https://orcid.org/0000-0001-9100-0476
Figures
Abstract
Cancer remains the second leading cause of death worldwide, with cases rising at an alarming rate. While the causes of cancer are complex and varied, certain risk factors - such as exposure to environmental pollutants and specific lifestyle choices - are modifiable and can be addressed. A case-control study was conducted in Bangladesh from 25 August 2023 to 18 April 2024 to examine the association between cancer risk and a range of lifestyle and environmental factors. The study specifically focused on six common cancer types: breast, hematological, oral, cervical, colorectal, and lung cancer. This study identified several lifestyle and environmental factors positively associated with cancer risk. Individuals using wood or kerosene for cooking had higher odds of cancer compared to those using supplied gas (AOR = 3.886). Consumption of overcooked or poorly cooked food was associated with an increased risk of cancer compared to the consumption of well-cooked food (AOR = 2.478). Oral hygiene also showed a relationship, with participants brushing their teeth only 2-3 times a week having a higher chance of cancer compared to those who brush regularly (AOR = 3.103). In addition, frequent exposure to mosquito repellent was positively associated with cancer risk (AOR = 1.569), and exposure to inorganic dust showed a similar association (AOR = 1.673). These findings highlight modifiable lifestyle and environmental factors that could inform future cancer prevention strategies in Bangladesh.
Citation: Rahman ML, Tanvir KM, Rahman F, Chowdhury S, Saha S, Khan MAS, et al. (2026) Lifestyle and environmental risk factors associated with cancer: A case-control study in Bangladesh. PLoS One 21(1): e0328745. https://doi.org/10.1371/journal.pone.0328745
Editor: Zubing Mei, Shuguang Hospital, CHINA
Received: July 7, 2025; Accepted: January 6, 2026; Published: January 28, 2026
Copyright: © 2026 Lutfor Rahman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting information files.
Funding: This study was partially supported by the Centennial Research Grant of the University of Dhaka (Grant Ref: Reg/Admin 3/19140-C), which provided BDT 365,000 (approximately USD 3,040) mainly for data collection and for hiring a postgraduate student to assist with data management and analysis. The project was not fully funded by the CRG, and several volunteers contributed to data collection without remuneration. The grant did not cover conference presentation or article processing fees. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Introduction
Cancer is one of the potential causes of death worldwide, presenting a serious public health concern. The World Health Organization (WHO) reported that in 2018, Bangladesh experienced 150,781 new cases of cancer and 108,137 cancer-related deaths [1]. These alarming statistics highlight the pressing need for effective strategies to combat cancer, especially as projections suggest that both incidence and mortality rates are expected to increase in the coming decades. However, ongoing research underscores the potential for preventing a significant proportion of cancer cases through modifications in lifestyle and environmental risk factors [2].
A growing body of evidence shows that lifestyle behaviors play an important role in cancer prevention. Smoking cessation remains one of the most important preventive measures, as smoking is a well-established risk factor for multiple cancers, most notably lung cancer [3]. Maintaining a healthy body weight is crucial, as obesity has been associated with increased risk of several cancers. Regular physical activity significantly reduces the risk of cancers such as breast cancer among women [4]. A balanced diet rich in fruits, vegetables, and whole grains, and avoidance of processed foods, has also been linked to cancer prevention [5]. In addition, poor oral hygiene has been identified as a risk factor for oral cancers [6].
Beyond lifestyle factors, reducing exposure to environmental pollutants is also critical. Both indoor and outdoor air pollution may have been associated with an increased risk of cancer [7]. Pollutants such as particulate matter and industrial chemicals can contribute to cancer development [8,9]. Occupational hazards, such as exposure to asbestos, inorganic dust, and silica, have consistently shown positive associations with cancer risk [10]. Furthermore, pesticide exposure, especially in agricultural communities, has been recognized as an important contributor to cancer [11]. Other environmental factors, such as soil contamination, and temperature variations may have also been positively correlated with increased cancer risk [12].
