Impact of Environmental Pollutants on Breast Cancer and*

描述：美国所有年龄段的乳腺癌发病率持续上升，从20世纪70年代初到90年代末，年龄调整后的发病率增加了40%以上。发病率因地域而异，随着妇女从低风险地区迁移到高风险地区，风险也会发生变化。已经确定了许多适度导致乳腺癌风险的因素--电离辐射、家族史、生育史、药物激素、体型、饮酒和缺乏体育活动--但这些因素加在一起，解释的风险还不到一半。在这方面，1994年发起了科德角乳腺癌与环境研究，以调查那里的较高发病率，重点是内分泌干扰化合物(EDCs)和来自广泛使用杀虫剂、饮用水和乳房致癌物质的可能作用 被废水和家居用品污染。接触内毒素和乳腺致癌物的来源很常见，如空气和水污染、洗涤剂、杀虫剂、化妆品、塑料、建筑材料和家具。这项研究包括对2100名妇女进行的病例对照流行病学研究，对120户家庭进行的家庭暴露研究，以及对受化粪池系统废物影响的地下水和饮用水中的内分泌干扰物进行环境采样。拟议的研究将涉及以下具体目标：(1)在病例对照研究中，评估与使用某些清洁和个人护理产品有关的乳腺癌风险；(2)在家庭暴露研究中，(A)比较科德角和国家的数据和 (B)描述室内空气、室内粉尘、尿液浓度和 (3)在地下水和饮用水研究中，利用化学分析和生物分析来调查地下水中内源性和药物性雌激素、其他内源性DC和来自地下水化粪池系统的其他药物的迁移和去向；(4)邀请公众提供意见并开展持续的外展计划。公共卫生相关性：广泛的目标是通过研究来促进对可能导致乳腺癌预防的环境因素的了解 常见暴露于空气、水污染和家用产品中的内分泌干扰化合物和乳腺癌致癌物质的可能作用。这些污染物对健康的影响相对较少，在确定可避免的疾病原因方面大有可为，包括乳腺癌、其他荷尔蒙癌症(卵巢癌、子宫内膜癌、睾丸癌、前列腺癌)以及生殖和儿童健康。

DESCRIPTION: Breast cancer incidence continues to rise in all age groups in the US, with an increase in age-adjusted incidence of more than 40% from the early 1970s to the late 1990s. Incidence varies geographically, and risk changes as women migrate from low- to high-risk regions. Many factors have been identified that contribute moderately to breast cancer risk -- ionizing radiation, family history, reproductive history, pharmaceutical hormones, body size, alcohol use, and lack of physical activity - but taken together these factors explain less than half of risk. In this context, the Cape Cod Breast Cancer and Environment Study was initiated in 1994 to investigate higher incidence there, focusing on the possible role of endocrine disrupting compounds (EDCs) and mammary carcinogens from wide-area pesticide use, drinking water contaminated by wastewater, and household products. Exposure to EDCs and mammary carcinogens is common from sources such as air and water pollution, detergents, pesticides, cosmetics, plastics, building materials, and furnishings. The study includes a case-control epidemiologic study of 2100 women, a household exposure study of 120 homes, and environmental sampling for EDCs in groundwater and drinking water impacted by septic system wastes. The proposed research will address the following specific aims: (1) in the case-control study, assess the breast cancer risk associated with use of certain cleaning and personal care products; (2) in the household exposure study, (a) compare Cape Cod and national data and (b) characterize the relationships among indoor air, house dust, urinary concentrations, and housing/personal activity variables for 67 EDCs detected in the homes in order to identify sources and pathways of exposure and inform pilot testing of exposure reduction; (3) in the groundwater and drinking water study, use chemical analysis and bioassays to investigate the transport and fate of endogenous and pharmaceutical estrogens, other EDCs, and other Pharmaceuticals from septic systems in groundwater; and (4) invite public input and conduct ongoing outreach programs. PUBLIC HEALTH RELEVANCE: The broad goal is to advance knowledge of environmental factors that may lead to breast cancer prevention by studying the possible role of endocrine disrupting compounds and mammary carcinogens from common exposures to air and water pollution and household products. The health effects of these pollutants are relatively unexplored and offer great promise for identifying avoidable causes of disease, including breast cancer, other hormonal cancers (ovarian, endometrial, testicular, prostate), and reproductive and children's health.