Fredslund Stine Overvad, Bonefeld-Jørgensen Eva Cecilie
Department of Public Health, Centre of Arctic Health & Unit of Cellular and Molecular Toxicology, University of Aarhus, Aarhus, Denmark.
Int J Circumpolar Health. 2012 Aug 16;71:19155. doi: 10.3402/ijch.v71i0.19155.
The purpose of this study is to review the current literatures on breast cancer (BC) in the Arctic, especially the trends in incidence during the last decades and the possible explanations. The design of this study is a literature review. The scientific literature concerning BC were reviewed, especially focusing on the Arctic and the special conditions that exist in this region. Breast cancer incidence is increasing all over the world, including in the Arctic. The enormous transition in health conditions and lifestyle in the Arctic might be contributing to the known risk factors. In Greenland, the age at menarche has diminished by 3 years during the course of 100 years, and the number of children per women as well as the duration of breastfeeding is decreasing. Obesity and intake of saturated fat is increasing and the intake of traditional food rich in unsaturated fat and vitamin D decreasing. Smoking and alcohol consumption in the Arctic has been relatively high but is now decreasing. More focus on genetic susceptibility in relation to BC has identified the specific BRCA1 founder mutation in the Greenlandic population, which might appear to be an important risk factor. However, the known established risk factors alone cannot account for the increasing trend observed. Studies suggest that environmental contaminants such as persistent organic pollutants (POPs) including perfluorinated compounds increase the risk of BC possibly in conjunction with certain genetic polymorphisms involved in carcinogen activation. The lipophilic POPs such as polychlorinated biphenyls and organochlorine pesticides are found at very high levels in the Arctic population. Several factors can explain the increasing incidence of BC in the Arctic. The transition in lifestyle and health conditions unfortunately increases the known risk factors of BC. Moreover, the population of the Arctic might show up to be especially vulnerable because of the contemporary high burden of POPs and genetic susceptibility.
本研究的目的是回顾当前关于北极地区乳腺癌（BC）的文献，特别是过去几十年的发病率趋势及其可能的解释。本研究的设计为文献综述。对有关乳腺癌的科学文献进行了综述，特别关注北极地区以及该地区存在的特殊情况。乳腺癌发病率在全球范围内都在上升，包括北极地区。北极地区健康状况和生活方式的巨大转变可能导致了已知的风险因素。在格陵兰，月经初潮年龄在100年中下降了3岁，每名妇女的子女数量以及母乳喂养时间都在减少。肥胖和饱和脂肪摄入量在增加，而富含不饱和脂肪和维生素D的传统食物摄入量在减少。北极地区的吸烟和饮酒率一直相对较高，但目前正在下降。对与乳腺癌相关的遗传易感性的更多关注已经在格陵兰人群中发现了特定的BRCA1始祖突变，这可能是一个重要的风险因素。然而，仅已知的既定风险因素无法解释观察到的上升趋势。研究表明，环境污染物如持久性有机污染物（POPs），包括全氟化合物，可能与某些参与致癌物激活的基因多态性共同作用，增加患乳腺癌的风险。在北极人群中发现了高浓度的亲脂性POPs，如多氯联苯和有机氯农药。有几个因素可以解释北极地区乳腺癌发病率的上升。不幸的是，生活方式和健康状况的转变增加了已知的乳腺癌风险因素。此外，由于当代持久性有机污染物的高负担和遗传易感性，北极地区的人群可能显得特别脆弱。
