Elevated bladder cancer risk due to colorants--a statewide case-control study in North Rhine-Westphalia, Germany

Occupational exposure to aromatic amines is a known bladder cancer risk factor, whereas the impact of exposure to azo dyes, which may release aromatic amines in humans, is at present controversial. Therefore, the impact of occupational exposures to colorants was investigated in 156 bladder cancer cases and 336 controls in the state of North Rhine-Westphalia. All bladder cancer cases and controls (diagnosed with prostate cancer) requested after-care treatment. The subjects were investigated using a questionnaire for all occupations ever performed for more than 6 mo and for exposures to several possible occupational and nonoccupational bladder carcinogens. The relative bladder cancer risk was adjusted for age and smoking. The adjusted odds ratio (OR) for bladder cancer was elevated in 7 painters (OR 1.98, 95% CI 0.64-6.11), 4 hairdressers (OR 4.9, 95% CI 0.85-28.39), and 16 cases who reported a wood processing occupation (OR 1.19, 95% CI 0.58-2.41). Ten of these 16 cases reported chronic exposure to colorants (OR 1.84, 95% CI 0.68-4.95). The results of this epidemiological study confirm the hypothesis that individuals exposed to colorants show an elevated bladder cancer risk.     

Exposure to organophosphorus insecticides and increased risks of health and cancer in US women

Results of this paper provide evidence that chronic long-term exposure to organophosphorus insecticides poses a significantly higher health risk for US women than for men, based on dialkylphosphate biomarker data from NHANES cycles 2003-2012. The risk of cardiovascular disease for female non-smokers aged 60-85 years in the highest dimethylthiophosphate (DMTP) urinary concentration quartile is 3.0 (odds ratio, OD = 3.0, 95%CI 1.4-6.4) times higher than that in the lowest quartile. Women with higher urinary DMTP concentrations also have significantly higher risk of asthma at the ages 6-39 years and an apparently higher risk of chronic bronchitis at the ages 60-85. Overall cancer risk is significantly higher for female non-smokers aged 60-85 years in the higher urinary DMTP quartiles (OD = 2.7, 95% CI 1.3-5.9). Increasing risks of breast cancer for female smokers and prostate cancer for male smokers aged 60-85 years with higher exposure to organophosphorus insecticides in the US are also significant.     

Increased risk of cancer in the offspring of female electronics workers

There is limited evidence on the hypothesis that maternal occupational exposure near conception increases the risk of cancer in offspring. This study is to investigate whether women employed in an electronics factory increases childhood cancer among first live born singletons. We linked the databases of Birth Registration and Labor Insurance, and National Cancer Registry, which identified 40,647 female workers ever employed in this factory who gave 40,647 first live born singletons, and 47 of them developed cancers during 1979-2001. Mothers employed in this factory during their periconceptional periods (3 months before and after conception) were considered as exposed and compared with those not employed during the same periods. Poisson regression model was constructed to adjust for potential confounding by maternal age, education, sex, and year of birth. Based on 11 exposed cases, the rate ratio of all malignant neoplasms was increased to 2.26 [95% confidence interval (CI), 1.12-4.54] among children whose mothers worked in this factory during periconceptional periods. The RRs were associated with 6 years or less (RR=3.05; 95% CI, 1.20-7.74) and 7-9 years (RR=2.49; 95% CI, 1.26-4.94) of education compared with 10 years or more. An increased association was also found between childhood leukemia and exposed pregnancies (RR=3.83; 95% CI, 1.17-12.55). Our study suggests that maternal occupation with potential exposure to organic solvents during periconception might increase risks of childhood cancers, especially for leukemia.     

