Exposure to fogger trucks and breast cancer incidence in the Long Island Breast Cancer Study Project: a case-control study.
Exposure to fogger trucks and breast cancer incidence in the Long Island Breast Cancer Study Project: a case-control study.
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DOI：
10.1186/1476-069x-12-24
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发表时间：
2013-03-15
期刊：
影响因子：
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通讯作者：
Gammon MD
中科院分区：
文献类型：
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作者：
White AJ;Teitelbaum SL;Wolff MS;Stellman SD;Neugut AI;Gammon MD
很少有研究支持乳腺癌与滴滴涕之间的联系，通常用生物标志物进行评估，无法辨别接触的时间，也无法区分过去慢性低剂量与急性高剂量接触的积累。以前的研究表明，这种关联可能只在生物学敏感窗口期间暴露于滴滴涕的妇女中，或在被诊断为雌激素受体/孕激素受体阳性（ER+PR+）乳腺癌亚型的妇女中明显。据推测，自我报告的急性暴露于1972年之前喷洒滴滴涕的烟雾车会增加患乳腺癌的风险，特别是在年轻时暴露或诊断为ER+PR+乳腺癌的女性中。我们在长岛乳腺癌研究项目（LIBCSP）（1，508例，1，556例对照）中检查了这些可能性，其中包括通过结构化问卷和1996-1998年收集的血清样本进行的暴露评估，使用调整后的logistic和多分类回归估计OR和95%CI。与其他亚型相比，ER+PR+乳腺癌女性看到1972年前的烟雾车的几率增加了44%（OR = 1.44; 95%CI 1.08-1.93）。然而，当考虑到所有报告在其住所（OR = 1.16; 95%CI 0.98，1.37）或在假设的易感窗口期间看到1972年前的烟雾车的妇女时，观察到的乳腺癌风险增加的变化很小。自我报告的急性暴露与血清浓度（长期暴露的生物标志物）无关。这些发现支持了这样的假设，即看到一辆烟雾车，一种急性滴滴涕暴露的替代措施，可能与ER+PR+肿瘤有关，ER+PR+肿瘤是美国妇女中最常见的乳腺癌亚型。
Few studies have supported an association between breast cancer and DDT, usually assessed with biomarkers that cannot discern timing of exposure, or differentiate between the accumulation of chronic low-dose versus acute high-dose exposures in the past. Previous studies suggest that an association may be evident only among women exposed to DDT during biologically susceptible windows, or among those diagnosed with estrogen receptor/progesterone receptor-positive (ER+PR+) breast cancer subtypes. Self-reported acute exposure to a fogger truck, which sprayed DDT prior to 1972, was hypothesized to increase the risk of breast cancer, particularly among women exposed at a young age or diagnosed with ER+PR+ breast cancer. We examined these possibilities in the Long Island Breast Cancer Study Project (LIBCSP) (1,508 cases, 1,556 controls), which included exposure assessment by structured questionnaire and serum samples collected between 1996–1998, using adjusted logistic and polytomous regression to estimate ORs and 95% CIs. Women with ER+PR+ breast cancer had a 44% increased odds of ever seeing a pre-1972 fogger truck compared to other subtypes (OR = 1.44; 95% CI 1.08-1.93). However, there was little variation in the observed increase in breast cancer risk when considering all women who reported seeing a pre-1972 fogger truck at their residence (OR = 1.16; 95% CI 0.98, 1.37), or during hypothesized susceptible windows. Self-reported acute exposure was not correlated with serum concentrations, a biomarker of long-term exposure. These findings support the hypothesis that seeing a fogger truck, a proxy measure for acute DDT exposure, may be associated with ER+PR+ tumors, the most commonly diagnosed breast cancer subtype among American women.