McElroy Jane A, Kruse Robin L, Guthrie James, Gangnon Ronald E, Robertson J David
Department of Family & Community Medicine, School of Medicine, University of Missouri, Columbia, Missouri, United States of America.
University of Missouri, Research Reactor Center, Columbia, Missouri, United States of America.
PLoS One. 2017 Jul 24;12(7):e0179360. doi: 10.1371/journal.pone.0179360. eCollection 2017.
Estrogen-mimicking chemicals, such as cadmium, may be associated with increased susceptibility to hormone-dependent cancers, though supporting data are sparse, particularly for endometrial cancer. The Health and Environmental Exposure Research (HEER) study worked with the Arkansas Central Cancer Registry, Iowa Cancer Registry and Missouri Cancer Registry to obtain names of women diagnosed with endometrial cancer who were willing to be contacted for participation in our case control study. Voter registration lists from Iowa and Missouri were used to randomly select similarly aged women as represented in the case population. Participants were interviewed by telephone to obtain information on known or suspected endometrial risk factors. Urine kits were sent to participants for home collection and returned for analysis. Our case-control study consisted of 631 incident cases of endometrial cancer diagnosed from January 2010 to October 2012 and 879 age-matched population-based controls, ages 18-81 years (mean age 65 years). We quantified cadmium amounts in urine and standardized these values through creatinine adjustment. Using data from all survey completers, we developed a multivariable model for endometrial cancer. Creatinine-adjusted cadmium concentration was added to this model. Odds ratio (OR) and 95% confidence intervals (CIs) for endometrial cancer were calculated. After multivariable adjustment, higher creatinine-adjusted cadmium exposure was associated with a statistically significant increase of endometrial cancer risk (OR: 1.22; 95% CI: 1.03-1.44). Our results provide evidence that cadmium may increase the risk of endometrial cancer, possibly through estrogenic effects.
诸如镉这类模仿雌激素的化学物质，可能与激素依赖性癌症易感性增加有关，尽管相关支持数据较少，尤其是关于子宫内膜癌的数据。健康与环境暴露研究（HEER）项目与阿肯色州中央癌症登记处、爱荷华州癌症登记处和密苏里州癌症登记处合作，获取被诊断为子宫内膜癌且愿意被联系以参与我们病例对照研究的女性名单。利用爱荷华州和密苏里州的选民登记名单，随机挑选与病例人群年龄相仿的女性。通过电话访谈参与者，以获取有关已知或疑似子宫内膜癌风险因素的信息。向参与者发送尿液检测试剂盒以便在家中采集，然后送回进行分析。我们的病例对照研究包括2010年1月至2012年10月期间诊断出的631例子宫内膜癌新发病例以及879名年龄匹配的基于人群的对照者，年龄在18 - 81岁之间（平均年龄65岁）。我们对尿液中的镉含量进行了量化，并通过肌酐校正对这些值进行标准化。利用所有完成调查者的数据，我们构建了一个子宫内膜癌的多变量模型。将肌酐校正后的镉浓度添加到该模型中。计算子宫内膜癌的比值比（OR）和95%置信区间（CI）。经过多变量调整后，较高的肌酐校正镉暴露与子宫内膜癌风险在统计学上显著增加相关（OR：1.22；95%CI：1.03 - 1.44）。我们的结果提供了证据表明镉可能增加子宫内膜癌风险，可能是通过雌激素效应。
