Environment and Breast Cancer: Science Review

Evidence From Humans
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Breast cancer risk by occupation and industry: analysis of the CECILE study, a population-based case-control study in France
Villeneuve, S., Fevotte, J., Anger, A., Truong, T., Lamkarkach, F., Gaye, O., Kerbrat, P., Arveux, P., Miglianico, L., Imbernon, E., Guenel, P. American Journal of Industrial Medicine. 2011. 54:7, 499-509.
Topic area
Environmental pollutant - Occupation Organic solvents PAHs Consumer product
Study design
Population based case-control
Funding agency
Fondation de France Institut National du Cancer As
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Analyses by menopausal status (data not shown)
Number of Controls
Controls: 1,315
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Cases and controls selected from CECILE Study. Eligible cases were all women aged 25-75 years diagnosed with in situ or invasive breast cancer between 2005 and 2007 who resided in two departments of France. Patients were recruited in the main cancer hospital in each area, as well as from smaller public and private hospitals that also recruited breast cancer patients. All cases were histologically confirmed. Controls were women from random telephone number selection, frequency-matched to cases by 5 year age group and study area (stratified recruitment by age and SES).
Comment about participation selection
General population, including both workers and non-workers, may not be an appropriate comparison group.
Exposure Investigated
Exposures investigated
Occupational categories obtained from in-person interviews and structured questionnaire including questions about workplace, tasks, materials and chemicals used. >20 job categories included.
How exposure was measured
Job history Questionnaire, in person
Exposure assessment comment
Authors state that serum measurements of environmental exposure biomarkers and DNA bank was implemented to investigate gene-environment interactions; these results are not reported.
Breast cancer outcome investigated
Primary incident breast cancer
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Age, study area, age at menarche, age at first full-term pregnancy, duration of breastfeeding, current HRT use, family history of breast cancer, history of benign breast disease, BMI
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Strength of associations reported
Compared to women who were never employed as/in/for:

Chemical manufacturing OR 2.1 (95% CI 1.3-3.4)
Non-metallic mineral product manufacturing OR 2.8 (95% CI 1.1-7.4)
Motor vehicle and trailer manufacturing, >10 years employment OR 2.6 (95% CI 1.0-6.3)
Rubber and plastic product makers OR 1.8 (95% CI 0.9-3.5)
Textile workers (spinners, weavers, knitters, dyers) OR 2.4 (95% CI 0.9-6.0)
Nursing aid OR 1.2 (95% CI 0.9-1.7)
Professional nurses and midwives OR 1.3 (95% CI 0.9-2.0)
Manufacture of electrical machinery OR 1.6 (95% CI 0.8-3.2)
Results Comments
Authors report that results of tumor subtype and menopausal status analyses did not show interesting results (data not shown).
Author address
National Institute of Health and Medical Research, Center for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France.
Reviewers Comments
It is helpful that the study assessed physical activity, because this can be a confounder in occupational studies, particularly with community controls who may not be workers.