Environment and Breast Cancer: Science Review

Evidence From Humans
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DDT/DDE and breast cancer: a meta-analysis
Ingber, S. Z., Buser, M. C., Pohl, H. R., Abadin, H. G., Murray, H. E., Scinicariello, F. Regul Toxicol Pharmacol. 2013. 67:3, 421-33.
Topic area
Environmental pollutant - DDT DDE
Study design
Funding agency
CDC Oak Ridge Institute for Science and Education
Study Participants
Number of Cases
Not reported
Menopausal Status
The menopausal status of women included in this study is listed here.
Stratified analyses based on menopausal status (data not shown)
Number of Controls
Not reported
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
The authors included 40 studies published on between breast cancer and DDT/DDE through June 2012. Commentaries, papers with duplicate data, studies without a date on the control group, studies lacking exposure data, studies without breast cancer risk data, and studies published in a language other than English were excluded.
Exposures investigated
DDT/DDE measured in adipose tissue, serum or plasma in case-control or nested case-control studies.
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.
Varied across studies from none to extensive
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
Highest exposure category vs. lowest exposure category:
All DDE (38 studies): OR 1.04 (95% CI 0.94-1.15)
All DDE case-control (27 studies): OR 1.11 (95% CI 0.98-1.23)
DDE adipose tissue case-control (7 studies): OR 0.89 (95% CI 0.65-1.22)
DDE blood serum case-control (20 studies): OR 1.15 (95% CI 1.01-1.32)
All DDE nested case-control (11 studies): OR 0.90 (95% CI 0.75-1.08)
DDE adipose tissue nested case-control (1 study): OR 0.70 (95% CI 0.45-1.08)
DDE blood serum nested case-control (10 studies): OR 0.95 (95% CI 0.78-1.17)

All DDT (18 studies): OR 1.02 (95% CI 0.92-1.13)
All DDT case-control (12 studies): OR 0.99 (95% CI 0.99-1.00)
DDT adipose tissue case-control (3 studies): OR 1.04 (95% CI 0.92-1.17)
DDT blood serum case-control (9 studies): OR 0.99 (95% CI 0.99-1.00)
All DDT nested case-control (6 studies): 0.85 (95% CI 0.56-1.28)
DDT adipose tissue nested case-control (1 study): OR 0.60 (95% CI 0.33-1.10)
DDT blood plasma nested case-control (1 study): OR 0.99 (95% CI 0.47-2.08)
DDT blood serum nested case-control (4 studies): OR 1.38 (95% CI 0.59-3.25)
Results Comments
For DDE, ORs were not different in analyses stratifying by menopausal status, for those studies that had menopausal status available.
Author address
Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA 30341, USA.
Reviewers Comments
Pooled ORs calculated from highest v. lowest exposures, which were determined on a study-by-study basis.