Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
Environ Health. 2013 Mar 15;12:24. doi: 10.1186/1476-069X-12-24.
Few studies have supported an association between breast cancer and DDT, usually assessed with biomarkers that cannot discern timing of exposure, or differentiate between the accumulation of chronic low-dose versus acute high-dose exposures in the past. Previous studies suggest that an association may be evident only among women exposed to DDT during biologically susceptible windows, or among those diagnosed with estrogen receptor/progesterone receptor-positive (ER+PR+) breast cancer subtypes. Self-reported acute exposure to a fogger truck, which sprayed DDT prior to 1972, was hypothesized to increase the risk of breast cancer, particularly among women exposed at a young age or diagnosed with ER+PR+ breast cancer.
We examined these possibilities in the Long Island Breast Cancer Study Project (LIBCSP) (1,508 cases, 1,556 controls), which included exposure assessment by structured questionnaire and serum samples collected between 1996-1998, using adjusted logistic and polytomous regression to estimate ORs and 95% CIs.
Women with ER+PR+ breast cancer had a 44% increased odds of ever seeing a pre-1972 fogger truck compared to other subtypes (OR = 1.44; 95% CI 1.08-1.93). However, there was little variation in the observed increase in breast cancer risk when considering all women who reported seeing a pre-1972 fogger truck at their residence (OR = 1.16; 95% CI 0.98, 1.37), or during hypothesized susceptible windows. Self-reported acute exposure was not correlated with serum concentrations, a biomarker of long-term exposure.
These findings support the hypothesis that seeing a fogger truck, a proxy measure for acute DDT exposure, may be associated with ER+PR+ tumors, the most commonly diagnosed breast cancer subtype among American women.
很少有研究支持乳腺癌与滴滴涕之间存在关联，这些研究通常使用无法辨别暴露时间或区分过去慢性低剂量与急性高剂量暴露的生物标志物进行评估。先前的研究表明，这种关联可能仅在过去曾暴露于滴滴涕的女性中，或在雌激素受体/孕激素受体阳性（ER+PR+）的乳腺癌亚型患者中显现。人们假设，自我报告的急性接触喷雾器卡车（1972 年之前曾喷洒滴滴涕）可能会增加乳腺癌的风险，尤其是在年轻时暴露或诊断为 ER+PR+乳腺癌的女性中。
我们在长岛乳腺癌研究项目（LIBCSP）（1508 例病例，1556 例对照）中检验了这些可能性，该研究包括通过结构问卷进行暴露评估以及在 1996-1998 年之间采集的血清样本，使用调整后的逻辑回归和多项式回归来估计比值比（OR）和 95%置信区间（CI）。
与其他亚型相比，患有 ER+PR+乳腺癌的女性看到过 1972 年之前喷雾器卡车的可能性增加了 44%（OR=1.44；95%CI 1.08-1.93）。然而，当考虑到所有报告在居住地看到过 1972 年之前喷雾器卡车的女性，或在假设的易感窗口期看到过喷雾器卡车时，乳腺癌风险观察到的增加几乎没有变化（OR=1.16；95%CI 0.98,1.37）。自我报告的急性接触与血清浓度（长期暴露的生物标志物）无关。
这些发现支持这样一种假设，即看到喷雾器卡车，这是急性滴滴涕暴露的替代指标，可能与 ER+PR+肿瘤有关，这是美国女性中最常见的乳腺癌亚型。