Despite these insights, there remains a research gap concerning the comprehensive effects of lifestyle factors and environmental exposures on cancer prevention and prognosis, particularly in Bangladesh. Specifically, a significant proportion of rural households in Bangladesh rely on traditional biomass fuels such as wood, cow dung, and kerosene for cooking. According to the Bangladesh Demographic and Health Survey report (2017-18) [13], over 80% of rural households continue to use biomass fuels, exposing women and children disproportionately to hazardous smoke in unventilated indoor spaces [14]. This level of reliance is significantly higher than in many neighboring South Asian countries, where access to cleaner fuels has improved more rapidly [15].
These fuels release harmful particulate matter and carcinogenic compounds into indoor environments, leading to prolonged exposure to toxic fumes. The concentration of indoor PM2.5 from biomass fuel in these households has been measured at levels exceeding 1000 , far above the WHO recommended limit of 25
, indicating an extreme level of exposure [14,16]. Given that approximately 59% of the Bangladeshi population resides in rural areas where the use of biomass fuels is widespread [17], Bangladesh provides a particularly relevant setting for evaluating the long-term health impacts of indoor air pollution on cancer development, especially among women and elderly individuals who spend extended periods indoors near cooking stoves [18].
In addition, Bengali cuisine frequently involves the consumption of fish and meat prepared at high temperatures or over open flames. Improper cooking practices, particularly charring or overcooking, can generate carcinogens such as heterocyclic amines and polycyclic aromatic hydrocarbons, both of which have been linked to cancer [19–21]. The cultural practice of cuisine distinguishes the Bangladeshi population from other ethnic groups, providing a critical area for investigation in cancer research.
Bangladesh’s rapid industrialization has led to increased exposure to various environmental pollutants such as inorganic dust, silica, and pesticides. Many rural Bangladeshis are exposed to these harmful environmental substances due to industrial and agricultural activities and poor occupational safety standards [22]. In addition, the use of mosquito repellents is widespread, especially during the monsoon season, and these repellents have been linked to increased cancer risk due to their chemical components [23]. The impact of these environmental exposures on cancer biology in the Bangladeshi population may differ from other regions due to both the intensity and duration of exposure.
Furthermore, there is a lack of case-control studies that explore how adherence to specific lifestyle patterns and exposure to environmental factors influence cancer risk. To address these research gaps, this study aims to update and synthesize existing knowledge on these associations. By focusing on epidemiological studies conducted in Bangladesh, we seek to provide a clearer understanding of how lifestyle and environmental factors contribute to cancer risk, ultimately informing more effective prevention and intervention strategies.
Materials and methods
Data
A case–control study was carried out to examine the influence of dietary and environmental factors on cancer over an eight-month period (25 August 2023 to 18 April 2024). The study included patients diagnosed with one of six cancer types—breast, hematological, oral, cervical, colorectal, or lung—who were classified as cases. Controls were carefully selected to match cases on gender, age, and family background. To ensure age compatibility, each control’s year of birth was required to fall within ±10 years of the corresponding case. Whenever feasible, controls were chosen from the same family to enhance genetic comparability. All controls were confirmed to be free of cancer and major comorbidities through screening based on medical history and self-reported absence of any past or present cancer diagnosis.
A structured questionnaire was developed to capture relevant variables, including demographic factors (age, gender, educational qualification, residence, marital status, and religion), lifestyle characteristics, environmental exposures, and dietary habits. This questionnaire was rigorously reviewed and refined by experts and was updated following a pilot survey conducted at National Institute of Cancer Research and Hospital (NICRH).
The sample size for a 1:1 matched case–control study was estimated using the Dupont (1988) method [24]. Assuming a two-sided significance level of 0.05, 80% power, and an expected exposure prevalence of 20% among controls, the required number of pairs to detect a matched odds ratio of 2.0 was calculated to be approximately 350 pairs. Data collection was carried out across the country at 20 reputable cancer hospitals, selected based on their high patient volume, availability of oncology services, and geographical accessibility. Within each hospital, proportional sampling was applied to capture variability in patient demographics. Intern doctors, who were thoroughly trained prior to the study, were assigned to collect the data.
