The Impact of the Natural, Social, Built, and Policy Environments on Breast Cancer.
The Impact of the Natural, Social, Built, and Policy Environments on Breast Cancer.
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DOI：
10.15436/2378-6841.15.020
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Smith SA
中科院分区：
文献类型：
--
作者：
Coughlin SS;Smith SA
女性乳腺癌的全球负担是巨大的，而且还在增加。解决乳腺癌问题的努力集中在初级预防、减少可改变的风险因素、早期发现、及时转诊接受适当治疗和生存率。增加乳腺癌风险的环境和生活方式因素包括电离辐射、外源性激素、某些女性生殖因素、酒精和其他饮食因素、肥胖和缺乏运动。据称，各种化学品暴露与乳腺癌有关。在这篇文章中，我们总结了自然，社会，建筑和政策环境对乳腺癌发病率和癌症复发的妇女的基础上，文献检索和相关的搜索条件的影响。尽管缺乏流行病学研究的结论性证据，但如果暴露于具有雌激素或其他与性类固醇活性相关的性质的化学品，则如果暴露发生在关键的生命阶段或与暴露于其他类似化学品相结合，则可能会影响乳腺癌风险。几项研究的结果支持轮班工作和昼夜节律紊乱与乳腺癌风险之间的联系。社会环境可能通过几种机制影响乳腺癌风险，包括与母乳喂养有关的社会规范，首次活产年龄，产次，口服避孕药和替代雌激素的使用，饮食和饮酒。社会规范也会影响体重、肥胖和体育活动，从而影响乳腺癌的发病率和复发风险。肥胖受社会、建筑和政策环境的影响，是绝经后乳腺癌和某些其他癌症类型发展的危险因素。自然，社会，建筑和政策环境影响乳腺癌的发病率和生存率。有效的医疗保健政策可以鼓励提供高质量的乳腺癌筛查和治疗，并就适当饮食、体重控制、筛查和治疗的价值进行公众教育。需要进行更多的研究和制定政策，以确定限制接触可能致癌的化学品对预防乳腺癌的价值。
The global burden of breast cancer in women is substantial and increasing. Efforts to address breast cancer have focused on primary prevention, reduction of modifiable risk factors, early detection, timely referral for appropriate treatment, and survivorship. Environmental and lifestyle factors that increase breast cancer risk include ionizing radiation, exogenous hormones, certain female reproductive factors, alcohol and other dietary factors, obesity, and physical inactivity. A variety of chemical exposures are purported to be associated with breast cancer. In this article, we summarize the influence of the natural, social, built, and policy environments on breast cancer incidence and cancer recurrence in women based upon bibliographic searches and relevant search terms. Despite a lack of conclusive evidence from epidemiologic studies, exposures to chemicals with estrogenic or other properties relevant to sex steroid activity could influence breast cancer risk if the exposures occur at critical life stages or in combination with exposure to other similar chemicals. Results from several studies support an association between shift work and disruption of the circadian rhythm with breast cancer risk. The social environment likely influences breast cancer risk through several mechanisms including social norms pertaining to breast feeding, age at first live birth, parity, use of oral contraceptives and replacement estrogens, diet, and consumption of alcohol. Social norms also influence body weight, obesity, and physical activity, which have an effect on risk of breast cancer incidence and recurrence. Obesity, which is influenced by the social, built, and policy environments, is a risk factor for the development of postmenopausal breast cancer and certain other cancer types. The natural, social, built, and policy environments affect breast cancer incidence and survival. Effective health care policies can encourage the provision of high-quality screening and treatment for breast cancer and public education about the value of proper diet, weight control, screening and treatment. Additional research and policy development is needed to determine the value of limiting exposures to potentially carcinogenic chemicals on breast cancer prevention.