DDT/DDE and breast cancer: A meta-analysis

The biological basis for investigating dichlorodiphenyltrichloroethane (DDT) exposure and breast cancer risk stems from in vitro and animal studies indicating that DDT has estrogenic properties. The objective of this study was to update a meta-analysis from 2004 which found no association between dichlorodiphenyldichloroethylene (DDE) and breast cancer. We searched PubMed and Web of Science for studies published through June 2012 assessing DDT/DDE exposure and breast cancer. Summary Odds Ratios (ORs) with 95% confidence intervals (CIs) were calculated for the prevalence of breast cancer in the highest versus the lowest exposed groups for DDT and DDE. Difference of means of exposure for cases versus controls was analyzed for DDT and DDE. From the 500 studies screened, 46 were included in the meta-analysis. Slightly elevated, but not statistically significant summary ORs were found for DDE (1.05; 95% CI: 0.93–1.18) and DDT (1.02; 95% CI: 0.92–1.13). Lipid adjusted difference of means analysis found a significantly higher DDE concentration in cases versus controls (11.30 ng/g lipid; p = 0.01). No other difference of means analysis found significant relationships. The existing information does not support the hypothesis that exposure to DDT/DDE increases the risk of breast cancer in humans.     

N-Acetyltransferase 2 and glutathione s-transferase M1 in colon and rectal cancer cases from an industrialized area

Apart from genetics, nutrition, and environment, occupational factors also play an important role in colon and rectal cancer development. The aim of this study was to examine these cancer types in an area of former coal, iron, and steel industries, which was found to display an increased incidence of colon cancer mortality. N-Acetyltransferase 2 (NAT2) and glutathione S-transferase M1 (GSTM1) genotypes were investigated in 108 colon cancer cases, 80 rectum cancer cases, and 188 controls (suffering from nonmalignant diseases). Further, in a pilot study, 28 colorectal cancer patients were NAT2 phenotyped by the caffeine test. Possible occupational and nonoccupational risk factors were investigated by a personal interview. The frequency of rapid NAT2 genotype was 35% in colon cancer cases, 47% in rectal cancer cases, and 42% in controls (GSTM1 0/0 genotype: 53, 46, and 47%, respectively). In the 29 patients with cancer in the ascending colon, 10% were of the rapid NAT2 genotype. In the pilot study the frequency of the rapid NAT2 phenotype was 49%. The only major professional group with an elevated risk was painters (colon cancer OR 2.48, 95% CI 0.4-15.23; rectal cancer OR 5.65, 95% CI 1.06-30.21). In contrast to early studies, in the present study the slow NAT2 status is overrepresented. As colorectal cancer is associated with nutrition and physical activity, present findings may be due to excessive physical heavy work and the resulting nutrition in this area.     

Serum levels of polychlorinated biphenyls in Mexican women and breast cancer risk

The most prevalent female cancer across the world is breast cancer. Current established breast cancer risk factors explain only a fraction of the breast cancer cases diagnosed, and for this reason, other environmental factors have been studied. Exposure to organochlorine compounds has been linked to an increased incidence of breast cancer, although not all data have been consistent. This study was designed to evaluate the relation between polychlorinated biphenyls (PCB) exposure and breast cancer risk in Mexican women. We recruited 140 women from the General Hospital. The cases were 70 newly diagnosed women. We collected environmental and reproductive information by questionnaire. Blood samples were taken for measurement of serum levels of 20 PCB congeners. Risk of breast cancer was found to be positively associated with heavy congeners, age, postmenopausal status, family history of breast cancer and living close to an industrial facility. When PCB were grouped by structure–activity relationships, the risk of breast cancer was positively associated with groups 2b (odds ratio, OR = 1.90, 95% confidence interval, CI, 1.25–2.88), 3 (OR = 1.81, 95% CI 1.08–3.04) and group 4 (OR = 1.57, 95% CI 1.20–2.07). Among postmenopausal women, PCB levels from groups 1a, 2b, and 4 and total PCB were higher in cases, and an association between risk of breast cancer with groups 1a (OR = 7.59, 95% CI 1.1–51.4), 2b (OR = 3.7, 95% CI 1.2–11.2) and 4 (OR = 1.8, 95% CI 1.1–3.1) was found in this group of women. This study showed an association between heavy and potentially estrogenic PCB congeners and breast cancer risk. Copyright © 2011 John Wiley & Sons, Ltd.     

