Environment and Breast Cancer: Science Review

Evidence From Humans
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Breast cancer incidence and its possible spatial association with pesticide application in two counties of England
Muir, K., Rattanamongkolgul, S., Smallman-Raynor, M., Thomas, M., Downer, S., Jenkinson, C. Public Health. 2004. 118:7, 513-20.
Topic area
Environmental pollutant - pesticide, lindane, cyanazine, aldicarb, atrazine
Study design
Ecological epidemiology
Funding agency
Not reported
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Cohort participation rate
375 geographic units (wards)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Female breast cancer diagnosed and age > 45 years, resident and diagnosed in Lincolnshire and Leicestershire in 1989-1991 obtained from Trent Cancer Registry.
Exposure Investigated
Exposures investigated
Location within electoral wards in Lincolnshire and Leicestershire. Address at diagnosis and kilograms of pesticide active ingredient per square kilometre used in 1991 obtained by parish group from the Pesticide Usage Survey Group, Ministry of Agricultur
How exposure was measured
GIS/geographic location
Exposure assessment comment
Ecologic measure does not assign individual exposure. Assessment of exposure by address at diagnosis may not reflect the etiologic period.
Breast cancer outcome investigated
Primary breast cancer, age-standardized breast cancer incidence rate for diagnosis at age > 45 years
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
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.
Urban vs. rural ward.
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
Analyses included: Spatial autocorrelation (Black-White join-count statistic and Moran I coefficient) to detect clustering of breast cancer, linear regression.
County-level incidence was 8.25 per 1000 women > 45 in Lincolnshire; 7.6 in Leicestershire.
No evidence of spatial autocorrelation (clustering).
No association with pesticide use in urban areas or in rural areas of Lincolnshire.
In rural Leicestershire, aldicarb (R-squared = 0.09), atrazine (R-squared = 0.11), and lindane (R-squared = 0.11) application rates were statistically significantly associated with breast cancer incidence
Results Comments
Authors state that crop types, and thus pesticide use, are likely to be stable over a 5-10-year period.
Author address
Division of Epidemiology and Public Health Sciences, School of Community Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK. kenneth.muir@nottingham.ac.uk