1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene and polychlorinated biphenyls and breast cancer:: Combined analysis of five US studies
1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene and polychlorinated biphenyls and breast cancer:: Combined analysis of five US studies
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DOI：
10.1093/jnci/93.10.768
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发表时间：
2001-05-16
影响因子：
10.3
通讯作者：
Hunter, DJ
中科院分区：
文献类型：
--
作者：
Laden, F;Collman, G;Hunter, DJ
背景：环境暴露于有机氯已被认为是乳腺癌的潜在危险因素。1993年，美国资助了5项主要针对美国东北部妇女的大型研究，以评估血浆或血清中1,1-二氯-2,2-双（对氯苯）乙烯（DDE）和多氯联苯（PCBs）水平与乳腺癌风险的关系。我们对这些结果进行了综合分析，以提高准确性，并最大限度地提高统计能力，以发现其他乳腺癌危险因素对疗效的影响。方法：我们重新分析了这5项研究的数据，包括1400例乳腺癌患者和1642例对照受试者，采用标准化的方法来控制混淆和评估疗效的改变。我们使用随机效应模型计算了合并优势比（ORs）和95%置信区间（ci）。结果：当我们比较脂质调整值的第五分位数与第一分位数的女性时，与多氯联苯相关的乳腺癌的多因素汇总OR为0.94 (95% CI = 0.73至1.21)，与DDE相关的OR为0.99 （95% CI = 0.77至1.27）。虽然在最初的研究中，根据胎次和哺乳期分层的某些妇女群体中，多氯联苯与乳腺癌风险升高有关，但这些观察结果在汇总分析中并不明显。在其他分层分析中没有观察到统计学上显著的关联，除了在体重指数（25-29.9 kg/m）处于中等水平的妇女中多氯联苯水平较高的风险增加(2)；然而，在体重较重的女性中，风险没有统计学上的显著降低。结论：综合证据不支持乳腺癌风险与多氯联苯或DDE的血浆/血清浓度相关。成年女性暴露于这些化合物中，不太可能解释美国东北部乳腺癌的高发病率。
Background: Environmental exposure to organochlorines has been examined as a potential risk factor for breast cancer, in 1993, five large U.S. studies of women located mainly in the northeastern United States were funded to evaluate the association of levels of 1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene (DDE) and polychlorinated biphenyls (PCBs) in blood plasma or serum with breast cancer risk. We present a combined analysis of these results to increase precision and to maximize statistical power to detect effect modification by other breast cancer risk factors, Methods: We reanalyzed the data from these five studies, consisting of 1400 case patients with breast cancer and 1642 control subjects, by use of a standardized approach to control for confounding and assess effect modification. We calculated pooled odds ratios (ORs) and 95% confidence intervals (CIs) by use of the random-effects model. All statistical tests were two-sided, Results: When we compared women in the fifth quintile of lipid-adjusted values with those in the first quintile, the multivariate pooled OR for breast cancer associated with PCBs was 0.94 (95% CI = 0.73 to 1.21), and that associated with DDE was 0.99 (95% CI = 0.77 to 1.27). Although in the original studies there were suggestions of elevated breast cancer risk associated with PCBs in certain groups of women stratified by parity and lactation, these observations were not evident in the pooled analysis. No statistically significant associations were observed in any other stratified analyses, except for an increased risk with higher levels of PCBs among women in the middle tertile of body mass index (25-29.9 kg/m(2)); however, the risk was statistically nonsignificantly decreased among heavier women. Conclusions: Combined evidence does not support an association of breast cancer risk with plasma/serum concentrations of PCBs or DDE. Exposure to these compounds, as measured in adult women, is unlikely to explain the high rates of breast cancer experienced in the northeastern United States.