Environment and Breast Cancer: Science Review

Evidence From Humans
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Cancer incidence in Priolo, Sicily: a spatial approach for estimation of industrial air pollution impact
Fazzo, L., Carere, M., Tisano, F., Bruno, C., Cernigliaro, A., Cicero, M. R., Comba, P., Contrino, M. L., De Santis, M., Falleni, F., Ingallinella, V., Madeddu, A., Marcello, I., Regalbuto, C., Sciacca, G., Soggiu, M. E., Zona, A. Geospat Health. 2016. 11:1, 320.
Topic area
Environmental pollutant - Air pollution
Study design
Funding agency
Not reported
Study Participants
Number of Cases
814 female/13 male
Menopausal Status
The menopausal status of women included in this study is listed here.
No analyses based on menopausal status
Number in Cohort
Cohort: 4 municipalities of Priolo, Sicily
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Information on population (male and female) breast cancer rates was obtained from the Cancer Registry of Syracuse Province during the period 1999-2006, which includes the four municipalities constituting Priolo CS.
Comment about participation selection
General population of Syracuse province (Priolo is a municipality of Syracuse) served as the study's reference group.
Exposure Investigated
Exposures investigated
Residence in a National Priority Contaminated Site (NPCS) in Priolo, Italy as proxy for exposure to 18 priority index contaminants in air from 100 industrial point sources.
How exposure was measured
GIS/geographic location
Exposure assessment comment
Environmental data made available by the Sicilian Region Environmental Protection Agency (ARPA) were used. Addresses of cases were mapped into GIS software and an atmospheric dispersion model was applied to industrial emissions in order to form concentration maps of SO2, NOx, and PM emitted by industrial point sources. Approximately 100 point sources were identified and emission data of specific contaminants were obtained.
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.
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
Overall Priolo area male breast cancer: SIR 2.00 (95% CI 1.06-3.42)
Overall Priolo area female breast cancer: SIR 1.15 (95% CI 1.07-1.23)

Female breast cancer by municipality:
Augusta: SIR 1.30 (95% CI 1.12-1.51)
Mellili: SIR 0.95 (95% CI 0.68-1.29)
Priolo: SIR 0.94 (95% CI 0.67-1.29)
Syracus: SIR 1.14 (95% CI 1.05-1.24)

Male breast cancer SIR by municipality:
Augusta (1 case): SIR 0.77 (95% CI 0.02-4.29)
Priolo (1 case): SIR 2.62 (95% CI 0.07-15.00)
Syracus (11 cases): SIR 2.50 (95% CI 1.25-4.47)
Results Comments
The southern area of Augusta municipality and part of Priolo municipality were associated with substantial atmospheric dispersion of industrial emissions based on environmental exposure models.
Author address
Department of Environment and Primary Prevention, National Institute of Health, Rome. lucia.fazzo@iss.it.