Regional Variation In PM2.5 And Lung Cancer Incidence Across South Korea, 2015–2022

Abstract

Air pollution, or particularly fine particulate matter (PM2.5), has been linked to numerous adverse health outcomes, including lung cancer. South Korea has PM2.5 levels that greatly surpass World Health Organization guidelines, making it an important context for studying this relationship. However, few studies have examined this association at a nationwide or regional level while simultaneously accounting for smoking prevalence and population age structure. This study investigated whether regional variation in average PM2.5 concentrations from 2015-2022 was associated with lung cancer incidence across South Korea’s 17 administrative divisions, adjusting for smoking prevalence and the percentage of the population aged 65 and older. Six linear regression models were used to evaluate these relationships, using regional PM2.5 concentrations, 2022 lung cancer incidence rates, smoking prevalence, and age structure data obtained from national databases. Results showed no statistically significant association between average PM2.5 concentrations and lung cancer incidence in any model (p>0.05), while smoking prevalence was a significant predictor (β = 1.104, p = 0.039), explaining 30.9% of regional variance. The final model, which included PM2.5 , smoking prevalence, and age structure, explained 40.3% of the variance in lung cancer incidence. These findings suggest that behavioral factors may play a larger role than regional PM2.5  differences in explaining lung cancer incidence across South Korea, though limited regional variation in PM2.5and a small sample size may have constrained statistical power.