Decadal trends in lung cancer incidence: effects of tree cover and arsenic exposure in Córdoba-Argentina

Abstract

This longitudinal ecological study analyzed temporal trends and the spatial distribution of lung cancer in Córdoba, Argentina, from 2005 to 2014, focusing on environmental factors. Crude incidence rates by sex were calculated for 26 departments using data from the provincial cancer registry. Joinpoint regression identified changes in annual trends and mixed-effects Poisson models assessed sex differences and interactions between groundwater arsenic and tree cover, incorporating random effects to account for spatial variation at the departmental level. A total of 8009 cases were recorded, with a mean age of 67.1 years and a male-to-female ratio of 2.5:1. Incidence decreased significantly among males (APC = –3.2%, p = 0.001), and rates were higher in southeastern departments. In 2005, arsenic exposure was strongly associated with increased risk (IRR = 9.4), with a reduced effect in 2014. Tree cover showed a protective effect in 2005 (IRR = 0.18, p = 0.002), which became less pronounced over time. Sex-specific interactions revealed a stronger influence of arsenic on male lung cancer risk (IRR = 58.4 in 2005; 12.6 in 2014). These findings highlight the relevance of environmental exposures and sex disparities in shaping lung cancer risk, even in the context of a declining overall incidence.