Environment and Breast Cancer: Science Review

Evidence From Humans
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Environmental toxins and breast cancer on Long Island. I. Polycyclic aromatic hydrocarbon DNA adducts
Gammon, M. D., Santella, R. M., Neugut, A. I., Eng, S. M., Teitelbaum, S. L., Paykin, A., Levin, B., Terry, M. B., Young, T. L., Wang, L. W., Wang, Q., Britton, J. A., Wolff, M. S., Stellman, S. D., Hatch, M., Kabat, G. C., Senie, R., Garbowski, G., Maffeo, C., Montalvan, P., Berkowitz, G., Kemeny, M., Citron, M., Schnabel, F., Schuss, A., Hajdu, S., Vinceguerra, V. Cancer Epidemiology, Biomarkers and Prevention. 2002. 11:8, 677-85.
Topic area
Environmental pollutant - PAHs
Study design
Population based case-control
Funding agency
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number of Controls
Controls: 427
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Female residents of Nassau and Suffolk Counties (Long Island), NY, participating in the Long Island Breast Cancer Study Project, age 20 or older, English-speaking, newly diagnosed with in situ or invasive breast cancer in 1996-1997. Cases identified by regional hospital pathology laboratories. Controls matched by 5-year age group, identified by random-digit-dialing or Medicare records (for women 65 and older). Participants in this analysis were randomly selected from study participants who donated blood samples.
Comment about participation selection
Low response rate among controls, especially older women. Differences between those who did/did not donate blood.
Exposure Investigated
Exposures investigated
Polycyclic aromatic hydrocarbons (PAHs) measured as PAH-DNA adducts in blood samples collected near time of diagnosis/reference. ELISA method.
Exposure assessment comment
Blood levels near diagnosis may not be representative of etiologically relevant exposure, which occurred years earlier.
Breast cancer outcome investigated
Primary breast cancer: invasive, in situ, ER status, PR status
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 at menarche, parity, number of live births, lactation, months of lactation, age at first birth, number of miscarriages, history of fertility problems, BMI at reference, BMI at age 20, alcohol intake, family history of breast cancer, history of benign
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Description of major analysis
Adduct levels log transformed on a natural scale; unconditional logistic regression. Effect modifiers considered: active and passive cigarette smoking, recent consumption of grilled and smoked foods, alcohol intake, menopausal status, length of residenc
Strength of associations reported
Multivariate adjusted OR (95% CI)
Quantile 1 (nondetect) (referent)
2: 1.45 (0.97-2.17)
3: 1.48 (0.99-2.21)
4: 1.01 (0.67-1.52)
5: 1.49 (1.00-2.21)
Results Comments
Overall elevated risk is observed for women with detectable levels of PAH DNA adducts, but with no evidence of dose-response effect. Elevated risk was seen for ER+PR+ and ER-PR- tumors, but not receptor discordant tumors. "Adduct levels among control women did not increase with increasing lifetime average intake of grilled or smoked foods" or with consumption during the 4 weeks before blood donation. Adduct levels among controls did not vary with current or former active or passive cigarette smoking. Authors propose that adduct levels may be more indicative of individual susceptibility rather than exposure.
Author address
Department of Epidemiology, University of North Carolina, School of Public Health, Chapel Hill, North Carolina 27599-7435, USA. gammon@email.unc.edu
Reviewers Comments
Because PAH DNA adducts represent relatively recent exposure, there is no reason to expect them to be related to past active or passive smoking or to past food consumption (unless it is consistent with current diet).