Breast Cancer and the Environment A Life Course Approach (2012) / Chapter Skim
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1 Introduction
1 Introduction
Pages 25-36
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From page 25... ...
. After lung cancer, it is the second most common cause of mortality from cancer for women, with about 39,520 deaths expected in the United States in 2011.
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From page 26... ...
At present, a large but incomplete body of evidence is available on the relationship between breast cancer and the wide variety of external factors that can be said to comprise the environment. Information on interactions between genetic susceptibility and environmental factors is particularly sparse.
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From page 27... ...
The new perspectives on breast cancer highlight the limitations of the current understanding of the disease, and innovative ideas are beginning to influence the design and analysis of epidemiologic studies, experimental studies in animals, and mechanistic studies of breast cancer biology, all directed toward elucidating how external factors may influence the etiology of breast cancer. This report presents the results of a study commissioned to review the current evidence on environmental risk factors for breast cancer, consider gene–environment interactions in breast cancer, explore evidence-based actions that might reduce the risk of breast cancer, and recommend research in these areas.
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From page 28... ...
This work served as an information resource for the committee and helped to identify some data presented in Chapter 4. The other project resulted in a paper examining temporal changes in the United States in exposure to ionizing radiation, with a particular focus on exposure from medical imaging (see Appendix F, available electronically at http://www.nap.
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From page 29... ...
With the timing of these developmental events related to risk for some types of breast cancer, there has been growing interest in exploring whether the timing of a variety of environmental exposures also is important in understanding what influences breast cancer risks. In Chapter 5, the committee has sought to link its examination of the mechanisms of carcinogenesis with a life course perspective on when and how those pathologic pathways may be particularly relevant in relation to when and how environmental exposures occur.
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From page 30... ...
Moreover, people are exposed to a complex and changing mix of environmental agents over the course of a lifetime, so discerning the effects of an individual agent, or knowing which components of the mixture may influence the development of disease or how the mixture's components may interact with each other or with genes, is not straightforward. Observational epidemiologic studies are a critical tool for learning about elevated risks, but they can be difficult to do well.
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From page 31... ...
, which is part of the World Health Organization, is a focal point for major international collaboration in such reviews.3 In addition, a collaborative project between the World Cancer Research Fund International and the American Institute for Cancer Research has an ongoing program to review evidence on diet, physical activity, and cancer (WCRF/AICR, 2007) .4 All of these review programs consider evidence concerning breast cancer (or mammary cancers in animal studies)
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From page 32... ...
These estimates of risk are a critical reference point for understanding the implications of findings from epidemiologic studies on factors associated with increased or decreased risk of breast cancer. These findings are typically reported in terms of relative risk, which reflects a comparison between the risk in a population exposed to a particular factor and that in a similar population that is not exposed.
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From page 33... ...
Influences on breast cancer mortality patterns include factors that affect diagnosis and treatment that are separate from the effects of environmental exposures on the incidence of the disease. The committee did not explicitly assess environmental risk factors for male breast cancer, beyond the general assumption that some of the risk factors identified through studies in women may also be relevant to the development of breast cancer in men.
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From page 34... ...
Chapter 5 examines mechanisms of carcinogenesis and links them to a life course perspective on breast development and the potential for environmental factors to influence risk for breast cancer. In Chapter 6, the committee examines opportunities for evidence-based action to reduce risks for breast cancer and also considers the challenges of avoiding the unintentional introduction of new risks.
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From page 35... ...
2007. The decrease in breast-cancer incidence in 2003 in the United States.
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