VoPham Trang, DuPré Natalie, Tamimi Rulla M, James Peter, Bertrand Kimberly A, Vieira Veronica, Laden Francine, Hart Jaime E
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Landmark Center 3rd Floor West (HSPH/BWH), 401 Park Drive, Boston, MA, 02215, USA.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Environ Health. 2017 Sep 7;16(1):97. doi: 10.1186/s12940-017-0305-6.
Radon and its decay products, a source of ionizing radiation, are primarily inhaled and can deliver a radiation dose to breast tissue, where they may continue to decay and emit DNA damage-inducing particles. Few studies have examined the relationship between radon and breast cancer.
The Nurses' Health Study II (NHSII) includes U.S. female registered nurses who completed biennial questionnaires since 1989. Self-reported breast cancer was confirmed from medical records. County-level radon exposures were linked with geocoded residential addresses updated throughout follow-up. Time-varying Cox regression models adjusted for established breast cancer risk factors were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
From 1989 to 2013, 3966 invasive breast cancer cases occurred among 112,639 participants. Increasing radon exposure was not associated with breast cancer risk overall (adjusted HR comparing highest to lowest quintile = 1.06, 95% CI: 0.94, 1.21, p for trend = 0.30). However, women in the highest quintile of exposure (≥74.9 Bq/m) had a suggested elevated risk of ER-/PR- breast cancer compared to women in the lowest quintile (<27.0 Bq/m) (adjusted HR = 1.38, 95% CI: 0.97, 1.96, p for trend = 0.05). No association was observed for ER+/PR+ breast cancer.
Although we did not find an association between radon exposure and risk of overall or ER+/PR+ breast cancer, we observed a suggestive association with risk of ER-/PR- breast cancer.
氡及其衰变产物是电离辐射源,主要通过吸入进入人体,可对乳腺组织造成辐射剂量,在乳腺组织中它们可能继续衰变并释放出可导致DNA损伤的粒子。很少有研究探讨氡与乳腺癌之间的关系。
护士健康研究II(NHSII)纳入了自1989年起每两年填写一次问卷的美国女性注册护士。通过医疗记录确认自我报告的乳腺癌病例。县级氡暴露水平与随访期间更新的地理编码居住地址相关联。使用针对已确定的乳腺癌风险因素进行调整的时变Cox回归模型来计算风险比(HRs)和95%置信区间(CIs)。
1989年至2013年期间,112,639名参与者中发生了3966例浸润性乳腺癌病例。总体而言,氡暴露增加与乳腺癌风险无关(最高五分位数与最低五分位数相比的调整后HR = 1.06,95% CI:0.94,1.21,趋势p值 = 0.30)。然而,暴露水平处于最高五分位数(≥74.9 Bq/m³)的女性与最低五分位数(<27.0 Bq/m³)的女性相比患雌激素受体阴性/孕激素受体阴性(ER-/PR-)乳腺癌的风险似乎有所升高(调整后HR = 1.38,95% CI:0.97,1.96;趋势p值 = 0.05)。未观察到雌激素受体阳性/孕激素受体阳性(ER+/PR+)乳腺癌与之存在关联。
尽管我们未发现氡暴露与总体或ER+/PR+乳腺癌风险之间存在关联,但我们观察到其与ER-/PR-乳腺癌风险之间存在提示性关联。