Trichloroethylene cancer epidemiology: a consideration of select issues.
Trichloroethylene cancer epidemiology: a consideration of select issues.
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DOI：
10.1289/ehp.8949
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发表时间：
2006-09
影响因子：
10.4
通讯作者：
Chiu, Weihsueh A
中科院分区：
文献类型：
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作者：
Scott, Cheryl Siegel;Chiu, Weihsueh A
存在大量流行病学证据用于探究癌症与三氯乙烯（TCE）暴露之间的因果关联。三氯乙烯健康风险评估草案得出结论，总体而言，流行病学研究支持三氯乙烯暴露与肾癌、肝癌和淋巴瘤的超额风险之间存在关联，在较小程度上也与宫颈癌和前列腺癌有关。作为关于三氯乙烯健康风险评估关键问题的小型专题论文的一部分，本文回顾了近期发表的有关癌症与三氯乙烯暴露的科学文献，并确定了对解读大量流行病学证据至关重要的四个问题：a）癌症发病率和死亡率数据的相对敏感性；b）淋巴瘤（包括非霍奇金淋巴瘤）的不同分类；c）确定三氯乙烯暴露状况的数据和方法的差异；d）用于因果推断的不同方法，包括统计或荟萃分析方法。近期的流行病学研究极大地扩充了流行病学数据库，有七项关于肾癌的新研究，而针对其他部位可能存在的关联的研究则相对较少。总体而言，近期发表的研究似乎进一步支持肾脏、肝脏和淋巴系统是三氯乙烯毒性的靶器官，与先前的研究一样，鉴于这些研究中的暴露条件，特定部位的相对风险有适度升高（通常为1.5 - 2.0）。然而，在从这些数据得出三氯乙烯暴露与癌症之间的因果结论之前，需要考虑许多具有挑战性的问题。
A large body of epidemiologic evidence exists for exploring causal associations between cancer and trichloroethylene (TCE) exposure. The draft TCE health risk assessment concluded that epidemiologic studies, on the whole, support associations between TCE exposure and excess risk of kidney cancer, liver cancer, and lymphomas, and, to a lesser extent, cervical cancer and prostate cancer. As part of a mini-monograph on key issues in the health risk assessment of TCE, this article reviews recently published scientific literature examining cancer and TCE exposure and identifies four issues that are key to interpreting the larger body of epidemiologic evidence: a) relative sensitivity of cancer incidence and mortality data; b) different classifications of lymphomas, including non-Hodgkin lymphoma; c) differences in data and methods for assigning TCE exposure status; and d) different methods employed for causal inferences, including statistical or meta-analysis approaches. The recent epidemiologic studies substantially expand the epidemiologic database, with seven new studies available on kidney cancer and somewhat fewer studies available that examine possible associations at other sites. Overall, recently published studies appear to provide further support for the kidney, liver, and lymphatic systems as targets of TCE toxicity, suggesting, as do previous studies, modestly elevated (typically 1.5–2.0) site-specific relative risks, given exposure conditions in these studies. However, a number of challenging issues need to be considered before drawing causal conclusions about TCE exposure and cancer from these data.