We successfully collected a total of 713 responses, with 361 from the case group. For each case, one control was intended to be matched; however, due to challenges in finding appropriate controls, nine cases did not have matched controls. To ensure data quality, completed questionnaires were checked on a regular basis for key variables by the field supervisor. In addition, a random subset of responses was re-validated through follow-up checks with participants to confirm accuracy and consistency. The collected data were then coded by a specialized data entry team.
Variables
Dependent Variable: The dependent variable was binary, indicating whether a patient was diagnosed with one of six specific types of cancer: breast, hematologic, oral, cervical, colorectal, or lung cancer. The presence of any type of cancer was considered a case and coded as 1, while the absence of cancer (controls) was coded as 0.
Independent Variables: There were two categories of independent variables- lifestyle and environmental factors. Lifestyle variables included type of transportation used, leisure time activity, type of cooking fuel, method of cooking meat, frequency of teeth cleaning, drinking water habit before breakfast, exposure to smoke during cooking, type of food consumed, amount of oil in food and, frequency of cleaning or vacuuming at home. Environmental variables included exposure to engine exhaust, inorganic dust, cotton dust, silica, smog, pesticides, and mosquito repellent.
To ensure clarity and reproducibility, operational definitions were established for dietary and environmental exposure categories used in this study. Foods were classified as very oily if prepared with excessive amounts of oil, such as deep-fried items. Regular oily foods referred to dishes prepared with moderate amounts of oil typical of daily cooking, while less oily foods were those prepared with minimal or no added oil, such as boiled, steamed, or lightly sauteed items. Food items were categorized as regular spicy when prepared with standard levels of spice common in Bangladeshi diets, very spicy when prepared with an excessive amount of chili or strong spices. Cooking practices were defined as overcooked when items were visibly charred or cooked at high temperatures for prolonged periods, and inadequately cooked when items were partially cooked with uncooked portions still visible.
Environmental exposure variables were also standardized. Frequent exposure indicated daily or near-daily contact with a pollutant such as engine exhaust, inorganic dust, or silica, whereas rare exposure referred to occasional or infrequent contact, defined as once per week or less. These definitions were explained to participants during data collection to ensure consistency in responses. To minimize the potential recall bias in questionnaire responses, participants were provided with examples of key variables. Interviewers were trained to use standardized, neutral questioning techniques and structured prompts to reduce misreporting.
Ethical considerations
This study adhered to the ethical guidelines of Dhaka Ahsania Mission’s Institutional Review Board (IRB)/Ethical Review Committee (ERC) (Approval No.: 2023/DAM/IRB/ERC/2302). The ethical standards outlined in the 1964 Helsinki Declaration and its later revisions were followed where applicable. Written informed consent was obtained from all participants during face-to-face interviews, ensuring they understood their participation was voluntary and could be withdrawn at any time before signing.
Statistical analysis
The chi-square test was applied to assess the associations between categorical variables and cancer events. Multiple logistic regression was used to calculate adjusted odds ratios to evaluate the effects of lifestyle and environmental factors on cancer, while controlling for age, gender, and smoking status. All statistical tests were conducted with a significance level set at 5%. Statistical analysis was performed using SPSS 25.
Results
Table 1 presents the distribution of the background characteristics for cases and controls. Statistically significant differences were observed between cases and controls in terms of educational attainment, occupational status, and marital status (p<0.05). In particular, educational levels differed significantly between the two groups: the majority of controls had higher levels of education, while the cases were more evenly distributed between various educational backgrounds. Furthermore, the study population was predominantly Muslim, with this characteristic being similarly distributed between both cases and controls. Other demographic and socioeconomic factors were also well distributed in cases and controls, indicating that the groups were comparable in these attributes. This distribution ensures that any observed differences in cancer risk factors are less likely to be attributable to discrepancies in these baseline characteristics.
Table 2 details the distribution of individual lifestyle characteristics among cases and controls. Several key indicators related to lifestyle were significantly associated with cancer risk, including the type of fuel used for cooking, methods of cooking meat, and exposure to smoke during cooking (p < 0.001).