Folic acid sensitive birth defects in association with intrauterine exposure to folic acid antagonists

Since the protective effect of folic acid (FA) on birth defects is well known, it is reasonable to assume intrauterine exposure to FA antagonists increases the risk on these defects. We have therefore performed case-control analyses to investigate the risk of intrauterine exposure to FA antagonists, using data on births from the EUROCAT Northern Netherlands registry from 1997 to 2002. Of the 815 cases, 11 were exposed to a FA antagonist compared to 16 of the 1402 controls. For FA sensitive defects as a group, the study showed no effect after exposure to a FA antagonist (odds ratio (OR)=1.18, 95% CI: 0.55-2.57). We found no effect after exposure to a dihydrofolate reductase inhibitor (DHFRI) (OR 0.44, 95% CI: 0.12-1.54), but we did find a statistically significant effect after exposure to an antiepileptic drug (OR=3.45, 95% CI: 1.04-11.48). This study supports the findings of various other studies on the teratogenicity of antiepileptics. An association between DHFRIs and FA sensitive defects was not found.     

Rs11892031[A] on chromosome 2q37 in an intronic region of the UGT1A locus is associated with urinary bladder cancer risk

Recently, rs11892031[A] has been identified in a genome-wide association study (GWAS) to confer increased risk of urinary bladder cancer (UBC). To confirm this association and additionally study a possible relevance of exposure to urinary bladder carcinogens, we investigated the IfADo UBC study group, consisting of eight case-control series from different regions including 1,805 cases and 2,141 controls. This analysis was supplemented by a meta-analysis of all published data, including 13,395 cases and 54,876 controls. Rs11892031 A/A was significantly associated with UBC risk in the IfADo case-control series adjusted to cigarette smoking, gender, age and ethnicity (OR?=?1.18; 95%?CI?=?1.02-1.37; P?=?0.026). In the meta-analysis, a convincing association with UBC risk was obtained (OR?=?1.19; 95%?Cl?=?1.12-1.26; P?相似文献   

Do sunscreens have a role in preventing skin cancer?

Solar ultraviolet (UV) radiation is largely responsible for the harmful effects of sun exposure, notably sunburn, photosensitivity and skin cancer. UV radiation is, for example, implicated in malignant melanoma (the most serious form of skin cancer), the incidence of which has risen in the UK over the last 30 years. Such risks make it crucial to know whether measures aimed at reducing sun damage offer worthwhile benefit. Here we assess whether the sunscreen products commonly used to prevent sunburn have a place in the prevention of skin cancer.     

Breast cancer incidence and use of antihypertensive medication in women

PURPOSE: Breast cancer is the most common cancer in women worldwide. We attempted to investigate the association between the risk of breast cancer and use of captopril and other antihypertensive medication. METHODS: We performed a cohort study with a nested case-control analysis using the General Practitioner Research Database (GPRD) from the UK. We obtained adjusted estimates by fitting logistic regression models. RESULTS: The incidence rate of breast cancer in our cohort of women aged 30-79 years was 156 per 100,000 person-years. Overall, incidence of breast cancer among users of antihypertensive drugs was no different from the one among non-users (odds ratio (OR): 1.0; 95% confidence interval (CI): 0.9-1.1). Captopril was not associated with a reduced risk of breast cancer (OR: 0.9; 95%CI: 0.6-1.3). CONCLUSIONS: We did not find any clear association between antihypertensive drugs and risk of breast cancer. Similarly, captopril was not associated with a reduced risk of breast cancer risk.     

