Journal Article
Urinary phthalate biomarker concentrations and postmenopausal breast cancer risk
Reeves, KW; Santana, MD; Manson, JE; Hankinson, SE; Zoeller, RT; Bigelow, C; Sturgeon, SR; Spiegelman, D; Tinker, L; Luo, J; Chen, B; Meliker, J; Bonner, MR; Cote, ML; Cheng, TD; Calafat, AM
Journal of the National Cancer Institute
ISSN: 0027-8874
EISSN: 1460-2105
Oxford University Press
Background: Growing laboratory and animal model evidence supports the potentially carcinogenic effects of some phthalates, chemicals used as plasticizers in a wide variety of consumer products, including cosmetics, medications, and vinyl flooring. However, prospective data on whether phthalates are associated with human breast cancer risk are lacking.
Methods: We conducted a nested case-control study within the Women's Health Initiative (WHI) prospective cohort (N = 419 invasive cases and 838 controls). Controls were matched 2:1 to cases on age, enrollment date, follow-up time, and WHI study group. We quantified thirteen phthalate metabolites and creatinine in two or three urine samples per participant over one to three years. Multivariable conditional logistic regression analysis was used to estimate odds ratios and 95% confidence intervals (OR, 95% CI) for breast cancer risk associated with each phthalate biomarker over up to 19 years of follow-up.
Results: Overall, we did not observe statistically significant positive associations between phthalate biomarkers and breast cancer risk in multivariable analyses (e.g. 4th vs 1st quartile of diethylhexyl phthalate OR 1.03, 95% CI 0.91 - 1.17). Results were generally similar in analyses restricted to disease subtypes, to non-users of postmenopausal hormone therapy, stratified by body mass index, or to cases diagnosed within three, five, or ten years.
Conclusions: In the first prospective analysis of phthalates and postmenopausal breast cancer, phthalate biomarker concentrations did not result in an increased risk of developing invasive breast cancer.
estrogen receptor; gestagen; phthalic acid; progesterone receptor; biological marker; creatinine; phthalic acid; phthalic acid derivative; tumor marker; adult; Article; body mass; breast cancer; cancer hormone therapy; cancer risk; case control study; controlled study; current smoker; electrospray mass spectrometry; female; follow up; high performance liquid chromatography; hormonal therapy; human; major clinical study; metabolic equivalent; middle aged; observational study; physical activity; postmenopause; priority journal; prospective study; social status; solid phase extraction; urine level; urine sampling; aged; breast tumor; disease predisposition; metabolism; odds ratio; risk assessment; risk factor; urine; Aged; Biomarkers; Biomarkers, Tumor; Breast Neoplasms; Case-Control Studies; Creatinine; Disease Susceptibility; Female; Humans; Middle Aged; Odds Ratio; Phthalic Acids; Risk Assessment; Risk Factors
