Benedetti Marta, Zona Amerigo, Beccaloni Eleonora, Carere Mario, Comba Pietro
Department of Environment and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
Int J Environ Res Public Health. 2017 Mar 29;14(4):355. doi: 10.3390/ijerph14040355.
The aim of the present study was to investigate the incidence of breast (females), prostate, testicular, and thyroid cancer in the Italian National Priority Contaminated Sites (NPCSs), served by cancer registries, where the presence of endocrine disruptors (EDs), reported to be linked to these tumours, was documented. Evidence of carcinogenicity of EDs present in NPCSs was assessed based on evaluation by international scientific institutions and committees. Standardized Incidence Ratios (SIRs) were computed for each NPCS and cancer site between 1996 and 2005. Excess incidence of one or more cancer site studied was found in twelve out of fourteen NPCSs. Significantly increased SIRs were found for breast cancer in eight NPCSs, for prostate cancer in six, for thyroid cancer (both gender) in four, and for testicular cancer in two. Non-significantly increased SIRs were found in five NPCSs for testicular cancer and in two for thyroid cancer (males). In a small number of instances a significant deficit was reported, mainly for thyroid and prostate cancer. Although increased incidence of one or more cancer sites studied were found in several NPCSs, the ecological study design and the multifactorial aetiology of the considered tumours do not permit concluding causal links with environmental contamination. Regarding the observation of some excesses in SIRs, continuing epidemiological surveillance is warranted.
本研究的目的是调查意大利国家重点污染场地(NPCSs)中乳腺癌(女性)、前列腺癌、睾丸癌和甲状腺癌的发病率,这些场地由癌症登记处提供服务,且有文献记载存在据报道与这些肿瘤有关的内分泌干扰物(EDs)。基于国际科学机构和委员会的评估,对NPCSs中存在的EDs的致癌性证据进行了评估。计算了1996年至2005年间每个NPCS和癌症部位的标准化发病率(SIRs)。在14个NPCSs中的12个中发现了一种或多种所研究癌症部位的发病率过高。在8个NPCSs中发现乳腺癌的SIRs显著升高,6个中前列腺癌显著升高,4个中甲状腺癌(男女)显著升高,2个中睾丸癌显著升高。在5个NPCSs中发现睾丸癌的SIRs非显著升高,在2个中男性甲状腺癌非显著升高。在少数情况下报告了显著不足,主要是甲状腺癌和前列腺癌。尽管在几个NPCSs中发现了一种或多种所研究癌症部位的发病率增加,但生态学研究设计和所考虑肿瘤的多因素病因不允许得出与环境污染的因果关系。关于SIRs中一些过高情况的观察,有必要继续进行流行病学监测。