Breast cancer risk and environmental exposures.
Breast cancer risk and environmental exposures.
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DOI：
10.1289/ehp.97105s4891
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发表时间：
1997-06
影响因子：
10.4
通讯作者：
Weston A
中科院分区：
文献类型：
--
作者：
Wolff MS;Weston A
虽然环境污染物有可能影响乳腺癌的风险，明确的环境与这种疾病的联系是有限的。最明确的环境风险因素是辐射照射和酒精摄入。饮食与发达国家乳腺癌发病率的增加明显相关，但其确切作用尚未确定。最近的研究表明，在美国、芬兰、墨西哥和加拿大，接触包括滴滴涕在内的有机氯是乳腺癌的一个危险因素。其他调查发现，乳腺癌风险与接触化学排放物和某些职业接触之间存在关联。在评估环境暴露与乳腺癌的关系时，必须考虑几点。这些考虑因素包括肿瘤发生的机制、环境暴露的时间和暴露的遗传调节。流行病学和生态学研究必须考虑到乳腺癌非常复杂的病因学和肿瘤发生可能由不同机制引起的知识。因此，与乳腺癌相关的关键暴露以及生殖事件可能发生在肿瘤明显之前的几年。此外，环境污染物可能直接或间接地改变生殖发育，从而影响肿瘤发生的过程。这些改变包括性别的改变、青春期开始的改变以及肿瘤形成的抑制或促进。因此，暴露的时间对于机制和易感性是重要的。最后，基因多态性存在于控制代谢环境污染物能力的基因中。如果某些人体内的酶在产生原致癌物方面更活跃，或者不能对环境中化学物质形成的致癌中间体进行解毒，那么这些人的风险可能更高。
Although environmental contaminants have potential to affect breast cancer risk, explicit environmental links to this disease are limited. The most well-defined environmental risk factors are radiation exposure and alcohol ingestion. Diet is clearly related to the increased incidence of breast cancer in developed countries, but its precise role is not yet established. Recent studies have implicated exposure to organochlorines including DDT as a risk factor for breast cancer in the United States, Finland, Mexico, and Canada. Other investigations have discovered associations between breast cancer risk and exposures to chemical emissions and some occupational exposures. Several points must be considered in evaluating the relationship of environmental exposure to breast cancer. Among these considerations are the mechanism of tumorigenesis, timing of environmental exposure, and genetic modulation of exposure. Epidemiologic and ecologic investigations must take into account the very complex etiology of breast cancer and the knowledge that tumorigenesis can arise from different mechanisms. Thus crucial exposures as well as reproductive events related to breast cancer may occur years before a tumor is evident. Moreover, environmental contaminants may alter reproductive development, directly or indirectly, and thereby effect the course of tumorigenesis. Such alterations include change in gender, change in onset of puberty, and inhibition or promotion of tumor formation. Timing of exposure is therefore important with respect to mechanism and susceptibility. Finally, genetic polymorphisms exist in genes that govern capacity to metabolize environmental contaminants. Higher risk may occur among persons whose enzymes either are more active in the production of procarcinogens or fail to detoxify carcinogenic intermediates formed from chemicals in the environment.