Abstract
BackgroundFindings from a recent prospective cohort study in California suggested increased risk of breast cancer associated with higher exposure to certain carcinogenic and estrogen-disrupting hazardous air pollutants (HAPs). However, to date, no nationwide studies have evaluated these possible associations. Our objective was to examine the impacts of mammary carcinogen and estrogen disrupting HAPs on risk of invasive breast cancer in a nationwide cohort.MethodsWe assigned HAPs from the US Environmental Protection Agency’s 2002 National Air Toxics Assessment to 109,239 members of the nationwide, prospective Nurses’ Health Study II (NHSII). Risk of overall invasive, estrogen receptor (ER)-positive (ER+), and ER-negative (ER-) breast cancer with increasing quartiles of exposure were assessed in time-varying multivariable proportional hazards models, adjusted for traditional breast cancer risk factors.ResultsA total of 3321 invasive cases occurred (2160 ER+, 558 ER-) during follow-up 1989–2011. Overall, there was no consistent pattern of elevated risk of the HAPs with risk of breast cancer. Suggestive elevations were only seen with increasing 1,2-dibromo-3-chloropropane exposures (multivariable adjusted HR of overall breast cancer = 1.12, 95% CI: 0.98–1.29; ER+ breast cancer HR = 1.09; 95% CI: 0.92, 1.30; ER- breast cancer HR = 1.14; 95% CI: 0.81, 1.61; each in the top exposure quartile compared to the lowest).ConclusionsExposures to HAPs during adulthood were not consistently associated with an increased risk of overall or estrogen-receptor subtypes of invasive breast cancer in this nationwide cohort of women.
Highlights
Findings from a recent prospective cohort study in California suggested increased risk of breast cancer associated with higher exposure to certain carcinogenic and estrogen-disrupting hazardous air pollutants (HAPs)
Two recent analyses based in the California Teachers Study (CTS) cohort have focused on Hazardous Air Pollutants (HAPs) as another potential group of environmental risk factors for breast cancer [26, 27]
Acrylamide, benzidine, carbon tetrachloride, ethylidene dichloride, and vinyl chloride were associated with increased risks of estrogen (ER) and progesterone (PR) receptor-positive tumors (ER+/PR+), and benzene was associated with an increased risk of receptor-negative (ER-/PR-) tumors
Summary
Findings from a recent prospective cohort study in California suggested increased risk of breast cancer associated with higher exposure to certain carcinogenic and estrogen-disrupting hazardous air pollutants (HAPs). Our objective was to examine the impacts of mammary carcinogen and estrogen disrupting HAPs on risk of invasive breast cancer in a nationwide cohort. Using information available from EPA, Garcia et al. Hart et al Environmental Health (2018) 17:28 examined the association of HAPs that had been previously identified from toxicological studies as mammary carcinogens and risk of invasive breast cancer [26]. Of the 24 HAPs examined, acrylamide, carbon tetrachloride, chloroprene, 4,4′-methylene bis(2-chloroaniline), propylene oxide, and vinyl chloride were associated with an increased risk of breast cancer overall. Acrylamide, benzidine, carbon tetrachloride, ethylidene dichloride, and vinyl chloride were associated with increased risks of estrogen (ER) and progesterone (PR) receptor-positive tumors (ER+/PR+), and benzene was associated with an increased risk of receptor-negative (ER-/PR-) tumors
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