This bivariate findings reveal that a higher proportion of cases used wood or kerosene as cooking fuel (59.7%) compared to controls (44.6%). This suggests a notable association between the type of cooking fuel and cancer risk (p < 0.001). Additionally, 29.2% of cases consumed overcooked or inadequately cooked meat in contrast to 13.7% of controls (p < 0.001). Exposure to smoke during cooking was also found to be significantly associated with cancer risk. A higher percentage of cases were exposed to cooking smoke (72.6%) compared to controls (60.9%), highlighting a strong association between smoke exposure and cancer incidence. Other lifestyle factors considered in the study did not show significant associations with cancer risk in this bivariate analysis.
Table 3 presents the associations between various lifestyle factors and cancer risk after adjusting for demographic variables, revealing several significant relations. The type of cooking fuel used was notably associated with cancer risk; specifically, individuals using wood or kerosene for cooking had 3.886 times odds of developing cancer compared to those using supplied gas (95% CI = 1.578–9.572), suggesting that the use of less clean cooking fuels may be linked with as increased cancer risk. Additionally, oral hygiene practices were significantly related to cancer risk, with individuals who brushed their teeth 2–3 times a week facing three times higher odds of cancer compared to those who brushed daily (95% CI = 1.021–9.428), indicating the impact of consistent oral care on cancer risk. Dietary habits also played a role: those consuming over or inadequately cooked food had a 2.478 times odds of cancer compared to those with well cooked food consumption (95% CI = 1.022-6.008), highlighting the potential benefits of consuming well cooked food.
Table 4 details the distribution of components of environmental exposures among cases and controls. Exposure to inorganic dust was significantly associated with cancer (p-value = 0.003) where 69.6% were cases and 58.0% were controls. Silica exposure also showed a strong association with cancer; 76.9% of cases were frequently exposed to silica, in contrast to 62.9% of controls, with the association being highly significant (p-value < 0.001).
Additionally, the use of mosquito repellent was significantly linked to cancer risk, with 53.7% of cases frequently exposed to mosquito repellent compared to 34.6% of controls (p-value < 0.001). Other environmental factors examined did not demonstrate significant associations with cancer at the 5% level of significance. These results highlight the substantial impact of inorganic dust, silica, and mosquito repellent exposure on cancer risk, emphasizing the need for targeted interventions in these areas.
Table 5 presents the adjusted odds ratios and confidence intervals for cancer prevalence associated with various environmental exposures taking into account the rarely exposed group as the reference. Our analysis indicates that exposure to mosquito repellent is marginally associated with an increased risk of cancer. Individuals who reported frequent exposure had 56.9% higher odds of developing cancer compared to those with rare exposure (95% CI: 0.965–2.549). Similarly, exposure to inorganic dust showed a marginal association with cancer prevalence, with 1.67 times higher odds (95% CI: 0.913–3.064).
Discussion
The current study investigated the association between lifestyle and environmental factors among cancer patients through a case-control study in Bangladesh. The primary objective was to identify potentially modifiable lifestyle risk factors that could help mitigate cancer prevalence. This study demonstrates significant associations between lifestyle and environmental exposures and elevated cancer risk in the Bangladeshi population. These findings align with prior research while highlighting context-specific risks relevant to low-resource settings, providing valuable insights for public health interventions.
The present study found a significant association between the method of cooking meat and cancer risk. Specifically, consuming overcooked meat was linked to an increased risk of cancer. This finding aligns with the European Food Safety Authority’s 2015 risk assessment, which indicated that overcooked food could elevate cancer risk across all age groups due to the formation of carcinogenic compounds such as heterocyclic amines and polycyclic aromatic hydrocarbons [19,25]. These compounds are formed particularly during frying, grilling, and roasting, processes that involve direct high-heat exposure. While most of the existing evidence comes from Western populations, our study provides important insights from Bangladesh, where frying and open-flame cooking of fish and meat are widespread, potentially leading to even greater exposure to heterocyclic amines and polycyclic aromatic hydrocarbons (PAHs).
