Objective To investigate the correlation between aerosol optical depth based on satellite remote sensing data and lung cancer incidence. Methods The aerosol optical depth data of Zhejiang Province was derived from the secondary level aerosol product synthesized from the data of the moderate-resolution imaging spectroradiometer (MODIS) carried by the American polar-orbiting satellites Terra and Aqua with a spatial resolution of 10 km. The data of lung cancer incidence in tumor registration area

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... f Zhejiang Province in 2015 was from Annual Report of Cancer Registration in China in 2018. Results From 2010 to 2014, the average aerosol optical depth levels of Zhejiang Province were 0.389±0.108, 0.539±0.146, 0.485±0.134, 0.458±0.140 and 0.550±0.149, respectively. The average aerosol optical depth in Zhejiang Province cancer registration area from 2010 to 2014 was 0.524±0.141, with 0.533±0.132 in urban area and 0.518±0.153 in rural area. The annual aerosol optical depth values in urban and rural areas had no statistical difference (all P > 0.05). Taken interquartile range of aerosol optical depth level as the boundary, the lung cancer incidence in Q1(P0-P25), Q2(P25-P50), Q3(P50-P75) and Q4(P75-P100) areas were 49.44/105, 76.58/105, 72.40/105 and 84.02/105, respectively. There was statistical differences in the incidence of lung cancer in different aerosol optical depth regions (P < 0.001). The multiple linear regression analysis showed that aerosol optical depth and per capita disposable income were statistically significant influencing factors for lung cancer incidence from 2010 to 2014 (P < 0.05). Conclusion Based on the satellite remote sensing data, the aerosol optical depth has a statistically significant correlation with the lung cancer incidence. The aerosol optical depth can reflect the risk of lung cancer clearly and can be used as a valuable indicator to monitor environmental quality.