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Wang H, Gan X, Tang Y. Mechanisms of Heavy Metal Cadmium (Cd)-Induced Malignancy. Biol Trace Elem Res 2024:10.1007/s12011-024-04189-2. [PMID: 38683269 DOI: 10.1007/s12011-024-04189-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
The environmental pollution of cadmium is worsening, and its significant carcinogenic effects on humans have been confirmed. Cadmium can induce cancer through various signaling pathways, including the ERK/JNK/p38MAPK, PI3K/AKT/mTOR, NF-κB, and Wnt. It can also cause cancer by directly damaging DNA and inhibiting DNA repair systems, or through epigenetic mechanisms such as abnormal DNA methylation, LncRNA, and microRNA. However, the detailed mechanisms of Cd-induced cancer are still not fully understood and require further investigation.
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Affiliation(s)
- Hairong Wang
- School of Public Health, Southwest Medical University, No. 1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, China
| | - Xuehui Gan
- School of Public Health, Southwest Medical University, No. 1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, China
| | - Yan Tang
- School of Public Health, Southwest Medical University, No. 1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, China.
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George MF, Paff S, Rojo J, Powell M, Benz C, Pope K, Kerlikowske K, Shepard J, Willis M, Ereman R, Prebil L. Assessment of salivary cadmium levels and breast density in the Marin Women's Study. Cancer Med 2024; 13:e6973. [PMID: 38379324 PMCID: PMC10831917 DOI: 10.1002/cam4.6973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/21/2023] [Accepted: 01/06/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND We aimed to determine if salivary cadmium (Cd) levels had any association with breast density, hoping to establish a less invasive cost-effective method of stratifying Cd burden as an environmental breast cancer risk factor. METHODS Salivary Cd levels were quantified from the Marin Women's Study, a Marin County, California population composite. Volumetric compositional breast density (BDsxa ) data were measured by single x-ray absorptiometry techniques. Digital screening mammography was performed by the San Francisco Mammography Registry. Radiologists reviewed mammograms and assigned a Breast Imaging-Reporting and Data System score. Early morning salivary Cd samples were assayed. Association analyses were then performed. RESULTS Cd was quantifiable in over 90% of saliva samples (mean = 55.7 pg/L, SD = 29). Women with higher saliva Cd levels had a non-significant odds ratio of 1.34 with BI-RAD scores (3 or 4) (95% CI 0.75-2.39, p = 0.329). Cd levels were higher in current smokers (mean = 61.4 pg/L, SD = 34.8) than former smokers or non-smokers. These results were non-significant. Pilot data revealed that higher age and higher BMI were associated with higher BI-RAD scores (p < 0.001). CONCLUSION Salivary Cd is a viable quantification source in large epidemiologic studies. Association analyses between Cd levels and breast density may provide additional information for breast cancer risk assessment, risk reduction plans, and future research directions. Further work is needed to demonstrate a more robust testing protocol before the extent of its usefulness can be established.
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Affiliation(s)
- Michaela F. George
- Global Public Health Department, School of Health and Natural SciencesDominican University of CaliforniaSan RafaelCaliforniaUSA
| | - Shayne Paff
- Epidemiology and Community HealthMarin County Department of Health and Human ServicesSan RafaelCaliforniaUSA
| | - Jenyse Rojo
- Global Public Health Department, School of Health and Natural SciencesDominican University of CaliforniaSan RafaelCaliforniaUSA
| | - Mark Powell
- Zero Breast CancerBuck Institute for Research on AgingSan RafaelCaliforniaUSA
| | - Christopher Benz
- Cancer & Developmental TherapeuticsBuck Institute for Research on AgingSan RafaelCaliforniaUSA
- Department of Medicine, Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Leonard Davis School of GerontologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Karl Pope
- Epidemiology and Community HealthMarin County Department of Health and Human ServicesSan RafaelCaliforniaUSA
| | - Karla Kerlikowske
- Department of Medicine, Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - John Shepard
- Population Sciences in the Pacific Program, Cancer EpidemiologyUniversity of Hawaii Cancer CenterHonoluluHawaiiUSA
| | - Matthew Willis
- Epidemiology and Community HealthMarin County Department of Health and Human ServicesSan RafaelCaliforniaUSA
| | - Rochelle Ereman
- Global Public Health Department, School of Health and Natural SciencesDominican University of CaliforniaSan RafaelCaliforniaUSA
- Epidemiology and Community HealthMarin County Department of Health and Human ServicesSan RafaelCaliforniaUSA
| | - LeeAnn Prebil
- Epidemiology and Community HealthMarin County Department of Health and Human ServicesSan RafaelCaliforniaUSA
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Song M, Huang X, Wei X, Tang X, Rao Z, Hu Z, Yang H. Spatial patterns and the associated factors for breast cancer hospitalization in the rural population of Fujian Province, China. BMC Womens Health 2023; 23:247. [PMID: 37161393 PMCID: PMC10170828 DOI: 10.1186/s12905-023-02336-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/07/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Despite the known increasing incidence of breast cancer in China, evidence on the spatial pattern of hospitalization for breast cancer is scarce. This study aimed to describe the disparity of breast cancer hospitalization in the rural population of Southeast China and to explore the impacts of socioeconomic factors and heavy metal pollution in soil. METHODS This study was conducted using the New Rural Cooperative Medical Scheme (NRCMS) claims data covering 20.9 million rural residents from 73 counties in Southeast China during 2015-2016. The associations between breast cancer hospitalization and socioeconomic factors and soil heavy metal pollutants were evaluated with quasi-Poisson regression models and geographically weighted Poisson regressions (GWPR). RESULTS The annual hospitalization rate for breast cancer was 101.40/100,000 in the studied area and the rate varied across different counties. Overall, hospitalization for breast cancer was associated with road density (β = 0.43, P = 0.02), urbanization (β = 0.02, P = 0.002) and soil cadmium (Cd) pollution (β = 0.01, P = 0.02). In the GWPR model, a stronger spatial association of Cd, road density and breast cancer hospitalization was found in the northeast regions of the study area while breast cancer hospitalization was mainly related to urbanization in the western regions. CONCLUSIONS Soil Cd pollution, road density, and urbanization were associated with breast cancer hospitalization in different regions. Findings in this study might provide valuable information for healthcare policies and intervention strategies for breast cancer.
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Affiliation(s)
- Mengjie Song
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122, China
| | - Xiaoxi Huang
- Department of Breast, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujjan Medical University, Fuzhou, 350001, China
| | - Xueqiong Wei
- School of Geographical Sciences, Nanjing University of Information Science and Technology, Nanjing, 210044, China
| | - Xuwei Tang
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122, China
| | - Zhixiang Rao
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122, China
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, Xue Yuan Road 1, Fuzhou, 350122, China
| | - Haomin Yang
- Department of Epidemiology and Health Statistics, School of Public Health & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122, China.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, 17177, Sweden.
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, University Town, Xue Yuan Road 1, Fuzhou, 350122, China.
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El Youssfi M, Sifou A, Ben Aakame R, Mahnine N, Arsalane S, Halim M, Laghzizil A, Zinedine A. Trace elements in Foodstuffs from the Mediterranean Basin-Occurrence, Risk Assessment, Regulations, and Prevention strategies: A review. Biol Trace Elem Res 2023; 201:2597-2626. [PMID: 35754061 DOI: 10.1007/s12011-022-03334-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
Trace elements (TEs) are chemical compounds that naturally occur in the earth's crust and in living organisms at low concentrations. Anthropogenic activities can significantly increase the level of TEs in the environment and finally enter the food chain. Toxic TEs like cadmium, lead, arsenic, and mercury have no positive role in a biological system and can cause harmful effects on human health. Ingestion of contaminated food is a typical route of TEs intake by humans. Recent data about the occurrence of TEs in food available in the Mediterranean countries are considered in this review. Analytical methods are also discussed. Furthermore, a discussion of existing international agency regulations will be given. The risk associated with the dietary intake of TEs was estimated by considering consumer exposure and threshold values such as Benchmark dose lower confidence limit and provisional tolerable weekly intake established by the European Food Safety Authority and the Joint FAO/WHO Expert Committee on Food Additives, respectively. Finally, several remediation approaches to minimize TE contamination in foodstuffs were discussed including chemical, biological, biotechnological, and nanotechnological methods. The results of this study proved the occurrence of TEs contamination at high levels in vegetables and fish from some Mediterranean countries. Lead and cadmium are more abundant in foodstuffs than other toxic trace elements. Geographical variations in TE contamination of food crops clearly appear, with a greater risk in developing countries. There is still a need for the regular monitoring of these toxic element levels in food items to ensure consumer protection.
