Impact of the atmospheric air pollution level and xenobiotic biotransformation systems on the incidence of breast cancer

Introduction. Under the conditions of high anthropogenic load, the search for exposure biomarkers and genetic susceptibility markers for personalized prevention of oncological diseases is relevant. The Kemerovo Region – Kuzbass is among the territories with critical level of air pollution. Breast cancer is the leader in the structure of female cancer incidence in the region.

Materials and methods. Data from the Kemerovo Region Cancer Registry, air pollution parameters (formaldehyde, benzo(a)pyrene, gross emissions), and polymorphism of the GSTT1/GSTM1 genes were analyzed in one hundred fifty nine female residents of Novokuznetsk. Cross-correlation and regression analyses with distributed lags (0–4 years) and calculation of cumulative effects were used. Genotyping of GSTT1/GSTM1 was performed by real-time PCR.

Results. During 2014–2025, breast cancer incidence in Novokuznetsk increased by 23.3%, mainly due to cases at early stages (I+II; +45%). Atmospheric formaldehyde concentration increased by 6.6 times. A strong direct correlation was found between formaldehyde level and breast cancer incidence (r=0.868 for all cases, r=0.900 for early stages; lag 0). Regression models explained up to 93.6% of the incidence variance. Significant associations of deletion polymorphisms of GSTT1 (OR=3.51; 95% CI 1.27–9.69; p=0.012) and GSTM1 (OR=2.41; 95% CI 1.23–4.74; p=0.010) with the risk of breast cancer were revealed. No significant associations were found for benzo(a)pyrene or gross emissions.

Limitations. small sample size, lack of data on genetic polymorphisms (ALDH2, ADH5, BRCA2) in the study population.

Conclusion. An increase in formaldehyde concentration in the air is associated with a gain in breast cancer incidence, especially at the early stages. The genetic markers of hypersensitivity are the null genotypes GSTT1 and GSTM1. To reduce the population risk, it is advisable to strengthen formaldehyde monitoring, implement molecular epidemiological screening of these polymorphisms and active detection of breast cancer in genetically determined risk groups.

Compliance with ethical standards. The study was approved by the local Ethics Committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases (Minutes of meeting No. 2, § 2 of March 11, 2025), and was conducted in accordance with the commonly accepted scientific principles of the Helsinki Declaration of the World Medical Association (2013 edition).

Contribution:
Gulyaeva O.N. – concept and design of the study, literature review, material processing, writing the text;
Tereshkin I.E. – material processing, writing the text; 
Ulanova E.V. – material processing;
Mikhailova N.N. – concept and design of the study, editing;
Chifranova M.V. – collection of material;
Renge L.V. – editing.
All co-authors – approval of the final version of the article, responsibility for the integrity of all its parts.

Conflict of interest. The authors declare no conflict of interest.

Funding. The study had no sponsorship.

Received: June 1, 2026 / Accepted: July 1, 2026 / Published: August 14, 2026

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