Environment and Breast Cancer: Science Review

Evidence From Humans
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Associations of serum concentrations of organochlorine pesticides with breast cancer and prostate cancer in U.S. adults
Xu, X., Dailey, A. B., Talbott, E. O., Ilacqua, V. A., Kearney, G., Asal, N. R. Environ Health Perspect. 2010. 118:1, 60-6.
Topic area
Environmental pollutant - Organochlorine pesticides
Study design
Funding agency
Not reported
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
No analysis based on menopausal status
Number in Cohort
Cohort: 2,251
Cohort participation rate
Not applicable, this is a records based study
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Participants from NHANES 1999-2000, 2001-2002, and 2003-2004 were included in this study. NHANES is a nationally representative survey conducted by the U.S. Centers for Disease Control and Prevention. Subjects from whom blood samples were collected, and were > 20 years of age, were included. Cases were women who self-reported breast cancer diagnosis.
Comment about participation selection
NHANES has a cluster sampling method that oversamples for specific minority groups.
Exposure Investigated
Exposures investigated
Lipid-standardized serum OCPs detected in at least 50% of samples: β-HCH, oxychlordane, trans-nonachlor dieldrin, heptachlor epoxide and p,p'-DDE.
Exposure assessment comment
Serum samples were collected between 1999-2004, many decades after some organochlorine chemicals were banned. Serum concentrations are subject to effects of time since exposure, lactation, recent diet, and weight loss.
Breast cancer outcome investigated
Primary incident breast cancer
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
White (48.2%), Black (19.7%), and Other (32.1%)
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, race and ethnicity
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
p,p'-DDE (ng/g) vs. T1
T2 OR 1.26 (0.49-3.27)
T3 OR 1.19 (0.40-3.50)

β-HCH (ng/g) vs. T1
T2 OR 2.82 (0.75-10.65)
T3 OR 2.33 (0.53-10.33)

Oxychlordane (ng/g) vs. T1
T2 OR 3.68 (1.12-12.13)
T3 OR 2.55 (0.73-8.83)

trans-Nonachlor (ng/g) vs. T1
T2 OR 2.80 (0.81-9.67)
T3 OR 2.60 (0.65-10.35)

Heptachlor epoxide (ng/g) vs. T1 OR 2.21 (1.01-4.83)
T2 OR 1.05 (0.36-3.05)
T3 OR 1.08 (0.40-2.93)

Dieldrin (ng/g) vs. T1 OR 2.28 (0.76-6.87)
T2 OR 1.21 (0.34-4.29)
T3 OR 1.04 (0.26-4.16)
BACKGROUND: Organochlorine (OC) pesticides are a group of environmental endocrine disruptors that may be associated with an increased risk for hormone-related cancers including cancers of the breast and prostate. However, epidemiologic evidence is limited and inconsistent. OBJECTIVES AND METHODS: We used 1999-2004 National Health and Nutrition Examination Survey data to examine associations between serum concentrations of OC pesticides and prostate and breast cancers. RESULTS: After adjustment for other covariates, serum concentrations of beta-hexachlorocyclohexane (HCH) (p for trend = 0.02), trans-nonachlor (p for trend = 0.002), and dieldrin (p for trend = 0.04) were significantly associated with the risk of prevalent prostate cancer. Adjusted odds ratios for the second and third tertiles of detectable values were 1.46 [95% confidence interval (CI), 0.52-4.13] and 3.36 (95% CI, 1.24-9.10) for beta-HCH; 5.84 (95% CI, 1.06-32.2) and 14.1 (95% CI, 2.55-77.9) for trans-nonachlor; and 1.06 (95% CI, 0.30-3.73) and 2.74 (95% CI, 1.01-7.49) for dieldrin compared with concentrations in the lowest tertile or below the limit of detection. However, there was no positive association between serum concentrations of OC pesticides and breast cancer prevalence. CONCLUSION: Although further study is necessary to confirm these findings, these results suggest that OC pesticide exposures may have a significant effect on cancer risk. Efforts to reduce worldwide OC use are warranted.
Author address
Department of Epidemiology and Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA. xhxu@phhp.ufl.edu
Reviewers Comments
The cross-sectional study design is a limiting factor in interpreting estimates. Because prevalent breast cancer cases were used, as opposed to incident, survival bias could attenuate estimates.