Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Santa María Ahuacatitlán, C.P. 62100, Cuernavaca, Morelos, Mexico.
CINVESTAV Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico.
Chemosphere. 2022 Mar;290:133237. doi: 10.1016/j.chemosphere.2021.133237. Epub 2021 Dec 17.
Breast cancer (BC) is the most frequently diagnosed cancer in women. However, only 58% of cases have been associated with known risk factors (reproductive, hormonal, lifestyles, and genetic), and the rest to unknown causes. Nevertheless, growing evidence suggests that exposure to environmental contaminants is an important risk factor for BC. Polycyclic aromatic hydrocarbons (PAHs) are formed during organic matter combustion, including smoking, grilled meat, and fuels, and are important carcinogenic constituents of environmental pollution. We examined the information generated by epidemiological studies evaluating the association between BC and PAHs exposure from multiple sources. Our work was conducted according to Conducting Systematic Reviews and Meta-Analyses of Observational Studies of Etiology (COSMOS-E) guidelines. We searched PubMed, Web of Science, and Scopus from January 2000 to December 2019. A total of 124 records were identified, and only 23 articles met all inclusion criteria. Occupational and/or environmental exposure to PAHs was significantly associated with BC, irrespective of exposure being assessed by direct or indirect methods. CYP1A1 and CYP1B1 adverse polymorphisms, familial BC history and smoking status, significantly strengthened the association between PAHs exposure and BC, whereas high fruit and vegetable intake had antagonistic associations. The positive relationships obtained in the studies here reviewed indicated that PAHs exposure is a risk factor for BC. Research needs include the improvement of exposure assessment, particularly identification of specific PAHs, reconstruction of time-varying and distant past exposures and further studies on the interaction between known BC factors and modifiable diet and life-style factors allowing BC prevention and control.
乳腺癌（BC）是女性最常见的癌症。然而，仅有 58%的病例与已知的风险因素（生殖、激素、生活方式和遗传因素）相关，其余的则与未知原因相关。尽管如此，越来越多的证据表明，接触环境污染物是乳腺癌的一个重要风险因素。多环芳烃（PAHs）是在有机物燃烧过程中形成的，包括吸烟、烤肉和燃料，是环境污染中重要的致癌成分。我们检查了评估 BC 与来自多个来源的 PAHs 暴露之间关联的流行病学研究产生的信息。我们的工作是根据进行观察性病因学研究的系统评价和荟萃分析（COSMOS-E）指南进行的。我们从 2000 年 1 月到 2019 年 12 月在 PubMed、Web of Science 和 Scopus 上进行了搜索。共确定了 124 条记录，只有 23 篇文章符合所有纳入标准。职业和/或环境暴露于 PAHs 与 BC 显著相关，无论暴露是通过直接还是间接方法评估的。CYP1A1 和 CYP1B1 不良多态性、家族性 BC 病史和吸烟状况显著增强了 PAHs 暴露与 BC 之间的关联，而高水果和蔬菜摄入则具有拮抗作用。这里综述的研究中获得的阳性关系表明，PAHs 暴露是 BC 的一个风险因素。研究需求包括暴露评估的改进，特别是特定 PAHs 的识别、时变和遥远过去暴露的重建，以及对已知 BC 因素与可改变的饮食和生活方式因素之间相互作用的进一步研究，以允许进行 BC 的预防和控制。