Similarly, the association observed between consumption of undercooked meat and cancer risk may be explained by microbial and parasitic contamination, as insufficient cooking can allow pathogens such as Helicobacter pylori, Salmonella, or liver flukes to survive. Chronic infections from these organisms may have been linked to cancer through mechanisms involving persistent inflammation and cellular damage [26]. This evidence underscores the need for public awareness about safe cooking practices to reduce cancer risk.
In addition, we observed a significant relationship between cancer risk and the type of fuel used for cooking. Specifically, using wood and kerosene was associated with higher cancer risk. This is consistent with a study conducted in Iran, which reported that burning biomass or kerosene, especially in poorly ventilated areas, increased the risk of digestive cancers [27]. The observed link between wood and kerosene cooking fuels and cancer risk supports existing evidence that biomass combustion releases carcinogenic pollutants such as PAHs, fine particulate matter (PM2.5), and volatile organic compounds [14–16,28]. Prolonged indoor exposure, particularly in poorly ventilated rural households, likely intensifies this risk [14,29]. The use of such fuels contributes to indoor air pollution, which has been identified as a significant cancer risk factor. The current study also highlighted the adverse effects of cooking smoke on cancer risk. This finding is supported by research from Taiwan, which demonstrated that exposure to cooking fumes is associated with an increased risk of lung cancer [7]. Effective kitchen ventilation and smoke control are essential in reducing the potential health risks associated with cooking fumes.
Although the association between very oily or less oily food and cancer risk was not statistically significant, the lower odds ratio observed is noteworthy. This counterintuitive trend may be explained by residual confounding, as the regular oily category represents the most common dietary practice in Bangladesh and likely represents more frequent and larger consumption of oil-based foods. While high-fat diets and repeated frying have been linked to carcinogenesis through mechanisms such as obesity, chronic inflammation, and oxidative stress [5,30], occasional deep-fried intake or low-oil cooking methods may not produce the same risks. Therefore, this finding should be interpreted with caution, and larger studies with more detailed dietary assessment are needed to clarify the relationship between oil use in cooking and cancer risk.
Furthermore, this study observed a marginally non-significant association between exposure to inorganic dust and cancer risk. This finding is consistent with results from a study in Montreal, which reported an increased cancer risk associated with inorganic dust exposure [31]. Although statistical significance was not reached in our study, the established carcinogenic nature of inorganic dust underscores the need for protective measures in occupational and environmental settings where such exposures are common.
Finally, a significant association was found between cancer risk and the use of mosquito repellents. This finding is in agreement with research conducted in Taiwan, which reported a correlation between exposure to mosquito repellents and cancer risk [32]. The potential carcinogenic effects of some chemicals in mosquito repellents warrant cautious use and further investigation.
The increased risk associated with mosquito repellent use may be linked to chronic exposure to chemicals such as N,N-diethyl-meta-toluamide and permethrin, which exhibit genotoxicity in experimental studies [33,34]. In addition, exposure to cooking fumes containing fine particulate matter and aldehydes can trigger oxidative stress and inflammation, biological processes that are well recognized as contributors to cancer development [14,16].
These combined inhalational, dietary, and dermal exposures can act synergistically with genetic and nutritional factors. The unique environmental context of Bangladesh including widespread biomass fuels, traditional cooking practices, and high chemical exposure underscores the need for localized epidemiological evidence to guide targeted cancer prevention efforts [14,28,29].
Limitations and future directions
There are several limitations in this study. For instance, the reliance on self-reported data may have introduced recall bias, potentially affecting the accuracy of exposure classification. Although structured questionnaires and clear definitions were used to minimize this risk, some degree of misclassification remains possible. In addition, the use of family-based controls, while reducing genetic and socio-cultural variability between cases and controls, may have introduced selection bias and limits the generalizability of our findings to the broader population. Moreover, although controls were matched to cases by age and sex, other important confounders—such as occupation, income, and place of residence—were not matched. This limitation may have led to residual confounding, which should be considered when interpreting the results.