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Affiliation(s)
- Mourad El Youssfi
- Laboratory of Applied Chemistry of Materials, Mohammed V University in Rabat, Faculty of Sciences, Avenue Ibn Battouta BP.1014 Agdal, Rabat, Morocco
- Laboratory of Nanomaterials, Nanotechnologies and Environment, Center of Materials, Mohammed V University in Rabat, Faculty of Sciences, Avenue Ibn Battouta, BP.1014, 10000, Rabat, Morocco
| | - Aicha Sifou
- Laboratory of Nanomaterials, Nanotechnologies and Environment, Center of Materials, Mohammed V University in Rabat, Faculty of Sciences, Avenue Ibn Battouta, BP.1014, 10000, Rabat, Morocco
| | - Rachid Ben Aakame
- Laboratory of Food Toxicology, National Institute of Hygiene (INH), BP 769 Agdal, 27, Avenue Ibn Batouta, Rabat, Morocco
| | - Naima Mahnine
- Laboratory of Food Toxicology, National Institute of Hygiene (INH), BP 769 Agdal, 27, Avenue Ibn Batouta, Rabat, Morocco
| | - Said Arsalane
- Laboratory of Nanomaterials, Nanotechnologies and Environment, Center of Materials, Mohammed V University in Rabat, Faculty of Sciences, Avenue Ibn Battouta, BP.1014, 10000, Rabat, Morocco
| | - Mohammed Halim
- Laboratory of Nanomaterials, Nanotechnologies and Environment, Center of Materials, Mohammed V University in Rabat, Faculty of Sciences, Avenue Ibn Battouta, BP.1014, 10000, Rabat, Morocco
| | - Abdelaziz Laghzizil
- Laboratory of Applied Chemistry of Materials, Mohammed V University in Rabat, Faculty of Sciences, Avenue Ibn Battouta BP.1014 Agdal, Rabat, Morocco
| | - Abdellah Zinedine
- BIOMARE Laboratory, Chouaib Doukkali University, Faculty of Sciences, Route Ben Maachou, PO Box 20, 24000, El Jadida, Morocco.
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Florez-Garcia VA, Guevara-Romero EC, Hawkins MM, Bautista LE, Jenson TE, Yu J, Kalkbrenner AE. Cadmium exposure and risk of breast cancer: A meta-analysis. ENVIRONMENTAL RESEARCH 2023; 219:115109. [PMID: 36563983 PMCID: PMC9957608 DOI: 10.1016/j.envres.2022.115109] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/28/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cadmium is a heavy metal with carcinogenic properties, highly prevalent in industrialized areas worldwide. Prior reviews evaluating whether cadmium influences breast cancer have been inconclusive and not reflected several recent studies. OBJECTIVE To evaluate the association between cadmium exposure and female breast cancer incidence, with an emphasis on separately estimating dietary vs. airborne vs. biomarker measures of cadmium and studies published until October 2022. METHODS We evaluated risk of bias using set criteria and excluded one study judged to have high risk based on self-report of breast cancer and insufficient adjustment. We conducted a random effects meta-analysis of epidemiological studies, including subgroups by exposure route and by menopausal status. RESULTS A total of 17 studies were eligible for our meta-analysis. Only 2 studies addressed airborne cadmium directly. Breast cancer risk was elevated in women exposed to higher levels of cadmium across all studies - pooled odds ratio: 1.13 (95% confidence interval: 1.00, 1.28), with notable heterogeneity between studies (I2 = 77%). When examining separately by exposure route, dietary cadmium was not linked with an elevated risk - (OR: 1.05; 95%CI: 0.91, 1.21; I2 = 69%), consistent with prior reviews, but biomarker-based studies showed an elevated but non-significant pooled measure (OR: 1.37; 95%CI: 0.96, 1.94; I2 = 84%). We did not observe any clear patterns of different risk by menopausal status. CONCLUSION Findings from our meta-analysis suggest that exposure to higher cadmium increases the risk of breast cancer in women, but with remaining questions about whether non-dietary exposure may be more risky or whether residual confounding by constituents of tobacco smoke may be at play.
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Affiliation(s)
- V A Florez-Garcia
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA; Department of Public Health. Universidad Del Norte, Barranquilla. Colombia.
| | - E C Guevara-Romero
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA
| | - M M Hawkins
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA; Public Health. Carroll University College of Health Sciences. 100 N East Ave, Waukesha, WI, 53186, USA
| | - L E Bautista
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, 610 Walnut Street, WARF 703, Madison, WI, 53726-2397, USA
| | - T E Jenson
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA
| | - J Yu
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA
| | - A E Kalkbrenner
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, 5321, USA
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Iqbal S, Ali I. Dietary Trace Element Intake and Risk of Breast Cancer: A Mini Review. Biol Trace Elem Res 2022; 200:4936-4948. [PMID: 35015245 DOI: 10.1007/s12011-021-03089-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/27/2021] [Indexed: 11/02/2022]
Abstract
Trace elements are essentially required for various physiological and metabolic functions, and any disturbance in the trace elements homeostasis may result in the development of chronic diseases including breast cancer. Breast cancer is the most prevalent cancer type reported in women equally affecting both the high-income and low-income countries. This review therefore aimed to evaluate the impact of dietary trace element intake in relation to the incidence of breast cancer. We focused on five trace elements, thus emphasizing dietary selenium, zinc, iron, copper, and cadmium intake and risk of breast cancer. A systematic approach was applied to perform this review through entering a search term in PubMed and Scopus databases. A total of 24 articles were included after meeting the inclusion and exclusion criteria. Most of the studies regarding dietary iron intake showed a detrimental effect of increased dietary heme iron on breast cancer incidence risk. In addition, there is a limited evidence of high dietary intake of selenium and zinc to reduce the risk of breast cancer. Also, a few studies showed a relationship between high cadmium consumption and risk of breast cancer. More studies related to cadmium and copper exposure are needed to confirm this relationship. As a result, the findings of this review suggested that high dietary heme iron is a potential risk factor for breast cancer.
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Affiliation(s)
- Sehar Iqbal
- NUMS Department of Nutrition and Dietetics, National University of Medical Sciences, PWD Campus, Police Foundation Road, Islamabad, Pakistan.
| | - Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna, Universitätsstrasse 7, 1010, Vienna, Austria
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Schaefer HR, Flannery BM, Crosby L, Jones-Dominic OE, Punzalan C, Middleton K. A systematic review of adverse health effects associated with oral cadmium exposure. Regul Toxicol Pharmacol 2022; 134:105243. [PMID: 35981600 DOI: 10.1016/j.yrtph.2022.105243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022]
Abstract
Scientific data characterizing the adverse health effects associated with dietary cadmium (Cd) exposure were identified in order to make informed decisions about the most appropriate toxicological reference value (TRV) for use in assessing dietary Cd exposure. Several TRVs are available for Cd and regulatory organizations have used epidemiologic studies to derive these reference values; however, risk of bias (RoB) evaluations were not included in the assessments. We performed a systematic review by conducting a thorough literature search (through January 4, 2020). There were 1714 references identified by the search strings and 328 studies identified in regulatory assessments. After applying the specific inclusion and exclusion criteria, 208 studies (Human: 105, Animal: 103) were considered eligible for further review and data extraction. For the epidemiologic and animal studies, the critical effects identified for oral Cd exposure from the eligible studies were a decrease in bone mineral density (BMD) and renal tubular degeneration. A RoB analysis was completed for 49 studies (30 epidemiological and 19 animal) investigating these endpoints. The studies identified through the SR that were considered high quality and low RoB (2 human and 5 animal) can be used to characterize dose-response relationships and inform the derivation of a Cd TRV.
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Affiliation(s)
- Heather R Schaefer
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA.
| | - Brenna M Flannery
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Lynn Crosby
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Olivia E Jones-Dominic
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Cecile Punzalan
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Karlyn Middleton
- US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
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Andersson EM, Sandsveden M, Forsgard N, Sallsten G, Manjer J, Engström G, Barregard L. Is Cadmium a Risk Factor for Breast Cancer - Results from a Nested Case-Control Study Using Data from the Malmö Diet and Cancer Study. Cancer Epidemiol Biomarkers Prev 2021; 30:1744-1752. [PMID: 34244159 DOI: 10.1158/1055-9965.epi-21-0181] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/06/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Some studies have shown that cadmium (Cd) is associated with breast cancer risk. One hypothesis is that Cd has estrogen-like properties. This case-control study investigated the association between breast cancer risk and blood Cd (BCd) levels. METHODS All breast cancers in the Malmö Diet and Cancer cohort were identified through linkage to the Swedish Cancer Registry, baseline (1991-1996) through 2014. Two controls per case were selected from the same cohort. BCd was analyzed at baseline. Associations were analyzed using logistic regression. RESULTS Mean BCd was 0.51 μg/L among 1,274 cases and 0.46 among 2,572 controls. There was an overall increased risk of breast cancer [OR, 1.18; 95% confidence interval (CI), 1.05-1.36] per μg/L of BCd. An increased risk was, however, only found at high BCd [OR, 1.34 (95% CI, 1.05-1.73)] for BCd more than 1.20 μg/L. The group with the highest BCd was mainly smokers. A spline indicated that at BCd less than 1.0 μg/L, the OR was not increased. The association with BCd was stronger in current smokers and at body mass index (BMI) above 25, while no modification due to receptor status was found. CONCLUSIONS The results indicated increased risk of breast cancer only for high Cd exposure, which occurred mainly among smokers. This made it difficult to disentangle the effects of smoking and Cd, despite inclusion of smoking habits in the models. IMPACT This study provides support for reducing Cd exposure through smoking cessation and dietary choice. On the population level, preventive measures against Cd pollution are warranted.
