DDT Exposure in Utero and Breast Cancer
DDT Exposure in Utero and Breast Cancer
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DOI：
10.1210/jc.2015-1841
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发表时间：
2015-08-01
影响因子：
5.8
通讯作者：
Cirillo, Piera M.
中科院分区：
文献类型：
--
作者：
Cohn, Barbara A.;La Merrill, Michele;Cirillo, Piera M.
背景：目前没有直接证据表明子宫内接触滴滴涕（DDT）与人类乳腺癌有关。然而，在子宫内暴露于另一种异种雌激素，己烯雌酚，预示着乳腺癌的风险增加。如果这一发现延伸到滴滴涕，它可能会产生深远的影响。在1960年代广泛使用滴滴涕期间，许多妇女在子宫内就大量接触滴滴涕。她们现在正处于患乳腺癌风险增加的年龄。滴滴涕的暴露持续存在，在非洲和亚洲继续使用，但对下一代的后果没有明确的认识。假设：子宫内接触滴滴涕与乳腺癌风险增加有关。设计：这是一项病例对照研究，对儿童健康与发育研究妊娠队列中的9300名女儿进行了54年的前瞻性随访（n = 118例乳腺癌病例，按年龄52岁诊断，354例对照按出生年份匹配）。设置和参与者：1959年至1967年在加州的阿拉米达县接受产科护理的凯撒基金会健康计划成员及其成年女儿参加了这项研究。主要结果测量：截至2012年，测量了52岁时诊断为乳腺癌的女儿。母亲o，p '-DDT可预测女儿的乳腺癌（第四个四分位数与第一个四分位数的比值比= 3.7，95%置信区间1.5-9.0）。母亲的血脂、体重、种族、年龄和乳腺癌病史不能解释这一发现。结论：这项前瞻性的人类研究将子宫内滴滴涕暴露量与乳腺癌风险联系起来。实验研究对于确认结果和发现因果机制至关重要。研究结果支持滴滴涕作为内分泌干扰物，乳腺癌的预测因子和高风险标志物的分类。
Context: Currently no direct evidence links in utero dichlorodiphenyltrichloroethane (DDT) exposure to human breast cancer. However, in utero exposure to another xenoestrogen, diethylstilbestrol, predicts an increased breast cancer risk. If this finding extends to DDT, it could have far-reaching consequences. Many women were heavily exposed in utero during widespread DDT use in the 1960s. They are now reaching the age of heightened breast cancer risk. DDT exposure persists and use continues in Africa and Asia without clear knowledge of the consequences for the next generation.Hypothesis: In utero exposure to DDT is associated with an increased risk of breast cancer.Design: This was a case-control study nested in a prospective 54-year follow-up of 9300 daughters in the Child Health and Development Studies pregnancy cohort (n = 118 breast cancer cases, diagnosed by age 52 y and 354 controls matched on birth year). Setting and Participants: Kaiser Foundation Health Plan members who received obstetric care in Alameda County, California, from 1959 to 1967, and their adult daughters participated in the study.Main Outcome Measure: Daughters' breast cancer diagnosed by age 52 years as of 2012 was measured.Results: Maternal o,p'-DDT predicted daughters' breast cancer (odds ratio fourth quartile vs first = 3.7, 95% confidence interval 1.5-9.0). Mothers' lipids, weight, race, age, and breast cancer history did not explain the findings.Conclusions: This prospective human study links measured DDT exposure in utero to risk of breast cancer. Experimental studies are essential to confirm results and discover causal mechanisms. Findings support classification of DDT as an endocrine disruptor, a predictor of breast cancer, and a marker of high risk.