The limited sample size also restricted our ability to perform stratified analyses by cancer type. Although significant associations were observed between exposures such as cooking fuel or mosquito repellents and overall cancer risk, we were unable to determine whether these relationships varied across cancers with distinct etiologies. Furthermore, the relatively wide confidence intervals observed for some exposures, such as cooking fuel type, likely reflect the limited sample size and the small number of participants within certain categories. Larger studies with greater statistical power are therefore needed to obtain more precise effect estimates and to confirm these associations.
Although we matched cases and controls by age and sex and adjusted for smoking status in the multivariate model, we were unable to adjust for other potential confounders such as occupation and income. In addition, cumulative long-term exposure to lifestyle and environmental factors could not be measured. Besides, we were unable to capture the duration and intensity of exposures, which may be critical in understanding cancer risk. Complete matching between cases and controls was not feasible; therefore, we used unconditional logistic regression with adjustment for the matching variables. Several methodological papers have noted that unconditional regression with covariate adjustment can yield valid and unbiased estimates in such scenarios, particularly when matching is not extensive or when some loss of pairs is expected in the analysis phase [35,36]. Moreover, the use of unconditional logistic regression in this study provided greater flexibility to include additional covariates and to retain unmatched observations, thereby preserving sample size and statistical power. However, conditional logistic regression might have been more appropriate for a fully matched design.
Future studies should address these limitations by recruiting larger, population-based samples, incorporating objective exposure assessments—such as air-quality monitoring or biological markers—and employing longitudinal or interventional study designs. These approaches will provide stronger evidence for causal relationships and improve the generalizability of the findings to broader populations.
Implications and recommendations
The study findings suggest that several lifestyle and environmental factors significantly influence cancer risk among Bangladeshis. These include the use of wood or kerosene as cooking fuel, the consumption of raw or overcooked food, poor oral hygiene, and frequent exposure to mosquito repellents. Addressing these risk factors through targeted public health interventions could play an important role in reducing cancer incidence.
Policy recommendations include promoting the adoption of cleaner household fuels through government-supported energy programs, improving household ventilation systems to reduce indoor air pollution, and raising awareness of safe cooking practices through nutrition education campaigns. Strengthening oral health promotion at the community level could encourage regular dental hygiene and preventive care. Finally, reducing the reliance on chemical mosquito repellents by expanding access to insecticide-treated nets and encouraging environmentally safe alternatives would help limit harmful exposures. Together, these interventions have the potential to mitigate cancer risk and improve population health outcomes in Bangladesh.
To reduce household exposure to indoor air pollution, the government could promote the transition to cleaner cooking fuels, such as liquefied petroleum gas or biogas, particularly in rural areas where biomass use remains high. This may be achieved through targeted subsidy programs, micro-financing options for low-income families, and awareness campaigns delivered via community health platforms. In addition, improvements to household ventilation systems, such as encouraging separate kitchen structures or smoke outlets in housing policy, can further help mitigate the health risks associated with traditional cooking practices.
Public health programs should also incorporate education on safe food preparation and hygiene practices, particularly emphasizing the risks of consuming improperly cooked meat or fish. Nutrition education, delivered through schools, health centers, or community workers, can help raise awareness of these issues in both urban and rural settings. Similarly, integrating oral health promotion into existing primary health care services may improve daily dental hygiene behaviors, especially if accompanied by community-led campaigns and preventive services such as mobile dental check-ups.
To address the risks associated with chemical mosquito repellents, expanding access to insecticide treated bed nets and promoting safer, environmentally friendly alternatives should be prioritized. Public messaging campaigns can help shift behavior away from frequent repellent use, especially in households with children or those at risk of chronic illnesses.
However, the feasibility and cultural acceptability of these interventions should be carefully considered. Barriers such as affordability of cleaner fuels, traditional cooking practices, and preferences for repellent use may limit widespread adoption. Identifying and engaging key stakeholders, including households, community leaders, health professionals, and policymakers, will be essential to ensure that interventions are practical, culturally appropriate, and sustainable.