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Affiliation(s)
- Eva M Andersson
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. .,Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Malte Sandsveden
- Department of Surgery, Skåne University Hospital Malmö, Lund University, Malmö, Sweden
| | - Niklas Forsgard
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Jonas Manjer
- Department of Clinical Science in Malmö, Lund University, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Science in Malmö, Lund University, Malmö, Sweden
| | - Lars Barregard
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.,Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Wacewicz-Muczyńska M, Socha K, Soroczyńska J, Niczyporuk M, Borawska MH. Cadmium, lead and mercury in the blood of psoriatic and vitiligo patients and their possible associations with dietary habits. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 757:143967. [PMID: 33302005 DOI: 10.1016/j.scitotenv.2020.143967] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/01/2020] [Accepted: 11/13/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Psoriasis and vitiligo are common, autoimmune skin diseases, their etiology is still unclear. The relationship between environmental factors including diet and various skin diseases has been studied. The general mechanism of cadmium (Cd), lead (Pb) and mercury (Hg) toxicity is through the production of reactive oxygen species which are known to play a role in etiopathogenesis of skin disorders. OBJECTIVE The aim of this study was to estimate the influence of dietary habits on the concentration of Cd, Pb and Hg in the peripheral blood samples of patients with psoriasis and vitiligo. METHODS In this case-control study, sixty patients with psoriasis, fifty patients with vitiligo and fifty eight healthy people were examined. Blood levels of Cd, Pb and Hg were determined by atomic absorption spectrometry. Food-frequency questionnaires were implemented to collect the dietary data. RESULTS Significant differences (p < 0.05) of Cd levels were found between women and men with psoriasis and women and men in the control group. The concentration of Pb was significantly higher among vitiligo patients (50.04 ± 26.54 μg/L) than in healthy controls (36.04 ± 27.35 μg/L). Significantly lower ratio of Se/Pb, Zn/Pb and Cu/Pb was found among psoriatic men. Significantly (p < 0.05) lower values of Se/Hg ratio were observed among vitiligo patients compared to controls. CONCLUSIONS The elevated levels of toxic elements could increase oxidative stress which may partly contribute to inflammation in the pathogenesis of psoriasis and vitiligo, which requires further research. Analysis of the influence of frequent consumption of food products on toxic metals concentration showed that the dietary habits have impact on the content of examined toxic metals in the blood of patients. The obtained results may be useful for composing the diet and could be helpful in prevention of psoriasis and vitiligo.
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Affiliation(s)
- Marta Wacewicz-Muczyńska
- Department of Specialist Cosmetology, Medical University of Bialystok, Akademicka 3 St., 15-267 Bialystok, Poland.
| | - Katarzyna Socha
- Department of Bromatology, Medical University of Bialystok, Mickiewicza 2D St., 15-222 Bialystok, Poland
| | - Jolanta Soroczyńska
- Department of Bromatology, Medical University of Bialystok, Mickiewicza 2D St., 15-222 Bialystok, Poland
| | - Marek Niczyporuk
- Department of Esthetic Medicine, Medical University of Bialystok, Akademicka 3 St., 15-267 Bialystok, Poland; Outdoor-Patients Dermatological Department, Medical University of Bialystok Clinical Hospital, Żurawia 14 St., 15-540 Bialystok, Poland
| | - Maria H Borawska
- Department of Bromatology, Medical University of Bialystok, Mickiewicza 2D St., 15-222 Bialystok, Poland
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Filippini T, Torres D, Lopes C, Carvalho C, Moreira P, Naska A, Kasdagli MI, Malavolti M, Orsini N, Vinceti M. Cadmium exposure and risk of breast cancer: A dose-response meta-analysis of cohort studies. ENVIRONMENT INTERNATIONAL 2020; 142:105879. [PMID: 32599354 DOI: 10.1016/j.envint.2020.105879] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Cadmium is a toxic heavy metal that has been implicated in breast cancer etiology, albeit with inconsistent results. OBJECTIVE To investigate the shape of the relation between cadmium exposure and breast cancer incidence and mortality in cohort studies. DATA SOURCES Following a literature search through April 14, 2020, we carried out a systematic review and dose-response meta-analysis to investigate the shape of the relation between cadmium exposure (assessed either through diet or urine excretion) and disease incidence and mortality. STUDY ELIGIBILITY CRITERIA For inclusion, a study had to report incidence or mortality for breast cancer according to baseline cadmium exposure category; be a prospective cohort, case-cohort or nested case-control study with a minimum one-year follow-up, and reporting effect estimates for all exposure categories. STUDY APPRAISAL AND SYNTHESIS METHODS Studies were evaluated using the ROBINS-E risk of bias tool. The effects in humans were assessed quantitatively using one-stage dose-response meta-analysis in a random effects meta-analytical model. RESULTS We identified 10 studies eligible for inclusion in the dose-response meta-analysis, six based on cadmium dietary intake, and four on urinary excretion levels. We found a marginal and imprecise positive relation between dietary cadmium intake and breast cancer, and no association when urinary cadmium excretion was used for exposure assessment. Compared to no exposure, at 20 µg/day of cadmium intake the summary risk ratio was 1.12 (95% confidence interval 0.80-1.56), while at 2 µg/g creatinine of cadmium excretion the summary risk ratio was 0.89 (95% confidence interval 0.38-2.14). Analysis restricted to post-menopausal women showed no association between either dietary or urinary cadmium and subsequent breast cancer incidence and mortality. LIMITATIONS AND CONCLUSIONS Overall, we found scant evidence of a positive association between cadmium and breast cancer. Available data were too limited to carry out stratified analyses according to age, smoking and hormone receptor status. Therefore, possible associations between cadmium exposure and breast cancer in selected subgroups cannot be entirely ruled out.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Duarte Torres
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Faculty of Food and Nutrition Sciences, University of Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Catarina Carvalho
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Faculty of Food and Nutrition Sciences, University of Porto, Porto, Portugal
| | - Pedro Moreira
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal; Faculty of Food and Nutrition Sciences, University of Porto, Porto, Portugal
| | - Androniki Naska
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Maria-Iosifina Kasdagli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, USA.
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11
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Wei Y, Zhu J. Blood levels of endocrine-disrupting metals and prevalent breast cancer among US women. Med Oncol 2019; 37:1. [DOI: 10.1007/s12032-019-1328-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/28/2019] [Indexed: 11/28/2022]
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12
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Wojtczyk-Miaskowska A, Schlichtholz B. Tobacco carcinogens and the methionine metabolism in human bladder cancer. MUTATION RESEARCH. REVIEWS IN MUTATION RESEARCH 2019; 782:108281. [PMID: 31843138 DOI: 10.1016/j.mrrev.2019.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 04/29/2019] [Accepted: 06/03/2019] [Indexed: 01/08/2023]
Abstract
Cigarette smoking is a strong risk factor for bladder cancer. It has been shown that the duration of smoking is associated with a poor prognosis and a higher risk of recurrence. This is due to tobacco carcinogens forming adducts with DNA and proteins that participate in the DNA repair mechanisms. Additionally, polymorphisms of genes responsible for methyl group transfer in the methionine cycle and dosages of vitamins (from diet and supplements) can cause an increased risk of bladder cancer. Upregulated DNA methyltransferase 1 expression and activity results in a high level of methylated products of metabolism, as well as hypermethylation of tumor suppressor genes. The development of a market that provides new inhibitors of DNA methyltransferase or alternatives for current smokers is essential not only for patients but also for people who are under the danger of secondhand smoking and can experience its long-term exposure consequences.
