Heikkinen Sanna, Pitkäniemi Janne, Sarkeala Tytti, Malila Nea, Koskenvuo Markku
Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Unioninkatu 22, FI-00130, Helsinki, Finland.
Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Unioninkatu 22, FI-00130, Helsinki, Finland; University of Helsinki, Hjelt Institute, Department of Public Health, PO Box 41 (Mannerheimintie 172), FI-00014 University of Helsinki, Helsinki, Finland.
PLoS One. 2015 Aug 11;10(8):e0135190. doi: 10.1371/journal.pone.0135190. eCollection 2015.
Role of hair dyes in the etiology of breast cancer has occasionally raised concern but previous research has concluded with mixed results. Remnants of prohibited aromatic amines have been found in many hair dye products, and elevated levels of DNA-adducts of these amines have been detected from breast epithelial cells of hair dye users. However, the IARC working group has concluded that there is inadequate evidence for carcinogenicity of personal hair dye use and limited evidence in experimental animals for carcinogenicity of hair colorants.
We investigated whether the use of hair dyes is associated with breast cancer risk in women. The study design was a retrospective population-based case-control study in Finland, with a self-administered questionnaire from 6,567 breast cancer patients, aged 22-60 years and diagnosed in 2000-2007, and their 21,598 matched controls. We report odds ratios (OR) with 95% confidence interval (95% CI) from a conditional logistic regression model applied to the frequency matched sets of cases and controls. Bias-adjusted odds ratios from the sensitivity analysis are also presented.
After adjusting for potential confounders, the odds of breast cancer increased by 23% (OR: 1.23, 95% CI: 1.11-1.36) among women who used hair dyes compared to those who did not. In women born before 1950 an increase of 28% was noted (OR: 1.28, 95% CI: 1.10-1.48). We also observed a significant trend between the OR and cumulative use of hair dyes (P: 0.005). Bias-adjusted odds ratios varied between 1.04 and 2.50.
Our results suggest that use of hair dyes is associated with breast cancer incidence. The impact on public health may be substantial due to vast popularity of hair coloring in modern societies. It should be noted that regardless of all efforts, a possibility of bias cannot definitively be ruled out and use of a prospective design is warranted. Based on the present results, it may be concluded however that safety of hair dyes in relation to breast cancer cannot yet be fully acknowledged and lack of external safety assessment within the cosmetics industry is of major concern.
染发剂在乳腺癌病因学中的作用偶尔会引发关注,但以往研究得出的结果不一。在许多染发剂产品中发现了违禁芳香胺残留,并且在使用染发剂的女性乳腺上皮细胞中检测到这些胺类物质的DNA加合物水平升高。然而,国际癌症研究机构工作组得出结论,个人使用染发剂致癌性的证据不足,染发剂在实验动物中的致癌性证据有限。
我们调查了女性使用染发剂是否与患乳腺癌风险相关。本研究设计为芬兰一项基于人群的回顾性病例对照研究,对6567名年龄在22至60岁之间、于2000年至2007年确诊的乳腺癌患者及其21598名匹配对照进行了自填式问卷调查。我们报告了应用于病例和对照频率匹配集的条件逻辑回归模型得出的比值比(OR)及95%置信区间(95%CI)。还给出了敏感性分析中经偏差调整的比值比。
在对潜在混杂因素进行调整后,与未使用染发剂的女性相比,使用染发剂的女性患乳腺癌的几率增加了23%(OR:1.23,95%CI:1.11 - 1.36)。在1950年以前出生的女性中,这一几率增加了28%(OR:1.28,95%CI:1.10 - 1.48)。我们还观察到OR与染发剂累积使用量之间存在显著趋势(P:0.005)。经偏差调整的比值比在1.04至2.50之间变化。
我们的结果表明,使用染发剂与乳腺癌发病率相关。由于染发在现代社会中非常普遍,其对公众健康的影响可能很大。应当指出,尽管已做出各种努力,但仍不能完全排除偏差的可能性,因此有必要采用前瞻性设计。然而,基于目前的结果,可以得出结论,染发剂与乳腺癌相关的安全性尚未得到充分认可,化妆品行业缺乏外部安全评估是主要问题。