Department of Epidemiology and Biostatistics and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California 94158, USA; email:
Silent Spring Institute, Newton, Massachusetts 02460, USA; email:
Annu Rev Public Health. 2018 Apr 1;39:113-133. doi: 10.1146/annurev-publhealth-040617-014101. Epub 2018 Jan 12.
In the United States, breast cancer is the most common invasive malignancy and the second most common cause of death from cancer in women. Reproductive factors, estrogen, and progesterone have major causal roles, but concerns about other potential causes in the external environment continue to drive research inquiries and stimulate calls for action at the policy level. The environment is defined as anything that is not genetic and includes social, built, and chemical toxicant aspects. This review covers the scope of known and suspected environmental factors that have been associated with breast cancer and illustrates how epidemiology, toxicology, and mechanistic studies work together to create the full picture of environmental effects on this malignancy. Newer approaches to risk-related evaluations may allow this field to move forward and more clearly delineate actionable environmental causes of this most common of cancers in women.
在美国,乳腺癌是最常见的侵袭性恶性肿瘤,也是女性癌症死亡的第二大常见原因。生殖因素、雌激素和孕激素都起着主要的致病作用,但人们对环境中其他潜在致癌因素的担忧仍在继续推动研究调查,并在政策层面引发行动呼吁。环境是指除遗传因素以外的所有因素,包括社会、建筑和化学有毒物质等方面。这篇综述涵盖了已知和可疑的与乳腺癌相关的环境因素的范围,并说明了流行病学、毒理学和机制研究如何共同构建环境对这种恶性肿瘤影响的全貌。风险相关评估的新方法可能使该领域向前发展,并更清楚地确定女性最常见癌症的可行动的环境病因。