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Affiliation(s)
- A Wojtczyk-Miaskowska
- Department of Biochemistry, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland.
| | - B Schlichtholz
- Department of Biochemistry, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland
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13
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Terry MB, Michels KB, Brody JG, Byrne C, Chen S, Jerry DJ, Malecki KMC, Martin MB, Miller RL, Neuhausen SL, Silk K, Trentham-Dietz A. Environmental exposures during windows of susceptibility for breast cancer: a framework for prevention research. Breast Cancer Res 2019; 21:96. [PMID: 31429809 PMCID: PMC6701090 DOI: 10.1186/s13058-019-1168-2] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background The long time from exposure to potentially harmful chemicals until breast cancer occurrence poses challenges for designing etiologic studies and for implementing successful prevention programs. Growing evidence from animal and human studies indicates that distinct time periods of heightened susceptibility to endocrine disruptors exist throughout the life course. The influence of environmental chemicals on breast cancer risk may be greater during several windows of susceptibility (WOS) in a woman’s life, including prenatal development, puberty, pregnancy, and the menopausal transition. These time windows are considered as specific periods of susceptibility for breast cancer because significant structural and functional changes occur in the mammary gland, as well as alterations in the mammary micro-environment and hormone signaling that may influence risk. Breast cancer research focused on these breast cancer WOS will accelerate understanding of disease etiology and prevention. Main text Despite the plausible heightened mechanistic influences of environmental chemicals on breast cancer risk during time periods of change in the mammary gland’s structure and function, most human studies of environmental chemicals are not focused on specific WOS. This article reviews studies conducted over the past few decades that have specifically addressed the effect of environmental chemicals and metals on breast cancer risk during at least one of these WOS. In addition to summarizing the broader evidence-base specific to WOS, we include discussion of the NIH-funded Breast Cancer and the Environment Research Program (BCERP) which included population-based and basic science research focused on specific WOS to evaluate associations between breast cancer risk and particular classes of endocrine-disrupting chemicals—including polycyclic aromatic hydrocarbons, perfluorinated compounds, polybrominated diphenyl ethers, and phenols—and metals. We outline ways in which ongoing transdisciplinary BCERP projects incorporate animal research and human epidemiologic studies in close partnership with community organizations and communication scientists to identify research priorities and effectively translate evidence-based findings to the public and policy makers. Conclusions An integrative model of breast cancer research is needed to determine the impact and mechanisms of action of endocrine disruptors at different WOS. By focusing on environmental chemical exposure during specific WOS, scientists and their community partners may identify when prevention efforts are likely to be most effective.
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Affiliation(s)
- Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1611, New York, NY, 10032, USA
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, 650 Charles E. Young Drive South, CHS 71-254, Los Angeles, CA, 90095, USA
| | | | - Celia Byrne
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road A-1039F, Bethesda, MD, 20814, USA
| | - Shiuan Chen
- Department of Cancer Biology, Beckman Research Institute of City of Hope, 1450 E. Duarte Road, Duarte, CA, 91010, USA
| | - D Joseph Jerry
- Pioneer Valley Life Sciences Institute and Department of Veterinary & Animal Sciences, University of Massachusetts Amherst, 661 North Pleasant St., Amherst, MA, 01003, USA
| | - Kristen M C Malecki
- Department of Population Health Sciences and the Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St., WARF Room 605, Madison, WI, 53726, USA
| | - Mary Beth Martin
- Departments of Oncology and Biochemistry & Molecular Biology, Georgetown University Medical Center, E411 New Research Building, Washington, DC, 20057, USA
| | - Rachel L Miller
- Departments of Medicine, Pediatrics, Environmental Health Sciences; Vagelos College of Physicians and Surgeons, Mailman School of Public Health, Columbia University, PH8E-101B, 630 W. 168th St, New York, NY, 10032, USA
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, 1450 E. Duarte Road, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Kami Silk
- Department of Communication, University of Delaware, 250 Pearson Hall, 125 Academy St, Newark, DE, 19716, USA
| | - Amy Trentham-Dietz
- Department of Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St., WARF Room 307, Madison, WI, 53726, USA.
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14
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Rocco SA, Koneva L, Middleton LYM, Thong T, Solanki S, Karram S, Nambunmee K, Harris C, Rozek LS, Sartor MA, Shah YM, Colacino JA. Cadmium Exposure Inhibits Branching Morphogenesis and Causes Alterations Consistent With HIF-1α Inhibition in Human Primary Breast Organoids. Toxicol Sci 2019; 164:592-602. [PMID: 29741670 DOI: 10.1093/toxsci/kfy112] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Developmental cadmium exposure in vivo disrupts mammary gland differentiation, while exposure of breast cell lines to cadmium causes invasion consistent with the epithelial-mesenchymal transition (EMT). The effects of cadmium on normal human breast stem cells have not been measured. Here, we quantified the effects of cadmium exposure on reduction mammoplasty patient-derived breast stem cell proliferation and differentiation. Using the mammosphere assay and organoid formation in 3D hydrogels, we tested 2 physiologically relevant doses of cadmium, 0.25 and 2.5 µM, and tested for molecular alterations using RNA-seq. We functionally validated our RNA-seq findings with a hypoxia-inducible factor (HIF)-1α activity reporter line and pharmaceutical inhibition of HIF-1α in organoid formation assays. 2.5 µM cadmium reduced primary mammosphere formation and branching structure organoid formation rates by 33% and 87%, respectively. Despite no changes in mammosphere formation, 0.25 µM cadmium inhibited branching organoid formation in hydrogels by 73%. RNA-seq revealed cadmium downregulated genes associated with extracellular matrix formation and EMT, while upregulating genes associated with metal response including metallothioneins and zinc transporters. In the RNA-seq data, cadmium downregulated HIF-1α target genes including LOXL2, ZEB1, and VIM. Cadmium significantly inhibited HIF-1α activity in a luciferase assay, and the HIF-1α inhibitor acriflavine ablated mammosphere and organoid formation. These findings show that cadmium, at doses relevant to human exposure, inhibited human mammary stem cell proliferation and differentiation, potentially through disruption of HIF-1α activity.
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Affiliation(s)
- Sabrina A Rocco
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029
| | - Lada Koneva
- Department of Computational Medicine and Bioinformatics
| | - Lauren Y M Middleton
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029
| | - Tasha Thong
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029
| | - Sumeet Solanki
- Molecular and Integrative Physiology and Internal Medicine, Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, Michigan 48109
| | - Sarah Karram
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029
| | - Kowit Nambunmee
- Department of Occupational Health and Safety, Mae Fah Luong University, Chiang Rai, Thailand, 57100
| | - Craig Harris
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029
| | - Laura S Rozek
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029
| | | | - Yatrik M Shah
- Molecular and Integrative Physiology and Internal Medicine, Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, Michigan 48109
| | - Justin A Colacino
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, 48109
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15
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Chiesa LM, Ceriani F, Procopio A, Bonacci S, Malandra R, Panseri S, Arioli F. Exposure to metals and arsenic from yellow and red tuna consumption. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2019; 36:1228-1235. [PMID: 31161922 DOI: 10.1080/19440049.2019.1619944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Tuna is one of the most frequently consumed fish and, as a predator, can biomagnify pollutants. Metal and other elements pollution is an important worldwide concern. Based on these considerations, the aim of this work was to investigate the occurrence of As, Cd, Cr, Ni, Hg and Pb in tuna coming from different FAO areas to evaluate human exposure. The analysis was performed on muscle tissues through a quadrupole inductively coupled mass spectrometry. One hundred thirty-one samples were analysed. One red tuna from the Adriatic Sea and 11 yellow tunas exceeded Pb maximum levels (MLs) with a concentration ranging 0.31-0.86 mg kg-1; three red tunas from different Mediterranean sub-areas exceeded Hg MLs, with a concentration range 1.19 to 1.80 mg kg-1. All the Hazard Indexes (HIs) were lower than one, indicating that only a negligible health hazard could derive from the ingestion of tuna, for both average and high consumers. The risk of carcinogenicity from Cr is still under debate at the concentrations detectable in food.
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Affiliation(s)
- Luca Maria Chiesa
- a Department of Health, Animal Science and Food Safety, University of Milan , Milan , Italy
| | - Federica Ceriani
- a Department of Health, Animal Science and Food Safety, University of Milan , Milan , Italy
| | - Antonio Procopio
- b Dipartimento di Scienze della Salute, Università Magna Græcia , Catanzaro , Italy
| | - Sonia Bonacci
- b Dipartimento di Scienze della Salute, Università Magna Græcia , Catanzaro , Italy
| | - Renato Malandra
- c Director of Veterinary Unit, ATS Milano-Città Metropolitana , Milan , Italy
| | - Sara Panseri
- a Department of Health, Animal Science and Food Safety, University of Milan , Milan , Italy
| | - Francesco Arioli
- a Department of Health, Animal Science and Food Safety, University of Milan , Milan , Italy
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16
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Grioni S, Agnoli C, Krogh V, Pala V, Rinaldi S, Vinceti M, Contiero P, Vescovi L, Malavolti M, Sieri S. Dietary cadmium and risk of breast cancer subtypes defined by hormone receptor status: A prospective cohort study. Int J Cancer 2019; 144:2153-2160. [PMID: 30515770 DOI: 10.1002/ijc.32039] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/23/2018] [Accepted: 11/21/2018] [Indexed: 02/03/2023]
Abstract
Diet is the primary source of cadmium-a proven Group 1 human carcinogen-for non-smokers. Observational studies investigating the effect of cadmium from food sources on breast cancer risk have produced inconsistent results. We examined the association between dietary cadmium and risk of breast cancer defined by estrogen receptor (ER), progesterone receptor (PR) and HER2 status, in 8924 women recruited to a prospective study between 1987 and 1992. Dietary cadmium intake was estimated using a semi-quantitative food frequency questionnaire at baseline. During a median of 22 years of follow-up, 451 incident cases of breast cancer were identified through the Varese Cancer Registry. Multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for breast cancer and receptor-defined breast cancer subtypes were estimated for quintiles of dietary cadmium intake, adjusting for confounding factors. Mean dietary cadmium intake was 7.8 (standard deviation 1.4) μg/day. Women with highest quintile of cadmium intake had a greater risk of breast cancer (HR 1.54; 95% CI, 1.06-2.22; p trend = 0.028) than those with lowest quintile of intake. Women premenopausal at recruitment had HR = 1.73 (95% CI, 1.10-2.71, highest vs. lowest quintile); postmenopausal women had HR = 1.32 (95% CI, 1.05-1.66 for each standard deviation increase in cadmium). Cadmium-related risk of breast cancer did not vary with ER, PR or HER2 status (p-heterogeneity not significant). These findings support the hypothesis that dietary cadmium is a risk factor for breast cancer.
