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Endocrine disrupting chemicals and breast cancer: a systematic review of epidemiological studies

期刊

CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION
卷 62, 期 24, 页码 6549-6576

出版社

TAYLOR & FRANCIS INC
DOI: 10.1080/10408398.2021.1903382

关键词

Breast cancer; dietary; endocrine-disrupting chemicals; environmental; epidemiological studies; systematic review

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This systematic review examined the association of environmental exposures of EDCs with breast cancer risk, identifying certain EDC exposures that could potentially elevate the risk of breast cancer. Assessing the long-term impacts of EDC exposures, especially multi-generational and transgenerational, is essential for understanding the potential link to breast cancer development and for future EDC policy making and regulations.
Background Endocrine-disrupting compounds (EDCs) are ubiquitous substances that are found in our everyday lives, including pesticides, plasticizers, pharmaceutical agents, personal care products, and also in food products and food packaging. Increasing epidemiological evidence suggest that EDCs may affect the development or progression of breast cancer and consequently lead to lifelong harmful health consequences, especially when exposure occurs during early life in humans. Yet so far no appraisal of the available evidence has been conducted on this topic. Objective To systematically review all the available epidemiological studies about the association of the levels of environmental exposures of EDCs with breast cancer risk. Methods The search was performed in accordance with the PRISMA guidelines. We retrieved articles from PubMed (MEDLINE) until 10 March 2021. The key words used in this research were: Endocrine disruptor(s) OR Endocrine disrupting chemical(s) OR any of the EDCs mentioned below AND Breast cancer to locate all relevant articles published. We included only cohort studies and case-control studies. All relevant articles were accessed in full text and were evaluated and summarized in tables. Results We identified 131 studies that met the search criteria and were included in this systematic review. EDCs reviewed herein included pesticides (e.g. p,p'-dichlorodiphenyltrichloroethane (DDT), p,p'-dichlorodiphenyldichloroethylene (DDE), atrazine, 2,3,7,8-tetrachloridibenzo-p-dioxin (TCDD or dioxin)), synthetic chemicals (e.g. bisphenol A (BPA), phthalates, per- and polyfluoroalkyl substances (PFAS), parabens, polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), contraceptive pills), phytoestrogens (e.g. genistein, resveratrol), and certain mycotoxins (e.g. zearalenone). Most studies assessed environmental EDCs exposure via biomarker measurements. Conclusion We identified certain EDC exposures could potentially elevate the risk of breast cancer. As majority of EDCs are highly persistent in the environment and bio-accumulative, it is essential to assess the long-term impacts of EDC exposures, especially multi-generational and transgenerational. Also, since food is often a major route of exposure to EDCs, well-designed exposure assessments of potential EDCs in food and food packing are necessary and their potential link to breast cancer development need to be carefully evaluated for subsequent EDC policy making and regulations.

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