Cyclooxygenase-2 (cox-2) blockade in the chemoprevention of cancers of the colon, breast, prostate, and lung

The existing epidemiologic literature was comprehensively reviewed to retrieve all epidemiologic studies (case control and cohort studies) that examined exposure to traditional over the counter nonsteroidal anti-inflammatory drugs (OTC NSAIDs) and the risk of cancers of the colon, breast, prostate and lung from 1980 forward. These malignancies account for more that half of all cancer deaths in the United States and the United Kingdom. Estimates of effects (relative risks or odds ratios) and 95% confidence intervals were abstracted from these reports for meta-analysis. Regular intake of OTC NSAIDs produced highly significant composite risk reductions of 43% for colon cancer, 25% for breast cancer, 28% for lung cancer, and 27% for prostate cancer. Furthermore, in a series of case control studies, daily use of a selective COX-2 inhibitor, either celecoxib or rofecoxib, significantly reduced the risk for each of these malignancies. The evidence is compelling that anti-inflammatory agents with selective or non-selective activity against cycloooxygenase- 2 (COX-2) have strong potential for the chemoprevention of cancers of the colon, breast, prostate and lung. Results confirming that COX-2 blockade is effective for cancer prevention have been tempered by observations that some selective COX-2 inhibitors pose a risk to the cardiovascular system. Nevertheless, meta-analysis of independent estimates from 72 studies provides no evidence that the selective COX-2 inhibitor, celecoxib, influences the relative risk of cardiovascular disease (composite relative risk = 0.98, 95% CI = 0.88–1.10). Molecular studies reveal that over-expression of COX-2 is a prominent feature of premalignant and malignant neoplasms. Evidence is accumulating that carcinogenesis often evolves as a progressive series of highly specific cellular and molecular changes in response to induction of constitutive over-expression of COX-2 and the prostaglandin cascade in the “inflammogenesis of cancer”. Received 20 October 2008; accepted 18 November 2008     

Meta-analysis: cancer risk of low-grade dysplasia in chronic ulcerative colitis

BACKGROUND: The cancer risk of low-grade dysplasia (LGD) in chronic ulcerative colitis is variable and its management remain contentious. AIM: To determine the risk of cancer or any advanced lesion once LGD is diagnosed. METHODS: A MEDLINE, EMBASE and Pub Med search was conducted using the key words 'surveillance', 'colorectal cancer', 'low-grade dysplasia' and 'ulcerative colitis'. A random effects model of meta-analysis was used. RESULTS: Twenty surveillance studies had 508 flat LGD or LGD with dysplasia-associated lesion or mass. An average of 4.3 colonoscopies was performed/patient post-LGD diagnosis (range: 3-7.6). An average of 18 biopsies taken per colonoscopy (range: 9-24) detected 73 advanced lesions (cancer or high-grade dysplasia) pre-operatively. The cancer incidence was 14 of 1000 (95% CI: 5.0-34) person years duration (pyd) and the incidence of any advanced lesion was 30 of 1000 pyd (95% CI: 12-76). When LGD is detected on surveillance there is a ninefold risk of developing cancer (OR: 9.0, 95% CI: 4.0-20.5) and 12-fold risk of developing any advanced lesion (OR: 11.9, 95% CI: 5.2-27). CONCLUSIONS: The risk of developing cancer in patients with LGD is high. These estimates are valuable for decision-making when LGD is encountered on surveillance.     