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Affiliation(s)
- Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sabina Rinaldi
- International Agency for Research on Cancer, Lyon, France
| | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Paolo Contiero
- Environmental Epidemiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luciano Vescovi
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marcella Malavolti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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17
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Kim K, Melough MM, Vance TM, Noh H, Koo SI, Chun OK. Dietary Cadmium Intake and Sources in the US. Nutrients 2018; 11:E2. [PMID: 30577418 PMCID: PMC6356330 DOI: 10.3390/nu11010002] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/11/2018] [Accepted: 12/15/2018] [Indexed: 11/19/2022] Open
Abstract
Cadmium (Cd) is a toxic heavy metal that can contribute to numerous diseases as well as increased mortality. Diet is the primary source of Cd exposure for most individuals, yet little is known about the foods and food groups that contribute most substantially to dietary Cd intake in the US. Therefore, the objective of this study was to estimate dietary Cd intake and identify major food sources of Cd in the US population and among subgroups of the population. Individuals aged 2 years and older from the National Health and Nutrition Examination Survey (NHANES) 2007⁻2012 were included in this study (n = 12,523). Cd intakes were estimated from two days of 24-h dietary recalls by matching intake data with the Cd database of the Food and Drug Administration (FDA)'s Total Diet Study 2006 through 2013. The average dietary Cd consumption in the population was 4.63 μg/day, or 0.54 μg/kg body weight/week, which is 22% of the tolerable weekly intake (TWI) of 2.5 μg/kg body weight/week. Greater daily Cd intakes were observed in older adults, males, those with higher income, higher education, or higher body mass index. The highest Cd intakes on a body weight basis were observed in children 10 years and younger (38% of TWI), underweight individuals (38% of TWI), and alcohol non-consumers (24% of TWI). The food groups that contributed most to Cd intake were cereals and bread (34%), leafy vegetables (20%), potatoes (11%), legumes and nuts (7%), and stem/root vegetables (6%). The foods that contributed most to total Cd intake were lettuce (14%), spaghetti (8%), bread (7%), and potatoes (6%). Lettuce was the major Cd source for Caucasians and Blacks, whereas tortillas were the top source for Hispanics, and rice was the top contributor among other ethnic subgroups including Asians. This study provides important information on the dietary Cd exposure of Americans, and identifies the groups with the greatest dietary Cd exposure as well as the major sources of dietary Cd among sociodemographic subgroups.
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Affiliation(s)
- Kijoon Kim
- Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Korea.
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Melissa M Melough
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Terrence M Vance
- Department of Nutrition and Dietetics, SUNY College at Plattsburgh, Plattsburgh, NY 12901, USA.
| | - Hwayoung Noh
- International Agency of Research on Cancer, World Health Organization, 69372 Lyon, France.
| | - Sung I Koo
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Ock K Chun
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
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18
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Gaudet MM, Deubler EL, Kelly RS, Ryan Diver W, Teras LR, Hodge JM, Levine KE, Haines LG, Lundh T, Lenner P, Palli D, Vineis P, Bergdahl IA, Gapstur SM, Kyrtopoulos SA. Blood levels of cadmium and lead in relation to breast cancer risk in three prospective cohorts. Int J Cancer 2018; 144:1010-1016. [PMID: 30117163 DOI: 10.1002/ijc.31805] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 07/10/2018] [Accepted: 07/26/2018] [Indexed: 01/05/2023]
Abstract
Cadmium and lead have been classified as carcinogens by the International Agency for Research on Cancer. However, their associations with breast cancer risk are unknown despite their persistence in the environment and ubiquitous human exposure. We examined associations of circulating levels of cadmium and lead with breast cancer risk in three case-control studies nested within the Cancer Prevention Study-II (CPS-II) LifeLink Cohort, European Prospective Investigation into Cancer and Nutrition - Italy (EPIC-Italy) and the Northern Sweden Health and Disease Study (NSHDS) cohorts. Metal levels were measured in stored erythrocytes from 1,435 cases and 1,433 controls using inductively coupled plasma-mass spectrometry. Summary relative risks (RR) and 95% confidence intervals (CI) were calculated using random-effects models with each study result weighted by the within- and between-study variances. I2 values were calculated to estimate proportion of between study variation. Using common cut-points, cadmium levels were not associated with breast cancer risk in the CPS-II cohort (continuous RR = 1.01, 95% CI 0.76-1.34), but were inversely associated with risk in the EPIC- Italy (continuous RR = 0.80, 95% CI 0.61-1.03) and NSHDS cohorts (continuous RR = 0.73, 95% CI 0.54-0.97). The inverse association was also evident in the meta-analysis (continuous RR = 0.84, 95% CI 0.69-1.01) with low between-study heterogeneity. Large differences in lead level distributions precluded a meta-analysis of their association with breast cancer risk; no associations were found in the three studies. Adult cadmium and lead levels were not associated with higher risk of breast cancer in our large meta-analysis.
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Affiliation(s)
- Mia M Gaudet
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Emily L Deubler
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, MA
| | - W Ryan Diver
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Lauren R Teras
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - James M Hodge
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | | | | | - Thomas Lundh
- Division of Occupational and Environmental MedicineLund University, Lund, Sweden
| | - Per Lenner
- Department of Radiation Science, Umeå University, Umeå, Sweden
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, ISPO, Cancer Prevention and Research Institute, Florence, Italy
| | - Paolo Vineis
- Grantham Institute, Imperial College, London, United Kingdom
| | - Ingvar A Bergdahl
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.,Department of Biobank Research, Umeå University, Umeå, Sweden
| | - Susan M Gapstur
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Soterios A Kyrtopoulos
- National Hellenic Research Foundation, Institute of Biology, Medicinal Chemistry and Biotechnology, Athens, Greece
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19
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Osorio-Yáñez C, Gelaye B, Enquobahrie DA, Qiu C, Williams MA. Dietary intake and urinary metals among pregnant women in the Pacific Northwest. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 236:680-688. [PMID: 29438954 DOI: 10.1016/j.envpol.2018.01.110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 01/28/2018] [Accepted: 01/31/2018] [Indexed: 05/25/2023]
Abstract
Pregnancy is a period when the mother and her offspring are susceptible to the toxic effects of metals. We investigated associations of intake of frequently consumed foods with urinary metals concentrations among pregnant women in the Pacific Northwest. We measured urinary cadmium (U-Cd), arsenic (U-As) and molybdenum (U-Mo) concentrations from spot urine samples in early pregnancy (15 weeks of gestation, on average) among 558 women from Seattle and Tacoma, Washington. We assessed periconceptional dietary intake using a semi-quantitative food frequency questionnaire (FFQ). We also determined early pregnancy zinc concentrations in serum. Statistical analyses involved multivariable linear regression models, adjusted for smoking status, age, race/ethnicity, multivitamin and supplement use, education, estimated total energy intake, and gravidity. The geometric mean and range in μg/g creatinine for U-Cd, U-As and U-Mo were 0.29 (0.1-8.2), 18.95 (3-550), and 72.1 (15-467), respectively. U-Cd was positively associated with dietary zinc intake (P-value = 0.004) and serum zinc (P-value<0.001) while it was negatively associated with coffee intake (P-value = 0.03). U-As was positively associated with dietary fish [(Lean fish, fatty fish, shellfish and non-fried fish) (P-values<0.01)], selenium (P-value = 0.004), zinc (P-value = 0.017), vegetables (P-value = 0.004), and low-fat yogurt (P-value = 0.03). Women who reported higher intake of dietary magnesium (Mg)(P-value = 0.04), insoluble fiber (P-value = 0.03), and low-fat yogurt (P-value = 0.04) had higher U-Mo concentrations. Our study suggests that vegetables, fish, fiber and yogurt might be significant dietary sources of metals. Future studies aimed at investigating the risk of exposure to metals from other various food sources among reproductive-age and pregnant women are needed.
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Affiliation(s)
- Citlalli Osorio-Yáñez
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) Barcelona, Spain.
