Breast Cancer and Socio-Environmental Indicators in the City of Maceió: An Ecological Study

Abstract

INTRODUCTION: Breast cancer incidence is rising worldwide. Since the recognized risk factors such as genetic inheritance, reproductive and individual lifestyle explain less than 50% of the cases, environmental exposures are of great interest. In the city of Maceio, northeastern Brazil, a different geographic pattern of breast cancer incidence has been observed. MATERIALS AND METHODS: Fifty women diagnosed with breast cancer in the period of 2011- 2012 were identified by the district of origin, where they have lived for at least 5 years. To evaluate the association of cases of breast cancer cases with socio-environmental indicators, we analysed the prevalence of cases by district in the city of Maceio and correlated with some parameters such as the presence of nitrate and ammonia in groundwater in the period of 2000-2009, deaths by breast cancer, sewer coverage and water distribution, income distribution of the district, deaths of infectious and parasitic diseases and deaths from all causes in 2009. The software SYSTAT 11 was used to perform the calculations of the Pearson correlations. RESULTS: Most of the parameters analyzed showed p value equal or close to zero, we can state that the Pearson coefficients obtained are satisfactory in the level of reliability of results (> 80%). Regarding the presence of nitrates in groundwater, was found a Pearson coefficient of 0. 187, p value of 0. 193, for a confidence level of 80. 7%. The correlation with the presence of ammonia showed a Pearson coefficient of 0. 688, p-value of 0. 0, for a confidence level of 99. 9%. The number of deaths from breast cancer was correlated with Pearson coefficient of 0. 486 for a p-value of 0. 0 and 99. 9% confidence. The water distribution showed a Pearson coefficient with the cases of 0. 215 for p-value of 0. 135 and 86.5% confidence. The correlation with income distribution showed a Pearson coefficient of -0. 212 for a p value of 0. 140, and 86% confidence. The Pearson coefficient for deaths from infectious and parasitic diseases was 0. 732, p-value of 0. 0 for a 99. 9% confidence. The correlation with the number of deaths from all causes showed a Pearson coefficient of 0. 754, p-value of 0. 0 and 99. 9% confidence. DISCUSSION: Components of environmental toxicants may impact the underground aquifers through persistent pollutants, including carcinogenic compounds, at doses greater than the standards of potability, reaching consumers through public sources of supply or domestic. Therefore, there is increasing demand for specific studies contemplate the role of the hydrogeology of contamination on the subject of public health, water-borne diseases and, particularly in etiology of breast cancer. CONCLUSION: This study, it is clear that breast cancer is prevalent in poor places without proper sewer coverage and with high indices of deaths due to waterborne diseases.