventions.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70409","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T04:31:56Z","timestamp":1761625916000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Air Pollution and the Risk of Liver Cancer Incidence and Mortality: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"45","author":[{"given":"Guodong","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery Affiliated Hospital of Hebei University  Baoding China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery Affiliated Hospital of Hebei University  Baoding China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery Affiliated Hospital of Hebei University  Baoding China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery Affiliated Hospital of Hebei University  Baoding China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3015-791X","authenticated-orcid":false,"given":"Weiying","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Radiology Affiliated Hospital of Hebei University  Baoding China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jijing","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Affiliated Hospital of Hebei University  Baoding China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.32723"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-020-01386-x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000515304"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2008.10.040"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jes.2022.05.037"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecoenv.2024.117437"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2022.160064"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2021.111487"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(22)00090-0"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21632"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.chemrestox.2c00216"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecoenv.2024.117469"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.5487\/TR.2014.30.2.065"},{"key":"e_1_2_10_16_1","first-page":"243","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 5.1. 0 (Updated March 2011)","author":"Higgins J. 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