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Daniel A Enquobahrie
- Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Chunfang Qiu
- Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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20
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Nordberg GF, Bernard A, Diamond GL, Duffus JH, Illing P, Nordberg M, Bergdahl IA, Jin T, Skerfving S. Risk assessment of effects of cadmium on human health (IUPAC Technical Report). PURE APPL CHEM 2018. [DOI: 10.1515/pac-2016-0910] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Abstract
Chemistry and Human Health, Division VII of the International Union on Pure and Applied Chemistry (IUPAC), provides guidance on risk assessment methodology and, as appropriate, assessment of risks to human health from chemicals of exceptional toxicity. The aim of this document is to describe dose-response relationships for the health effects of low-level exposure to cadmium, in particular, with an emphasis on causation. The term “cadmium” in this document includes all chemical species of cadmium, as well as those in cadmium compounds. Diet is the main source of cadmium exposure in the general population. Smokers and workers in cadmium industries have additional exposure. Adverse effects have been shown in populations with high industrial or environmental exposures. Epidemiological studies in general populations have also reported statistically significant associations with a number of adverse health effects at low exposures. Cadmium is recognized as a human carcinogen, a classification mainly based on occupational studies of lung cancer. Other cancers have been reported, but dose-response relationships cannot be defined. Cardiovascular disease has been associated with cadmium exposure in recent epidemiological studies, but more evidence is needed in order to establish causality. Adequate evidence of dose-response relationships is available for kidney effects. There is a relationship between cadmium exposure and kidney effects in terms of low molecular mass (LMM) proteinuria. Long-term cadmium exposures with urine cadmium of 2 nmol mmol−1 creatinine cause such effects in a susceptible part of the population. Higher exposures result in increases in the size of these effects. This assessment is supported by toxicokinetic and toxicodynamic (TKTD) modelling. Associations between urine cadmium lower than 2 nmol mmol−1 creatinine and LMM proteinuria are influenced by confounding by co-excretion of cadmium with protein. A number of epidemiological studies, including some on low exposures, have reported statistically significant associations between cadmium exposure and bone demineralization and fracture risk. Exposures leading to urine cadmium of 5 nmol mmol−1 creatinine and more increase the risk of bone effects. Similar associations at much lower urine cadmium levels have been reported. However, complexities in the cause and effect relationship mean that a no-effect level cannot be defined. LMM proteinuria was selected as the critical effect for cadmium, thus identifying the kidney cortex as the critical organ, although bone effects may occur at exposure levels similar to those giving rise to kidney effects. To avoid these effects, population exposures should not exceed that resulting in cadmium values in urine of more than 2 nmol mmol−1 creatinine. As cadmium is carcinogenic, a ‘safe’ exposure level cannot be defined. We therefore recommend that cadmium exposures be kept as low as possible. Because the safety margin for toxic effects in kidney and bone is small, or non-existent, in many populations around the world, there is a need to reduce cadmium pollution globally.
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Affiliation(s)
- Gunnar F. Nordberg
- Occupational and Environmental Medicine , Department of Public Health and Clinical Medicine , Umeå University , SE-90187 Umeå , Sweden
| | - Alfred Bernard
- Department of Toxicology , Catholic University of Louvain , Brussels , Belgium
| | | | - John H. Duffus
- The Edinburgh Centre for Toxicology , 43 Mansionhouse Road , Edinburgh EH9 2JD, Scotland , UK
| | | | - Monica Nordberg
- Institute of Environmental Medicine, Karolinska Institutet , Stockholm , Sweden
| | - Ingvar A. Bergdahl
- Occupational and Environmental Medicine , Department of Public Health and Clinical Medicine , Umeå University , SE-90187 Umeå , Sweden
| | - Taiyi Jin
- Department of Occupational Health and Toxicology , School of Public Health, Fudan University , Shanghai , China
| | - Staffan Skerfving
- Division of Occupational and Environmental Medicine, University Hospital , Lund , Sweden
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Gray JM, Rasanayagam S, Engel C, Rizzo J. State of the evidence 2017: an update on the connection between breast cancer and the environment. Environ Health 2017; 16:94. [PMID: 28865460 PMCID: PMC5581466 DOI: 10.1186/s12940-017-0287-4] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 07/17/2017] [Indexed: 05/23/2023]
Abstract
BACKGROUND In this review, we examine the continually expanding and increasingly compelling data linking radiation and various chemicals in our environment to the current high incidence of breast cancer. Singly and in combination, these toxicants may have contributed significantly to the increasing rates of breast cancer observed over the past several decades. Exposures early in development from gestation through adolescence and early adulthood are particularly of concern as they re-shape the program of genetic, epigenetic and physiological processes in the developing mammary system, leading to an increased risk for developing breast cancer. In the 8 years since we last published a comprehensive review of the relevant literature, hundreds of new papers have appeared supporting this link, and in this update, the evidence on this topic is more extensive and of better quality than that previously available. CONCLUSION Increasing evidence from epidemiological studies, as well as a better understanding of mechanisms linking toxicants with development of breast cancer, all reinforce the conclusion that exposures to these substances - many of which are found in common, everyday products and byproducts - may lead to increased risk of developing breast cancer. Moving forward, attention to methodological limitations, especially in relevant epidemiological and animal models, will need to be addressed to allow clearer and more direct connections to be evaluated.
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Affiliation(s)
- Janet M. Gray
- Department of Psychology and Program in Science, Technology, and Society, Vassar College, 124 Raymond Avenue, Poughkeepsie, NY 12604-0246 USA
| | - Sharima Rasanayagam
- Breast Cancer Prevention Partners, 1388 Sutter St., Suite 400, San Francisco, CA 94109-5400 USA
| | - Connie Engel
- Breast Cancer Prevention Partners, 1388 Sutter St., Suite 400, San Francisco, CA 94109-5400 USA
| | - Jeanne Rizzo
- Breast Cancer Prevention Partners, 1388 Sutter St., Suite 400, San Francisco, CA 94109-5400 USA
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Satarug S, Vesey DA, Gobe GC. Current health risk assessment practice for dietary cadmium: Data from different countries. Food Chem Toxicol 2017; 106:430-445. [PMID: 28602857 DOI: 10.1016/j.fct.2017.06.013] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 02/01/2023]
Abstract
Cadmium (Cd) is an environmental toxicant with high rates of soil-to-plant transference. This makes exposure to Cd through the food-chain contamination a public health concern. Cd accumulates in kidneys, and the most frequently reported adverse effect of long-term Cd intake is injury to kidneys. The FAO/WHO Joint Expert Committee on Food Additives established a tolerable dietary intake level and a threshold to safeguard population health. The FAO/WHO tolerable intake was set at 25 μg per kg body weight per month (58 μg per day for a 70-kg person) with urinary Cd threshold at 5.24 μg/g creatinine. Worldwide population data indicate that urinary Cd excretion reflects cumulative Cd exposure or body burden more accurately than estimated Cd intake, derived from total diet study (TDS). For the adult population, TDS estimated Cd intake of 8-25 μg/day, while urinary Cd levels suggest higher intake levels (>30 μg/day). These Cd intake estimates are below the FAO/WHO intake guideline, but they exceed the levels that are associated with distinct pathologies in many organ systems. A wide diversity of Cd toxicity targets and Cd toxicity levels argue for a more restrictive dietary Cd intake guideline and the measures that minimize Cd levels in foodstuffs.
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Affiliation(s)
- Soisungwan Satarug
- UQ Diamantina Institute and Centre for Health Services Research, Translational Research Institute, The University of Queensland, Woolloongabba, Brisbane, Australia.
| | - David A Vesey
- UQ Diamantina Institute and Centre for Health Services Research, Translational Research Institute, The University of Queensland, Woolloongabba, Brisbane, Australia; Department of Renal Medicine, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Australia
| | - Glenda C Gobe
- UQ Diamantina Institute and Centre for Health Services Research, Translational Research Institute, The University of Queensland, Woolloongabba, Brisbane, Australia
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Endocrine Disrupting Chemicals and Endometrial Cancer: An Overview of Recent Laboratory Evidence and Epidemiological Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030334. [PMID: 28327540 PMCID: PMC5369169 DOI: 10.3390/ijerph14030334] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 02/13/2017] [Accepted: 02/22/2017] [Indexed: 01/10/2023]
Abstract
Background: Although exposure to endocrine disruptor compounds (EDCs) has been suggested as a contributing factor to a range of women's health disorders including infertility, polycystic ovaries and the early onset of puberty, considerable challenges remain in attributing cause and effect on gynaecological cancer. Until recently, there were relatively few epidemiological studies examining the relationship between EDCs and endometrial cancer, however, in the last years the number of these studies has increased. Methods: A systematic MEDLINE (PubMed) search was performed and relevant articles published in the last 23 years (from 1992 to 2016) were selected. Results: Human studies and animal experiments are confirming a carcinogenic effect due to the EDC exposure and its carcinogenesis process result to be complex, multifactorial and long standing, thus, it is extremely difficult to obtain the epidemiological proof of a carcinogenic effect of EDCs for the high number of confusing factors. Conclusions: The carcinogenic effects of endocrine disruptors are plausible, although additional studies are needed to clarify their mechanisms and responsible entities. Neverthless, to reduce endocrine disruptors (ED) exposure is mandatory to implement necessary measures to limit exposure, particularly during those periods of life most vulnerable to the impact of oncogenic environmental causes, such as embryonic period and puberty.