Oncostatic effects of the pineal gland

There is increasing evidence that the pineal gland has a role in the control of neoplastic processes. Kerenyi found hyperplasia of the pineal gland in patients with widely disseminated malignant melanoma. Feuer and Kerenyi reported significantly higher serum melatonin levels with malignant melanoma. Beral et al. found 2.1 times increased risks of melanoma and Pasternak et al. described a relative risk of 1.87, related to exposure to fluorescent light. In our study, white New Zealand rabbits were exposed for 12 months to fluorescent light. The serum melatonin levels of the control group were significantly higher, p less than 0.005. According to Cohen, the pineal gland has a role in the etiology of breast cancer. Melatonin inhibits MCF-7 human breast cancer cell growth in culture. In our study of 500 surgically removed breast tumors, 254 were melatonin receptor positive, 246 negative. Most melatonin receptor positive breast cancer occurred between 60-65 years of age, receptor negative breast cancer peaked between 40-45 years. Benign breast tumors were almost invariably melatonin receptor positive. It is proposed that melatonin may have a direct effect on breast tumors, the melatonin receptors being the probable sites of interaction between melatonin and the tumor cell.     

Environmental tobacco smoke exposure and risk of breast cancer in nonsmoking women: a review with meta-analyses

Recent authoritative reviews consider smoking has no effect on breast cancer risk, but some studies report an increase from environmental tobacco smoke (ETS). We reviewed the overall evidence on ETS and breast cancer in nonsmoking women. We extracted details of available studies, derived relative risk (RR) estimates with confidence intervals (CIs) for various ETS exposure indices and conducted meta-analyses. Using an index for each study most closely equivalent to "spouse ever smoked," a weak, but significant, association was seen (random-effects RR = 1.12, 95% CI = 1.02-1.24, n = 22). However, the estimates were heterogeneous: close to 1.0 for prospective, North American and larger studies, and those adjusting for many potential confounders, but significantly (p < .05) elevated in case-control, European, and smaller studies, and those accounting for fewer potential confounders. Risk was increased in premenopausal women (RR = 1.54, 95% CI = 1.16-2.05, n = 10), but not postmenopausal women. Dose-response findings were similarly heterogeneous. No significant increase was seen for ETS in childhood or the workplace or from the spouse specifically, but an increase was seen for total exposure (RR = 1.54, 95% CI = 1.17-2.04, n = 6). Increases mainly derive from case-control studies asking detailed ETS histories, where RRs depend heavily on who is classified in the totally unexposed reference group, and may be prone to recall bias. Results from prospective studies using similar histories are needed. Study weaknesses and possible publication bias also limit interpretation. Because of the inherent implausibility that ETS exposure might cause breast cancer, given the similar risks of smokers and nonsmokers, one cannot confidently conclude ETS exposure increases risk in nonsmokers.     

Risk assessment of lung cancer related to environmental PAH pollution sources

We assessed the lung cancer risk in six localities with aluminium smelting activities and five with other polycyclic aromatic hydrocarbon (PAH) pollution sources, using two quantitative risk assessment (QRA) approaches for PAH mixtures and compared their risk predictions against actual cancer incidence. In the first approach, carcinogen exposure was estimated from animal-derived BaP toxic equivalents (BaPeq) of individual PAHs. The upper bound lifetime risk estimates ranged between 0.012-4.7 x 10(-5) and 0.019-0.94 x 10(-5) in the aluminium and other localities, respectively. The second approach assumed that the potency of PAH mixtures was linked to their BaP content and lifetime lung cancer unit risk gradients were estimated from epidemiological studies based on BaP exposure measurements. Lifetime risks ranged between 0.02-89 x 10(-5) and 0.06-6.8 x 10(-5) in the aluminium and other localities, respectively. Predicted risks were generally higher in smelter towns, and higher when based on epidemiological studies than on BaPeq. In smelting communities, there was a linear relationship (R2 approximately 0.8) between female lung cancer rates and PAH exposure estimates. To conclude, animal/BaPeq-based QRAs predicted lower risks than occupational/BaP-based QRAs. Epidemiological validation of the QRA could be performed for elevated past exposure to PAHs, but not for currently lower concentrations.     

