Environmental Quality and Invasive Breast Cancer.
Environmental Quality and Invasive Breast Cancer.
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DOI：
10.1158/1055-9965.epi-19-1497
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Devi GR
中科院分区：
文献类型：
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作者：
Gearhart-Serna LM;Hoffman K;Devi GR
乳腺癌是一种复杂且多因素的疾病，环境因素已被认为会增加其风险。然而，先前的研究主要集中在研究一次接触一种因素/污染物的情况，这并不能反映现实世界的环境。在此，我们调查了乳腺癌与环境质量指数 (EQI) 之间的关联，该指数是对县级环境质量五个领域（空气、水、土地、社会人口和建筑）的综合评估。北卡罗来纳州女性的乳腺癌诊断数据来自北卡罗来纳州中央癌症登记处（2009-2014 年），诊断时的居住县与 EQI 相关联。我们使用患有原位癌的女性作为基于登记的对照，评估了环境质量类别中局部、区域或远处转移性乳腺癌的几率。总体环境质量通常与浸润性乳腺癌无关；然而，所有乳腺癌类型往往与土地质量呈负相关，特别是在更多农村社区[与原位癌相比，远处转移性乳腺癌的可能性高出 5-8%（OR 1.08；95% CI：1.02、1.14，p=0.02）]。总的来说，我们的结果表明，一些广泛的环境质量指标与浸润性乳腺癌相关，但这种关联因环境领域、癌症阶段、亚型和城市而异。我们的研究结果表明，土地质量的组成部分（例如农药的使用和动物设施）值得对浸润性乳腺癌进行额外的调查。
Breast cancer is a complex and multifactorial disease, and environmental factors have been suggested to increase its risk. However, prior research has largely focused on studying exposures to one factor/contaminant at a time, which does not reflect the real-world environment. Herein, we investigate associations between breast cancer and the Environmental Quality Index (EQI), a comprehensive assessment of five domains of environmental quality (air, water, land, sociodemographic, and built) at the county level. Breast cancer diagnoses for North Carolina women were obtained from the North Carolina Central Cancer Registry (2009-2014) and the county of residence at the time of diagnosis was linked with the EQI. We evaluated the odds of localized, regional, or distant metastatic breast cancer in categories of environmental quality using women with carcinoma in situ as registry-based controls. Overall environmental quality was generally not associated with invasive breast cancer; however, all breast cancer types tended to be inversely associated with land quality, particularly in more rural communities [distant metastatic breast cancer was 5-8% more likely (OR 1.08; 95% CI: 1.02, 1.14, p=0.02) compared to carcinoma in situ]. Cumulatively, our results suggest that some broad measures of environmental quality are associated with invasive breast cancer but that associations vary by environmental domain, cancer stage, subtype, and urbanicity. Our findings suggest that components of land quality (e.g. pesticide applications and animal facilities) warrant additional investigation in relation to invasive breast cancer.