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Eriksen KT, McElroy JA, Harrington JM, Levine KE, Pedersen C, Sørensen M, Tjønneland A, Meliker JR, Raaschou-Nielsen O. Urinary Cadmium and Breast Cancer: A Prospective Danish Cohort Study. J Natl Cancer Inst 2016; 109:djw204. [DOI: 10.1093/jnci/djw204] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 08/05/2016] [Indexed: 11/13/2022] Open
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Lin J, Zhang F, Lei Y. Dietary intake and urinary level of cadmium and breast cancer risk: A meta -analysis. Cancer Epidemiol 2016; 42:101-7. [DOI: 10.1016/j.canep.2016.04.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 03/15/2016] [Accepted: 04/05/2016] [Indexed: 12/27/2022]
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Adams SV, Shafer MM, Bonner MR, LaCroix AZ, Manson JE, Meliker JR, Neuhouser ML, Newcomb PA. Urinary Cadmium and Risk of Invasive Breast Cancer in the Women's Health Initiative. Am J Epidemiol 2016; 183:815-23. [PMID: 27037269 DOI: 10.1093/aje/kwv285] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 10/13/2015] [Indexed: 12/26/2022] Open
Abstract
Cadmium is a widespread heavy metal pollutant that may act as an exogenous estrogenic hormone. Environmental cadmium exposure has been associated with risk of breast cancer in retrospective studies. We prospectively assessed the relationship between cadmium exposure, evaluated by creatinine-normalized urinary cadmium concentration, and invasive breast cancer among 12,701 postmenopausal women aged ≥50 years in a Women's Health Initiative study of bone mineral density. After a median of 13.2 years of follow-up (1993-2010), 508 cases of invasive breast cancer and 1,050 comparison women were identified for a case-cohort analysis. Multivariable Cox regression was used to calculate hazard ratios and 95% confidence intervals. Risk of breast cancer was not associated with urinary cadmium parameterized either in quartiles (comparing highest quartile with lowest, hazard ratio = 0.80, 95% confidence interval: 0.56, 1.14; P for trend = 0.20) or as a log-transformed continuous variable (per 2-fold higher urinary cadmium concentration, hazard ratio = 0.94, 95% confidence interval: 0.86, 1.03). We did not observe an association between urinary cadmium and breast cancer risk in any subgroup examined, including never smokers and women with body mass index (weight (kg)/height (m)(2)) less than 25. Results were consistent in both estrogen receptor-positive and estrogen receptor-negative tumors. Our results do not support the hypothesis that environmental cadmium exposure is associated with risk of postmenopausal breast cancer.
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Quraishi SM, Adams SV, Shafer M, Meliker JR, Li W, Luo J, Neuhouser ML, Newcomb PA. Urinary cadmium and estimated dietary cadmium in the Women's Health Initiative. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:303-8. [PMID: 26015077 PMCID: PMC5077304 DOI: 10.1038/jes.2015.40] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 04/17/2015] [Indexed: 05/04/2023]
Abstract
Cadmium, a heavy metal dispersed in the environment as a result of industrial and agricultural applications, has been implicated in several human diseases including renal disease, cancers, and compromised bone health. In the general population, the predominant sources of cadmium exposure are tobacco and diet. Urinary cadmium (uCd) reflects long-term exposure and has been frequently used to assess cadmium exposure in epidemiological studies; estimated dietary intake of cadmium (dCd) has also been used in several studies. The validity of dCd in comparison with uCd is unclear. This study aimed to compare dCd, estimated from food frequency questionnaires, to uCd measured in spot urine samples from 1,002 participants of the Women's Health Initiative. Using linear regression, we found that dCd was not statistically significantly associated with uCd (β=0.006, P-value=0.14). When stratified by smoking status, dCd was not significantly associated with uCd both in never smokers (β=0.006, P-value=0.09) and in ever smokers (β=0.003, P-value=0.67). Our results suggest that because of the lack of association between estimated dCd and measured uCd, dietary estimation of cadmium exposure should be used with caution in epidemiologic studies.
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Affiliation(s)
- Sabah M Quraishi
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Fred Hutchinson Cancer Research Center, Cancer Prevention, Public Health Sciences, Seattle, Washington, USA
| | - Scott V Adams
- Fred Hutchinson Cancer Research Center, Cancer Prevention, Public Health Sciences, Seattle, Washington, USA
| | - Martin Shafer
- Environmental Chemistry and Technology Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Jaymie R Meliker
- Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Wenjun Li
- Department of Medicine, University of Massachusetts, Worcester, Massachusetts, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - Marian L Neuhouser
- Fred Hutchinson Cancer Research Center, Cancer Prevention, Public Health Sciences, Seattle, Washington, USA
| | - Polly A Newcomb
- Fred Hutchinson Cancer Research Center, Cancer Prevention, Public Health Sciences, Seattle, Washington, USA
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Van Maele-Fabry G, Lombaert N, Lison D. Dietary exposure to cadmium and risk of breast cancer in postmenopausal women: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2016; 86:1-13. [PMID: 26479829 DOI: 10.1016/j.envint.2015.10.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/05/2015] [Accepted: 10/05/2015] [Indexed: 05/21/2023]
Abstract
BACKGROUND With tobacco smoking, diet is the main source of cadmium (Cd) exposure in the general population. The carcinogenic and estrogenic activities of Cd make it a contaminant of potential concern for hormone-dependent cancers including breast cancer. Postmenopausal women represent the most appropriate population to investigate the possible impact of exogenous factors with potential estrogenic activity on breast cancer as, after menopause, their estrogenic influence is predominant. OBJECTIVES We systematically reviewed available studies on the association between dietary exposure to Cd and breast cancer focusing on postmenopausal women. A meta-analysis combining the risk estimators was performed and potential sources of between studies heterogeneity were traced. METHODS Studies were searched from MEDLINE through 31 January 2015 and from the reference lists of relevant publications. Six eligible studies published between 2012 and 2014 were identified and relative risk estimates were extracted. Meta-rate ratio estimates (mRR) were calculated according to fixed and random-effect models. Meta-analyses were performed on the whole set of data and separate analyses were conducted after stratification for study design, geographic location, use of hormone replacement therapy (HRT), tumor estrogen receptor status (ER+ or ER-), progesterone receptor status (PGR+ or PGR-), body mass index (BMI), smoker status, zinc or iron intake. RESULTS No statistically significant increased risk of breast cancer was observed when all studies were combined (mRR=1.03; 95% confidence interval [CI]: 0.89-1.19). Several sources of heterogeneity and inconsistency were identified, including smoker status, HRT use, BMI, zinc and iron intake. Inconsistency was also strongly reduced when only considering ER-, PGR-, tumors subgroups from USA and from Japan. The risks were, however, not substantially modified after stratifications. No evidence of publication bias was found. CONCLUSION The present study does not provide support for the hypothesis that dietary exposure to Cd increases the risk of breast cancer in postmenopausal women. Misclassification in dietary Cd assessment in primary studies could have biased the results towards a finding of no association.
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Affiliation(s)
- Geneviève Van Maele-Fabry
- Université catholique de Louvain, SSS/IREC/LTAP (Louvain Center for Toxicology and Applied Pharmacology), Avenue E. Mounier 53, bte B1.52.12, B-1200 Brussels, Belgium.
| | - Noömi Lombaert
- International Zinc/Cadmium Association, Avenue de Tervueren 168/Box 4, B-1150 Brussels, Belgium.
| | - Dominique Lison
- Université catholique de Louvain, SSS/IREC/LTAP (Louvain Center for Toxicology and Applied Pharmacology), Avenue E. Mounier 53, bte B1.52.12, B-1200 Brussels, Belgium.
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Peng L, Huang Y, Zhang J, Peng Y, Lin X, Wu K, Huo X. Cadmium exposure and the risk of breast cancer in Chaoshan population of southeast China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2015; 22:19870-8. [PMID: 26289334 DOI: 10.1007/s11356-015-5212-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 08/10/2015] [Indexed: 02/05/2023]
Abstract
Recently, there is increasing evidence indicating a link between cadmium exposure and human breast cancer. This study was aimed to explore the relationship between blood cadmium burden and the risk of breast cancer in Chaoshan women with no occupational exposure. Blood cadmium levels (BCLs) were determined in whole blood of 186 breast cancer cases and 139 controls. Basic clinical data and information of age, occupation, blood types, family cancer history, and disease history, as well as other demographic characteristics were collected from medical records. BCLs were detected by graphite-furnace atomizer absorption spectrophotometer (GFAAS). BCLs and proportions of BCLs over 3 μg/L between cases and controls were compared. The relationships between BCLs and breast cancer were explored by comparing BCL differences between/among different characteristics of investigated factors. In addition, BCLs within cases were also compared in relation to the disease clinical stages, tumor-node-metastasis (TNM) stages, and estrogen receptor (ER), progesterone receptor (PR), and Cerb-B2 expressions. The breast cancer patients had a higher median concentration of blood cadmium (2.28, interquartile range 1.57-3.15 μg/L) than the controls (1.77, 1.34-2.57 μg/L; P = 0.001). The proportion of BCLs over 3 μg/L was 2.35 times higher in the breast cancer cases than that of the controls after adjusting for age. Cadmium tends to accumulate in the human body with age and body mass index (BMI) but not associates with type of job, family history, disease history, and other investigated characters. With the increase of clinical stages and T and M stages, the BCLs in the breast cancer cases also increased. BCLs were positively associated with Cerb-B2 expression (r = 0.152, P = 0.038) but not significantly associated with ER and PR expressions. The data obtained show that cadmium concentration is significantly higher in blood of breast cancer patients in comparison to healthy controls. Cadmium seems to be a risk factor of breast cancer, and high cadmium exposure was observed in advanced stages of this disease, which indicates that it may promote the development of breast cancer.
