The Cancer Registry of Norway, Oslo, Norway.
Saf Health Work. 2011 Mar;2(1):1-8. doi: 10.5491/SHAW.2011.2.1.1. Epub 2011 Mar 31.
The knowledge on the etiology of breast cancer has advanced substantially in recent years, and several etiological factors are now firmly established. However, very few new discoveries have been made in relation to occupational risk factors. The International Agency for Research on Cancer has evaluated over 900 different exposures or agents to-date to determine whether they are carcinogenic to humans. These evaluations are published as a series of Monographs (www.iarc.fr). For breast cancer the following substances have been classified as "carcinogenic to humans" (Group 1): alcoholic beverages, exposure to diethylstilbestrol, estrogen-progestogen contraceptives, estrogen-progestogen hormone replacement therapy and exposure to X-radiation and gamma-radiation (in special populations such as atomic bomb survivors, medical patients, and in-utero exposure). Ethylene oxide is also classified as a Group 1 carcinogen, although the evidence for carcinogenicity in epidemiologic studies, and specifically for the human breast, is limited. The classification "probably carcinogenic to humans" (Group 2A) includes estrogen hormone replacement therapy, tobacco smoking, and shift work involving circadian disruption, including work as a flight attendant. If the association between shift work and breast cancer, the most common female cancer, is confirmed, shift work could become the leading cause of occupational cancer in women.
近年来，乳腺癌病因学的知识已经有了很大的进展，现在已经确定了几个病因因素。然而，与职业风险因素相关的新发现却很少。国际癌症研究机构已经评估了 900 多种不同的暴露或物质，以确定它们是否对人类具有致癌性。这些评估结果作为一系列专论发布（www.iarc.fr）。对于乳腺癌，以下物质被归类为“对人类致癌”（第 1 组）：酒精饮料、己烯雌酚暴露、雌激素-孕激素避孕药、雌激素-孕激素激素替代疗法以及 X 射线和γ射线暴露（在特殊人群中，如原子弹幸存者、医疗患者和宫内暴露）。环氧乙烷也被归类为第 1 组致癌物，尽管在流行病学研究中，特别是在人类乳房中，致癌性的证据有限。“可能对人类致癌”（第 2A 组）包括雌激素激素替代疗法、吸烟和涉及昼夜节律打乱的轮班工作，包括空乘人员的工作。如果轮班工作与乳腺癌（最常见的女性癌症）之间的关联得到证实，轮班工作可能成为女性职业性癌症的主要原因。