Increased risk of hyperglycemia associated with the use of everolimus in patients with cancer: a systematic review and meta-analysis

Everolimus is an orally administered rapamycin analogue that has been approved to treat several types of solid tumors. However, some patients develop hyperglycemia after being treated with everolimus. In this meta-analysis, we aimed to evaluate the incidence and risk of hyperglycemia in patients with cancer who received everolimus. We searched the medical literature, as index in the Cochrane Library, PubMed, EMBASE, and abstracts from the top scientific meetings (AACR, ASCO, and ESMO). Our meta-analysis included the randomly controlled trials published before November 2014. We calculated overall incidence, relative risk (RR) and 95% confidence intervals (CI) using fixed-effects or random-effects models, depending on the heterogeneity among the trials. A total of 3377 patients (everolimus: 1971; control: 1406) from 8 randomized clinical trials were included in the meta-analysis. In the everolimus groups, the incidence of all grades of hyperglycemia was 20.0% (95% CI: 11.0%–29.0%), while the incidence of high-grade hyperglycemia was 6.0% (95% CI: 3.0%–8.0%). Patients treated with everolimus had an increased risk of hyperglycemia as compared with that of controls (all-grade RR: 2.94, 95% CI: 2.34–3.70; high-grade RR: 4.66, 95% CI: 2.75–7.89). Everolimus significantly increased the risk of hyperglycemia. This risk may depend on the tumor type and the everolimus dosage.     

Reproductive disorders among male and female greenhouse workers

The aim of this study was to evaluate reproductive disorders in male and female greenhouse workers. In 2002, data were collected from 4872 Dutch greenhouse workers and 8133 referents through postal questionnaires with detailed questions on reproductive disorders of the most recent pregnancy, lifestyle habits, and occupational exposures (e.g. pesticides) prior to conception. Different reproductive outcome measures were compared between 957 male and 101 female greenhouse workers and 1408 referents by means of logistic regression analyses. The analyses of primigravidous couples showed a slightly elevated risk of prolonged TTP (OR(women)=1.9; 95% CI: 0.8-4.4) and an increased risk of spontaneous abortion among female greenhouse workers (OR(women)=4.0; 95% CI: 1.1-14.0). A decreased risk of preterm birth was found among male greenhouse workers (OR(men)=0.1; 95% CI: 0.03-0.5). This study may offer some evidence for the hypothesis that pesticide exposure affects human reproduction leading to spontaneous abortion and possibly to prolonged time-to-pregnancy.     

Pre-diagnostic acrylamide exposure and survival after breast cancer among postmenopausal Danish women

Acrylamide is a probable human carcinogen, with industrial contact, tobacco smoking and foods processed at high temperatures as the main routes of exposure. In animal studies oral intake of acrylamide has been related to cancer development, with indications that the increased cancer occurrence especially regards endocrine related tumors. In human epidemiological studies, dietary exposure to acrylamide has also been suggested related to higher risk of endocrine related tumors, like estrogen sensitive breast cancer. The aim of the present study was to evaluate if pre-diagnostic acrylamide exposure, measured by acrylamide and glycidamide hemoglobin adducts (AA-Hb and GA-Hb), were associated to mortality in breast cancer cases. Among 24,697 postmenopausal women included into a Danish cohort between 1993 and 1997, 420 developed breast cancer before 2001 and 110 died before 2009. AA-Hb and GA-Hb concentrations measured in blood samples were related to mortality by Cox proportional hazard models. Estimates are given per 25 pmol/g globin higher levels. Among non-smokers, higher concentrations of GA-Hb were associated to a higher hazard rate of breast cancer specific mortality (HR (95% CI): 1.63 (1.06-2.51)), the hazard rate among women diagnosed with estrogen receptor positive tumors was (HR (95% CI): 2.23 (1.38-3.61)). For AA-Hb the tendency was similar, but only statistically significant among those with estrogen receptor positive tumors (HR (95% CI): 1.31 (1.02-1.69)). In conclusion, the present study indicates that pre-diagnostic exposure to acrylamide may be related to mortality among breast cancer patients and that this may especially concern the most endocrine related type of breast cancer.