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ESMO 2026 | Airborne carcinogen exposure and lung cancer risk in urban Rhode Island
Hina Khan, MD, Brown University, Providence, RI, discusses neighborhood-level fine particulate matter (PM2.5) exposure across Providence, Rhode Island, measured by the Breathe Providence Project, and its potential link to the state’s elevated lung cancer incidence. Although annual averages were near World Health Organization guidelines at some sites, daily limits were exceeded far more often than recommended, particularly during summer months, possibly reflecting wildfire activity. This interview took place at the European Society for Medical Oncology (ESMO) 2026 Congress in Madrid, Spain.
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Transcript
So PM2.5, or particulate matter 2.5, is fine particulate matter less than 2.5 micrometers in diameter, and it’s considered a Group 1 carcinogen as classified by the International Agency for Research on Cancer. The WHO has recommended safe levels across the world of less than 5 micrograms per cubic meter for an annual average and less than 15 micrograms per cubic meter for a 24-hour average, and these higher levels should not be exceeded more than three to four days per year...
So PM2.5, or particulate matter 2.5, is fine particulate matter less than 2.5 micrometers in diameter, and it’s considered a Group 1 carcinogen as classified by the International Agency for Research on Cancer. The WHO has recommended safe levels across the world of less than 5 micrograms per cubic meter for an annual average and less than 15 micrograms per cubic meter for a 24-hour average, and these higher levels should not be exceeded more than three to four days per year. So, you know, for context, Rhode Island has one of the highest lung cancer incidences in the country, with 59 cases per 100,000, as opposed to a national average of 53. So we sought out, in addition to the known carcinogens, additional environmental carcinogens that could be increasing the risk of lung cancer in our state. And so we utilized ambient neighborhood-level PM2.5 monitoring through 23 monitors across the state. We collected data from certain monitors in the port area, which gets a lot of diesel and port-related industrial smoke, and then we got inland measurements. Some of the monitors were on the Brown University campus, which is more of the downtown area. So, very interestingly, what we saw is that we collected data over 2023 and 2024, and we saw that the average PM2.5 levels were significantly higher in the summers of 2023 and 2024. But the cumulative levels were higher in 2024 than they were in 2023. And so, while the summer increase in PM2.5 levels was not unanticipated because of the Canadian wildfires in the past few years and the smoke that they have brought with the winds, what we noticed is that the cumulative level was much higher in 2024. And interestingly, the number of daily exceedances in 2024 was much higher than in 2023. And these higher levels were not just seen along the port, where you would think that the wind and environmental factors would come into play. These were found also in the very inland areas of the state. So certainly, this is an area worth looking further into. We are planning to do more case-control studies in patients who have been exposed in the state, with or without lung cancer, to identify and establish a clear correlation.
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