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BACKGROUND Information on the association between long-term exposure to PM2.5 and gastrointestinal cancer mortality is scarce. OBJECTIVES This study investigated the association between long-term exposure to PM2.5 and deaths from gastrointestinal cancer and its subtypes in adults in Taiwan. METHODS A total of 385,650 Taiwanese adults (≥18 years old) jointed a standard medical examination program between 2001 and 2014 and were followed up until 2016. Their vital data were obtained from the National Death Registry maintained by the Minis