Lung cancer incidence decreases with elevation: evidence for oxygen as an inhaled carcinogen

Overview of attention for article published in PeerJ, January 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#29 of 3,050)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (97th percentile)

Mentioned by

news
42 news outlets
blogs
9 blogs
twitter
88 tweeters
peer_reviews
1 peer review site
weibo
1 weibo user
facebook
7 Facebook pages
googleplus
2 Google+ users
reddit
2 Redditors
video
1 video uploader

Readers on

mendeley
23 Mendeley
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Title
Lung cancer incidence decreases with elevation: evidence for oxygen as an inhaled carcinogen
Published in
PeerJ, January 2015
DOI 10.7717/peerj.705
Pubmed ID
Authors

Kamen P. Simeonov, Daniel S. Himmelstein

Abstract

The level of atmospheric oxygen, a driver of free radical damage and tumorigenesis, decreases sharply with rising elevation. To understand whether ambient oxygen plays a role in human carcinogenesis, we characterized age-adjusted cancer incidence (compiled by the National Cancer Institute from 2005 to 2009) across counties of the elevation-varying Western United States and compared trends displayed by respiratory cancer (lung) and non-respiratory cancers (breast, colorectal, and prostate). To adjust for important demographic and cancer-risk factors, 8-12 covariates were considered for each cancer. We produced regression models that captured known risks. Models demonstrated that elevation is strongly, negatively associated with lung cancer incidence (p < 10(-16)), but not with the incidence of non-respiratory cancers. For every 1,000 m rise in elevation, lung cancer incidence decreased by 7.23 99% CI [5.18-9.29] cases per 100,000 individuals, equivalent to 12.7% of the mean incidence, 56.8. As a predictor of lung cancer incidence, elevation was second only to smoking prevalence in terms of significance and effect size. Furthermore, no evidence of ecological fallacy or of confounding arising from evaluated factors was detected: the lung cancer association was robust to varying regression models, county stratification, and population subgrouping; additionally seven environmental correlates of elevation, such as exposure to sunlight and fine particulate matter, could not capture the association. Overall, our findings suggest the presence of an inhaled carcinogen inherently and inversely tied to elevation, offering epidemiological support for oxygen-driven tumorigenesis. Finally, highlighting the need to consider elevation in studies of lung cancer, we demonstrated that previously reported inverse lung cancer associations with radon and UVB became insignificant after accounting for elevation.

Twitter Demographics

The data shown below were collected from the profiles of 88 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 4 17%
Portugal 1 4%
Japan 1 4%
Unknown 17 74%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 30%
Other 5 22%
Student > Bachelor 3 13%
Student > Ph. D. Student 3 13%
Professor 2 9%
Other 3 13%
Readers by discipline Count As %
Agricultural and Biological Sciences 9 39%
Medicine and Dentistry 6 26%
Mathematics 4 17%
Environmental Science 1 4%
Earth and Planetary Sciences 1 4%
Other 2 9%

Attention Score in Context

This research output has an Altmetric Attention Score of 419. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 February 2017.
All research outputs
#9,292
of 7,424,936 outputs
Outputs from PeerJ
#29
of 3,050 outputs
Outputs of similar age
#390
of 234,673 outputs
Outputs of similar age from PeerJ
#2
of 90 outputs
Altmetric has tracked 7,424,936 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,050 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.4. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 234,673 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 90 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.