Exposure to di-2-ethylhexyl phthalate and breast neoplasm incidence: A cohort study

作者全名：Tang, Lijuan; Wang, Yimeng; Yan, Wenting; Zhang, Zhe; Luo, Siwen; Wang, Shengfeng; Zhou, Niya; Chen, Qing; Xu, Yan

作者地址：[Tang, Lijuan; Zhang, Zhe; Xu, Yan] Army Med Univ, Daping Hosp, Dept Breast & Thyroid Surg, Chongqing 400042, Peoples R China; [Wang, Yimeng; Luo, Siwen; Chen, Qing] Third Mil Med Univ, Coll Prevent Med, Key Lab Med Protect Electromagnet Radiat, Inst Toxicol,Minist Educ China,Army Med Univ, Chongqing 400038, Peoples R China; [Yan, Wenting] Army Med Univ, Southwest Hosp, Dept Breast & Thyroid Surg, Chongqing, Peoples R China; [Wang, Shengfeng] Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing, Peoples R China; [Wang, Shengfeng] Peking Univ, Key Lab Epidemiol Major Dis, Minist Educ, Beijing, Peoples R China; [Zhou, Niya] Chongqing Med Univ, Clin Res Ctr, Women & Childrens Hosp, Chongqing 401120, Peoples R China; [Zhou, Niya] Chongqing Med Univ, Chongqing Res Ctr Prevent & Control Maternal & Chi, Women & Childrens Hosp, Chongqing 401120, Peoples R China

通信作者：Xu, Y (通讯作者)，Army Med Univ, Daping Hosp, Dept Breast & Thyroid Surg, Chongqing 400042, Peoples R China.; Chen, Q (通讯作者)，Third Mil Med Univ, Coll Prevent Med, Key Lab Med Protect Electromagnet Radiat, Inst Toxicol,Minist Educ China,Army Med Univ, Chongqing 400038, Peoples R China.; Zhou, NY (通讯作者)，Chongqing Med Univ, Clin Res Ctr, Women & Childrens Hosp, Chongqing 401120, Peoples R China.; Zhou, NY (通讯作者)，Chongqing Med Univ, Chongqing Res Ctr Prevent & Control Maternal & Chi, Women & Childrens Hosp, Chongqing 401120, Peoples R China.

来源：SCIENCE OF THE TOTAL ENVIRONMENT

ESI学科分类：ENVIRONMENT/ECOLOGY

WOS号：WOS:001219145200001

JCR分区：Q1

影响因子：8.2

年份：2024

卷号：926

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Di-2-ethylhexyl phthalate; Malignant neoplasm of breast; Carcinoma in situ of breast; Benign neoplasm of breast; Risk assessment

摘要：Background: Phthalates are ubiquitous environmental endocrine disruptors. As the predominant phthalate, di-2ethylhexyl phthalate (DEHP) has been considered possibly carcinogenic to humans but large-scale longitudinal evidence is needed to further clarify its carcinogenicity. Objectives: To examine the association between DEHP exposure and incidence of breast malignant neoplasm, carcinoma in situ and benign neoplasm. Methods: A total of 273,295 women from UK Biobank cohort were followed up for a median of 13.5 years. Disease information was collected from National Health Service Cancer Registry and National Death Index. Baseline and yearly -average level of DEHP exposure were estimated for each individual by linking chemical monitoring record of European Environment Agency with home address of the participants by Kriging interpolation model. Cox proportional hazard model was employed to estimate the association between DEHP exposure and breast neoplasms. Results: The median (IQR) of baseline and yearly -average DEHP concentration were 8000.25 (interquartile range: 6657.85 - 11,948.83) and 8000.25 (interquartile range: 1819.93 - 11,359.55) mu g/L. The highest quartile of baseline DEHP was associated with 1.11 fold risk of carcinoma in situ (95 % CI, 1.00, 1.23, p < 0.001) and 1.27 fold risk of benign neoplasm (95 % CI, 1.05, 1.54, p < 0.001). As for yearly -average exposure, each quartile of DEHP was positively associated with higher risk of malignant neoplasm (HR, 1.05; 95 % CI, 1.03, 1.07, p < 0.001), carcinoma in situ (HR, 1.08; 95 % CI, 1.04, 1.11, p < 0.001) and benign neoplasm (HR, 1.13; 95 % CI, 1.07, 1.20, p < 0.001). Stratification analysis showed no significant modification effects on the DEHP-neoplasm relationship by menopausal status or ethnicity but a suggestive higher risk in younger women and those who underwent oral contraceptive pill therapy. In sensitivity analysis, the associations remained when excluding the cases diagnosed within 2 years post baseline. Conclusions: Real -world level of DEHP exposure was associated with higher risk of breast neoplasms. Because of the health risks associated with DEHP, its release to the environment should be managed.

基金机构：National Key Research and Development Program of China [2022YFC2702900]; Key Program of National Natural Science Foundation of China [82130097]; Technical Innovation Program in Clinical Major Fields of Army Military Medical University [CX2019LC120]; Northern Ireland

基金资助正文：This work was supported by the National Key Research and Development Program of China (grant numbers: 2022YFC2702900) , the Key Program of National Natural Science Foundation of China (grant numbers: 82130097) and Technical Innovation Program in Clinical Major Fields of Army Military Medical University (CX2019LC120) .We are grateful to the UK Biobank participants, as well as to the project development and management teams of the UK Biobank. We are thankful to the European Environment Agency (EEA) , the official environmental agencies in England, Scotland, Wales, and Northern Ireland.