Weiderpass E, Adami H O, Baron J A, Wicklund-Glynn A, Aune M, Atuma S, Persson I
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Cancer Epidemiol Biomarkers Prev. 2000 May;9(5):487-93.
There is concern that persistent environmental pollutants such as dichlorodiphenyltrichloroethane (DDT) and polychlorinated biphenyls (PCBs) increase breast cancer risk, at least partially through estrogenic effects. Because the endometrium is more sensitive to estrogenic stimulation than the breast, such a carcinogenic effect should be more pronounced in the endometrium than the breast. In a population-based case-control study in Sweden, we measured serum concentrations of 10 chlorinated pesticides and 10 PCB congeners in 154 endometrial cancer cases and 205 population controls. Information on potential confounders was obtained by mailed questionnaires. We used logistic regression to calculate odds ratios (ORs) as measures of relative risk. We performed analyses for lipid-adjusted concentrations of each individual substance and after grouping substances according to putative hormonal effects. We found no significant associations of increasing levels of pesticide or PCB exposure with endometrial cancer risk. The multivariate OR was 1.0 (95% confidence interval, 0.6-2.0; P for trend, 0.78) for the highest compared with the lowest quartile of dichlorodiphenyldichloroethylene (DDE), the predominant dichlorodiphenyltrichloroethane metabolite. Corresponding ORs were 1.0 for hexachlorobenzene, 0.9 for beta-hexachlorocyclohexane, 1.4 for oxychlordane, and 1.2 for trans-nonachlor. Analyses of substances grouped by putative hormonal effect also showed no associations with endometrial cancer risk. For all estrogenic compounds, the OR for the highest compared with the lowest quartile was 1.1 (95% confidence interval, 0.6-2.2; P for trend, 0.90). Our data do not support the hypothesis that the organochlorine exposure studied increases the risk for endometrial cancer.
人们担心,诸如滴滴涕(DDT)和多氯联苯(PCBs)等持久性环境污染物会增加患乳腺癌的风险,至少部分是通过雌激素效应起作用。由于子宫内膜对雌激素刺激比乳腺更敏感,这种致癌作用在子宫内膜中应比在乳腺中更明显。在瑞典一项基于人群的病例对照研究中,我们测量了154例子宫内膜癌病例和205名人群对照者血清中10种氯代农药和10种多氯联苯同系物的浓度。通过邮寄问卷获取有关潜在混杂因素的信息。我们使用逻辑回归计算比值比(ORs)作为相对风险的衡量指标。我们对每种物质的脂质调整浓度以及根据假定的激素效应将物质分组后进行了分析。我们发现农药或多氯联苯暴露水平升高与子宫内膜癌风险之间无显著关联。与最低四分位数相比,最高四分位数的二氯二苯二氯乙烯(DDE)(滴滴涕的主要代谢产物)的多变量OR为1.0(95%置信区间,0.6 - 2.0;趋势P值,0.78)。六氯苯的相应OR为1.0,β - 六氯环己烷为0.9,氧氯丹为1.4,反式九氯为1.2。按假定激素效应分组的物质分析也显示与子宫内膜癌风险无关联。对于所有雌激素化合物,最高四分位数与最低四分位数相比的OR为1.1(95%置信区间,0.6 - 2.2;趋势P值,0.90)。我们的数据不支持所研究的有机氯暴露会增加子宫内膜癌风险这一假设。