Supporting information
S1 Fig. Percentage distribution of lifestyle components among cases and controls.
https://doi.org/10.1371/journal.pone.0328745.s001
(JPEG)
S2 Fig. Percentage of case and control with frequent exposure to environmental components.
https://doi.org/10.1371/journal.pone.0328745.s002
(JPG)
S1 Data. De-identified dataset used in this study.
https://doi.org/10.1371/journal.pone.0328745.s003
(SAV)
Acknowledgments
The authors would like to thank the dedicated public health researchers from the Department of Public Health, North South University, for their invaluable contributions to questionnaire development, data collection, and project implementation.
References
- 1.
World Health Organization. Cancer Fact Sheet. 2021. https://www.who.int/news-room/fact-sheets/detail/cancer
- 2. Colditz GA, Wolin KY, Gehlert S. Applying what we know to accelerate cancer prevention. Sci Transl Med. 2012;4(127):127rv4. pmid:22461645
- 3. Jassem J. Tobacco smoking after diagnosis of cancer: clinical aspects. Transl Lung Cancer Res. 2019;8(Suppl 1):S50–8. pmid:31211105
- 4. Boraka Ö, Klintman M, Rosendahl AH. Physical activity and long-term risk of breast cancer, associations with time in life and body composition in the prospective Malmö diet and cancer study. Cancers (Basel). 2022;14(8):1960. pmid:35454864
- 5.
World Cancer Research Fund International. Cancer prevention organisation. 2022. https://www.wcrf.org/
- 6. Mathur R, Singhavi HR, Malik A, Nair S, Chaturvedi P. Role of poor oral hygiene in causation of oral cancer-a review of literature. Indian J Surg Oncol. 2019;10(1):184–95. pmid:30948897
- 7. Hashim D, Boffetta P. Occupational and environmental exposures and cancers in developing countries. Ann Glob Health. 2014;80(5):393–411. pmid:25512155
- 8. Wang M, Kim RY, Kohonen-Corish MRJ, Chen H, Donovan C, Oliver BG. Particulate matter air pollution as a cause of lung cancer: epidemiological and experimental evidence. Br J Cancer. 2025;132(11):986–96. pmid:40185876
- 9. Shankar A, Dubey A, Saini D, Singh M, Prasad CP, Roy S, et al. Environmental and occupational determinants of lung cancer. Transl Lung Cancer Res. 2019;8(Suppl 1):S31–49. pmid:31211104
- 10. Thakur JS, Rana A, Kaur R, Malhotra S. Exposure to occupational carcinogens and risk of lung cancer: a systematic review and meta-analysis. International Journal of Noncommunicable Diseases. 2023;8(3):129–36.
- 11. Gerken J, Vincent GT, Zapata D, Barron IG, Zapata I. Comprehensive assessment of pesticide use patterns and increased cancer risk. Front Cancer Control Soc. 2024;2.
- 12. Zhao-hua Z, Xue-ping Z. Study on correlation between cervix cancer and chemical elements of soil environment in China. Hunan Geology. 2001;2.
- 13.
National Institute of Population Research and Training (NIPORT), Mitra and Associates, ICF. Bangladesh Demographic and Health Survey 2017–18. 2020.
- 14. Begum BA, Paul SK, Dildar Hossain M, Biswas SK, Hopke PK. Indoor air pollution from particulate matter emissions in different households in rural areas of Bangladesh. Building and Environment. 2009;44(5):898–903.
- 15. Mishra R, Rahut DB, Bera S, Dendup N, Sonobe T. In pursuit of sustainable development goal 7-evidence of clean cooking fuel usage from 46 developing countries. The Electricity Journal. 2024;37(4–5):107408.
- 16.
World Health Organization. WHO global air quality guidelines: particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide; 2021.
- 17.
World Bank. Rural population (% of total population) – Bangladesh; 2024. https://data.worldbank.org/indicator/SP.RUR.TOTL.ZS?locations=BD.
