Plasma organochlorine levels and the risk of breast cancer

被引:267
作者
Hunter, DJ
Hankinson, SE
Laden, F
Colditz, GA
Manson, JE
Willett, WC
Speizer, FE
Wolff, MS
机构
[1] HARVARD UNIV, SCH MED, DIV PREVENT MED, BOSTON, MA 02115 USA
[2] BRIGHAM & WOMENS HOSP, BOSTON, MA 02115 USA
[3] HARVARD UNIV, SCH PUBL HLTH, DEPT EPIDEMIOL, BOSTON, MA 02115 USA
[4] HARVARD UNIV, SCH PUBL HLTH, DEPT ENVIRONM HLTH, BOSTON, MA 02115 USA
[5] HARVARD UNIV, SCH PUBL HLTH, DEPT NUTR, BOSTON, MA 02115 USA
[6] HARVARD CTR CANC PREVENT, BOSTON, MA USA
[7] MT SINAI HOSP, DIV ENVIRONM & OCCUPAT MED, NEW YORK, NY 10029 USA
关键词
D O I
10.1056/NEJM199710303371801
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Exposure to ''environmental estrogens'' such as organochlorines in pesticides and industrial chemicals has been proposed as a cause of increasing rates of breast cancer. Several studies have reported higher blood levels of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE) and polychlorinated biphenyls (PCBs) in patients with breast cancer than in controls. Methods We measured plasma levels of DDE and PCBs prospectively among 240 women who gave a blood sample in 1989 or 1990 and who were subsequently given a diagnosis of breast cancer before June 1, 1992. We compared these levels with those measured in matched control women in whom breast cancer did not develop. Data on DDE were available for 236 pairs, and data on PCBs were available for 230 pairs. Results The median level of DDE was lower among case patients than among controls (4.71 vs, 5.35 parts per billion, P = 0.14), as was the median level of PCBs (4.49 vs. 4.68 parts per billion, P = 0.72), The multivariate relative risk of breast cancer for women in the highest quintile of exposure as compared with women in the lowest quintile was 0.72 for DDE (95 percent confidence interval, 0.37 to 1.40) and 0.66 for PCBs (95 percent confidence interval, 0.32 to 1.37). Exposure to high levels of both DDE and PCBs was associated with a nonsignificantly lower risk of breast cancer (relative risk for women in the highest quintiles of both DDE and PCBs as compared with women in the lowest, 0.43; 95 percent confidence interval, 0.13 to 1.44). Conclusions Our data do not support the hypothesis that exposure to 2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane (DDT) and PCBs increases the risk of breast cancer. (C) 1997, Massachusetts Medical Society.
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页码:1253 / 1258
页数:6
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