Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.
Nykøbing F Hospital, University of Copenhagen, Ejegodvej 63, 4800, Nykøbing F, Denmark.
Breast Cancer Res. 2018 Oct 5;20(1):119. doi: 10.1186/s13058-018-1047-2.
Exposure to road traffic noise was associated with increased risk of estrogen receptor (ER)-negative (ER-) breast cancer in a previous cohort study, but not with overall or ER-positive (ER+) breast cancer, or breast cancer prognosis. We examined the association between long-term exposure to road traffic noise and incidence of breast cancer, overall and by ER and progesterone receptor (PR) status.
We used the data from a nationwide Danish Nurse Cohort on 22,466 female nurses (age > 44 years) who at recruitment in 1993 or 1999 reported information on breast cancer risk factors. We obtained data on the incidence of breast cancer from the Danish Cancer Registry, and on breast cancer subtypes by ER and PR status from the Danish Breast Cancer Cooperative Group, up to 31 December 2012. Road traffic noise levels at the nurses' residences were estimated by the Nord2000 method between 1970 and 2013 as annual means of a weighted 24 h average (L) at the most exposed facade. We used time-varying Cox regression to analyze the associations between the 24-year, 10-year, and 1-year mean of L and breast cancer, separately for total breast cancer and by ER and PR status.
Of the 22,466 women, 1193 developed breast cancer in total during 353,775 person-years of follow up, of whom 611 had complete information on ER and PR status. For each 10 dB increase in 24-year mean noise levels at their residence, we found a statistically significant 10% (hazard ratio and 95% confidence interval 1.10; 1.00-1.20) increase in total breast cancer incidence and a 17% (1.17; 1.02-1.33) increase in analyses based on 611 breast cancer cases with complete ER and PR information. We found positive, statistically significant association between noise levels and ER+ (1.23; 1.06-1.43, N = 494) but not ER- (0.93; 0.70-1.25, N = 117) breast cancers, and a stronger association between noise levels and PR+ (1.21; 1.02-1.42, N = 393) than between noise levels and PR- (1.10; 0.89-1.37, N = 218) breast cancers. Association between noise and ER+ breast cancer was statistically significantly stronger in nurses working night shifts (3.36; 1.48-7.63) than in those not working at night (1.21; 1.02-1.43) (p value for interaction = 0.05).
Long-term exposure to road traffic noise may increase risk of ER+ breast cancer.
在之前的一项队列研究中，道路交通噪声暴露与雌激素受体（ER）阴性（ER-）乳腺癌的风险增加有关，但与总体乳腺癌或 ER 阳性（ER+）乳腺癌或乳腺癌预后无关。我们研究了长期暴露于道路交通噪声与乳腺癌发病风险之间的关系，包括总体情况以及根据 ER 和孕激素受体（PR）状态进行的情况。
我们使用了一项来自丹麦护士队列的全国性数据，该队列由 22466 名年龄大于 44 岁的女性护士组成（年龄>44 岁），她们在 1993 年或 1999 年招募时报告了乳腺癌风险因素的信息。我们从丹麦癌症登记处获得了乳腺癌发病数据，并从丹麦乳腺癌合作组获得了 ER 和 PR 状态的乳腺癌亚型数据，截至 2012 年 12 月 31 日。通过 Nord2000 方法估算了护士住所的道路交通噪声水平，该方法在 1970 年至 2013 年期间，在最暴露的立面上，每年估算一个加权 24 小时平均值（L）。我们使用时间变化的 Cox 回归分析了 24 年、10 年和 1 年平均 L 与乳腺癌之间的关系，分别针对总乳腺癌和根据 ER 和 PR 状态进行分析。
在 22466 名女性中，在 353775 人年的随访期间，共有 1193 人总共发生了乳腺癌，其中 611 人有完整的 ER 和 PR 状态信息。与 24 年平均噪声水平每增加 10dB 相比，我们发现总乳腺癌发病率有统计学意义的增加了 10%（危险比和 95%置信区间 1.10；1.00-1.20），并且基于 611 名具有完整 ER 和 PR 信息的乳腺癌病例的分析也有统计学意义的增加了 17%（1.17；1.02-1.33）。我们发现噪声水平与 ER+（1.23；1.06-1.43，N=494）乳腺癌呈正相关，但与 ER-（0.93；0.70-1.25，N=117）乳腺癌无关，与 PR+（1.21；1.02-1.42，N=393）乳腺癌的相关性强于与 PR-（1.10；0.89-1.37，N=218）乳腺癌的相关性。与不值夜班的护士（1.21；1.02-1.43）相比，值夜班的护士（3.36；1.48-7.63）与 ER+乳腺癌之间的噪声相关性更强（交互检验的 P 值为 0.05）。
长期暴露于道路交通噪声可能会增加 ER+乳腺癌的风险。