- 18. Quansah R, Semple S, Ochieng CA, Juvekar S, Armah FA, Luginaah I, et al. Effectiveness of interventions to reduce household air pollution and/or improve health in homes using solid fuel in low-and-middle income countries: a systematic review and meta-analysis. Environ Int. 2017;103:73–90. pmid:28341576
- 19. Zheng W, Lee S-A. Well-done meat intake, heterocyclic amine exposure, and cancer risk. Nutr Cancer. 2009;61(4):437–46. pmid:19838915
- 20. Sebeková K, Somoza V. Dietary advanced glycation endproducts (AGEs) and their health effects–PRO. Mol Nutr Food Res. 2007;51(9):1079–84. pmid:17854003
- 21. Abid Z, Cross AJ, Sinha R. Meat, dairy, and cancer. Am J Clin Nutr. 2014;100 Suppl 1(1):386S-93S. pmid:24847855
- 22. Shammi M, Sultana A, Hasan N, Mostafizur Rahman Md, Saiful Islam Md, Bodrud-Doza Md, et al. Pesticide exposures towards health and environmental hazard in Bangladesh: a case study on farmers’ perception. Journal of the Saudi Society of Agricultural Sciences. 2020;19(2):161–73.
- 23. Shahidullah AKM, Islam A, Rahman M. Knowledge, attitude, and practice of pesticide use by vegetable growers in Bangladesh: a health literacy perspective in relation to non-communicable diseases. Front Sustain Food Syst. 2023;7.
- 24. Dupont WD. Power calculations for matched case-control studies. Biometrics. 1988;44(4):1157–68. pmid:3233252
- 25. EFSA Panel on Contaminants in the Food Chain (CONTAM). Scientific opinion on acrylamide in food. EFSA Journal. 2015;13(6):4104.
- 26.
Mobley HLT, Mendz GL, Hazell SL. Helicobacter pylori: physiology and genetics. Washington (DC): ASM Press; 2001.
- 27. Sheikh M, Poustchi H, Pourshams A, Khoshnia M, Gharavi A, Zahedi M, et al. Household fuel use and the risk of gastrointestinal cancers: the golestan cohort study. Environ Health Perspect. 2020;128(6):67002. pmid:32609005
- 28. Smith KR, Bruce N, Balakrishnan K, Adair-Rohani H, Balmes J, Chafe Z, et al. Millions dead: how do we know and what does it mean? methods used in the comparative risk assessment of household air pollution. Annu Rev Public Health. 2014;35:185–206. pmid:24641558
- 29. Begum BA, Biswas SK, Hopke PK. Key issues in controlling air pollutants in Dhaka, Bangladesh. Atmospheric Environment. 2011;45(40):7705–13.
- 30. Schwab U, Lauritzen L, Tholstrup T, Haldorssoni T, Riserus U, Uusitupa M, et al. Effect of the amount and type of dietary fat on cardiometabolic risk factors and risk of developing type 2 diabetes, cardiovascular diseases, and cancer: a systematic review. Food Nutr Res. 2014;58:10.3402/fnr.v58.25145. pmid:25045347
- 31. Siemiatycki J, Dewar R, Lakhani R, Nadon L, Richardson L, Gérin M. Cancer risks associated with 10 inorganic dusts: results from a case-control study in Montreal. Am J Ind Med. 1989;16(5):547–67. pmid:2556028
- 32. Chen S-C, Wong R-H, Shiu L-J, Chiou M-C, Lee H. Exposure to mosquito coil smoke may be a risk factor for lung cancer in Taiwan. J Epidemiol. 2008;18(1):19–25. pmid:18305363
- 33. Swale DR, Sun B, Tong F, Bloomquist JR. Neurotoxicity and mode of action of N, N-diethyl-meta-toluamide (DEET). PLoS One. 2014;9(8):e103713. pmid:25101788
- 34. Jaga K, Dharmani C. The epidemiology of pesticide exposure and cancer: A review. Rev Environ Health. 2005;20(1):15–38. pmid:15835496
- 35. Greenland S. Modeling and variable selection in epidemiologic analysis. Am J Public Health. 1989;79(3):340–9. pmid:2916724
- 36. Pearce N. Analysis of matched case-control studies. BMJ. 2016;352:i969. pmid:26916049