Tippila Jeeraporn, Wah Naw Lah Say, Akbar Kurnia Ardiansyah, Bhummaphan Narumol, Wongsasuluk Pokkate, Kallawicha Kraiwuth
College of Public Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand.
College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani 34190, Thailand.
Int J Environ Res Public Health. 2024 Dec 23;21(12):1713. doi: 10.3390/ijerph21121713.
Breast cancer is the most prevalent malignancy among women. Certain air pollutants have carcinogenic and estrogenic properties that can contribute to breast cancer development. This systematic review aimed to investigate the association between air pollution and breast cancer based on epidemiological evidence. This systematic review included articles published between 2013 and 2022 from Scopus and PubMed databases, focusing on cohort and nested case-control studies examining the association between outdoor air pollution and breast cancer. A total of 25 articles were included. A total of eight outdoor pollutants were analyzed, with seven showing a significant association with breast cancer risk. Specifically, the strong association between benzo[a]pyrene and breast cancer risk was reported. Furthermore, all four studies on nitrogen oxides (NO, fifteen out of eighteen (83.33%) on particulate matter less than 2.5 µm (PM), nine out of thirteen studies (69.23%) on nitrogen dioxide (NO), and three out of seven studies (42.86%) on particulate matter less than 10 µm PM showed an association with breast cancer risk (hazard ratio [HR]: 1.05-1.56; odds ratio [OR]: 1.03-1.86). In contrast, only one out of three studies (33.33%) on O (HR: 0.76-1.03) and all studies on cadmium (OR: 0.88-0.97) suggested a negative association with breast cancer risk. None of the studies on black carbon found an association with breast cancer risk. It is important to note the methodological limitations of this review, including potential publication bias due to the inclusion of only English-language articles and a regional focus on developed countries, which may limit the generalizability of findings. This study suggests that exposure to outdoor air pollutants is linked to an increased risk of breast cancer. Further research is needed to establish a causal relationship and the mechanisms by which environmental pollutants may trigger carcinogenic effects and contribute to breast cancer development through epigenetic pathways.
乳腺癌是女性中最常见的恶性肿瘤。某些空气污染物具有致癌和雌激素特性，可能促使乳腺癌的发生。本系统评价旨在基于流行病学证据研究空气污染与乳腺癌之间的关联。本系统评价纳入了2013年至2022年期间发表于Scopus和PubMed数据库的文章，重点关注队列研究和巢式病例对照研究，这些研究探讨了室外空气污染与乳腺癌之间的关联。共纳入25篇文章。总共分析了8种室外污染物，其中7种与乳腺癌风险存在显著关联。具体而言，有报道称苯并[a]芘与乳腺癌风险之间存在强关联。此外，关于氮氧化物的所有4项研究、关于小于2.5微米颗粒物（PM）的18项研究中的15项（83.33%）、关于二氧化氮（NO）的13项研究中的9项（69.23%）以及关于小于10微米颗粒物（PM）的7项研究中的3项（42.86%）均显示与乳腺癌风险存在关联（风险比[HR]：1.05 - 1.56；比值比[OR]：1.03 - 1.86）。相比之下，关于臭氧的3项研究中只有1项（33.33%）（HR：0.76 - 1.03）以及关于镉的所有研究（OR：0.88 - 0.97）表明与乳腺癌风险呈负相关。关于黑碳的研究均未发现与乳腺癌风险存在关联。需要注意本评价的方法学局限性，包括仅纳入英文文章以及区域上侧重于发达国家可能导致的潜在发表偏倚，这可能会限制研究结果的普遍性。本研究表明，接触室外空气污染物与乳腺癌风险增加有关。需要进一步研究以确定因果关系以及环境污染物可能通过表观遗传途径引发致癌作用并促使乳腺癌发生的机制。
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