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Affiliation(s)
- Lin Peng
- Clinical Laboratory, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Yiteng Huang
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Jingwen Zhang
- Department of Preventive Medicine, Shantou University Medical College, No.22, Xinling Rd, Shantou, 515041, Guangdong, China
| | - Yuhui Peng
- Clinical Laboratory, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xueqiong Lin
- Clinical Laboratory, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, No.22, Xinling Rd, Shantou, 515041, Guangdong, China.
| | - Xia Huo
- Analytical Cytology Laboratory and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, 515041, Guangdong, China.
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Vacchi-Suzzi C, Eriksen KT, Levine K, McElroy J, Tjønneland A, Raaschou-Nielsen O, Harrington JM, Meliker JR. Dietary Intake Estimates and Urinary Cadmium Levels in Danish Postmenopausal Women. PLoS One 2015; 10:e0138784. [PMID: 26390122 PMCID: PMC4577120 DOI: 10.1371/journal.pone.0138784] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 09/03/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Cadmium is a known carcinogen that can disrupt endocrine signalling. Cigarette smoking and food are the most common routes of non-occupational exposure to cadmium. Cadmium accumulates in the kidney and can be measured in urine, making urine cadmium (U-Cd) a biomarker of long-term exposure. However dietary-cadmium (D-Cd) intake estimates are often used as surrogate indicator of cadmium exposure in non-smoking subjects. It is therefore important to investigate the concordance between D-Cd estimates obtained with Food Frequency Questionnaires and U-Cd. METHODS U-Cd levels were compared with estimated dietary-cadmium (D-Cd) intake in 1764 post-menopausal women from the Danish Diet, Cancer and Health cohort. For each participant, a food frequency questionnaire, and measures of cadmium content in standard recipes were used to judge the daily intake of cadmium, normalized by daily caloric intake. Cadmium was measured by ICP-MS in spot urine sampled at baseline and normalized by urinary creatinine. Information on diet, socio-demographics and smoking were self-reported at baseline. RESULTS Linear regressions between U-Cd and D-Cd alone revealed minimal but significant positive correlation in never smokers (R2 = 0.0076, β = 1.5% increase per 1 ng Cd kcal(-1), p = 0.0085, n = 782), and negative correlation in current smokers (R2 = 0.0184, β = 7.1% decrease per 1 ng Cd kcal(-1) change, p = 0.0006, n = 584). In the full study population, most of the variability in U-Cd was explained by smoking status (R2 = 0.2450, n = 1764). A forward selection model revealed that the strongest predictors of U-Cd were age in never smokers (Δ R2 = 0.04), smoking duration in former smokers (Δ R2 = 0.06) and pack-years in current smokers (Δ R2 = 0.07). Food items that contributed to U-Cd were leafy vegetables and soy-based products, but explained very little of the variance in U-Cd. CONCLUSIONS Dietary-Cd intake estimated from food frequency questionnaires correlates only minimally with U-Cd biomarker, and its use as a Cd exposure indicator may be of limited utility in epidemiologic studies.
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Affiliation(s)
- Caterina Vacchi-Suzzi
- Department of Preventive Medicine and Program in Public Health, Stony Brook University, Stony Brook, New York, United States of America
| | | | - Keith Levine
- RTI International Trace Inorganics Department, Research Triangle Park, North Carolina, United States of America
| | - Jane McElroy
- Family and Community Medicine, University of Missouri, Columbia, Missouri, United States of America
| | | | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - James M. Harrington
- RTI International Trace Inorganics Department, Research Triangle Park, North Carolina, United States of America
| | - Jaymie R. Meliker
- Department of Preventive Medicine and Program in Public Health, Stony Brook University, Stony Brook, New York, United States of America
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Larsson SC, Orsini N, Wolk A. Urinary cadmium concentration and risk of breast cancer: a systematic review and dose-response meta-analysis. Am J Epidemiol 2015; 182:375-80. [PMID: 26254432 DOI: 10.1093/aje/kwv085] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 03/30/2015] [Indexed: 11/12/2022] Open
Abstract
Cadmium is a toxic and persistent heavy metal with estrogenic activities. We conducted a systematic review and meta-analysis of cohort, case-control, and cross-sectional studies of the association between urinary cadmium concentration, a biomarker of cadmium exposure, and breast cancer risk. Studies were identified by searching PubMed and Embase (to March 15, 2015) and by reviewing the reference lists of pertinent articles. Study-specific risk estimates were combined by using a random-effects model. We identified 2 cohort studies (with 67 breast cancer deaths) and 5 case-control studies and 1 cross-sectional study (with 1,416 cases and 5,083 controls) on urinary cadmium concentration in relation to breast cancer risk. The studies were published during the past 10 years (2006-2015). There was no consistent association between urinary cadmium and breast cancer mortality in the cohort studies. In case-control and cross-sectional studies, the pooled odds ratios were 2.24 (95% confidence interval: 1.50, 3.34; I(2) = 63.4%) for the highest versus lowest category of cadmium concentration and 1.66 (95% confidence interval: 1.23, 2.25) for each 0.5-µg/g creatinine increase of cadmium concentration. This meta-analysis suggests that a high cadmium exposure may be a risk factor for breast cancer, but large prospective studies are needed to confirm this finding.
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Wu X, Zhu X, Xie M. Association between dietary cadmium exposure and breast cancer risk: an updated meta-analysis of observational studies. Med Sci Monit 2015; 21:769-75. [PMID: 25771535 PMCID: PMC4371715 DOI: 10.12659/msm.892743] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Diet is the primary way cadmium (Cd) enters the body in those without occupational exposure and who do not inhabit Cd-polluted regions. Findings on the relationship between dietary Cd exposure and breast cancer (BC) risk have been inconsistent; a meta-analysis has supported this association but 2 recent cohort studies showed inconsistent results. Hence, we performed an updated meta-analysis to re-evaluate the association between dietary Cd exposure and BC risk. MATERIAL AND METHODS We searched PubMed, Medline, and EMBASE to identify relevant studies published through September 2014. Combined relative risks (RRs) and the corresponding 95% confidence intervals (CIs) were used to assess the association between dietary Cd exposure and BC risk. RESULTS We identified 6 studies involving 321 315 participants and 11 978 cases. Our study suggested there was no statistically significant positive association between dietary Cd exposure and BC risk, the combined RR and corresponding 95% CI was 1.01 [0.88, 1.14]. The result was not modified by menopause status, geographic area, or study design. CONCLUSIONS Our study did not find a statistically significant positive association between dietary Cd exposure and BC risk. It is necessary to investigate this relationship among the high-risk groups and more cohort studies based on diverse populations are needed.
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Affiliation(s)
- Xiujuan Wu
- Department of General Surgery, Luzhou Medical College, Luzhou, Sichuan, China (mainland)
| | - Xiaofeng Zhu
- Department of Hematology, Luzhou Medical College, Luzhou, Sichuan, China (mainland)
| | - Mingjun Xie
- Department of General Surgery, First People's Hospital of Yibin, Yibin, Sichuan, China (mainland)
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Modified effect of urinary cadmium on breast cancer risk by selenium. Clin Chim Acta 2015; 438:80-5. [DOI: 10.1016/j.cca.2014.08.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 08/11/2014] [Accepted: 08/11/2014] [Indexed: 11/21/2022]
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Khojastehfar A, Aghaei M, Gharagozloo M, Panjehpour M. Cadmium induces reactive oxygen species-dependent apoptosis in MCF-7 human breast cancer cell line. Toxicol Mech Methods 2014; 25:48-55. [DOI: 10.3109/15376516.2014.985353] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Ali I, Engström A, Vahter M, Skerfving S, Lundh T, Lidfeldt J, Samsioe G, Halldin K, Åkesson A. Associations between cadmium exposure and circulating levels of sex hormones in postmenopausal women. ENVIRONMENTAL RESEARCH 2014; 134:265-269. [PMID: 25173093 DOI: 10.1016/j.envres.2014.08.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 08/06/2014] [Accepted: 08/09/2014] [Indexed: 06/03/2023]
Abstract
Recent epidemiological as well as in vivo and in vitro studies collectively suggest that the metalloestrogen cadmium (Cd) could be a potential risk factor for hormone-related cancers in particularly breast cancer. Assessment of the association between Cd exposure and levels of endogenous sex hormones is of pivotal importance, as increased levels of such have been associated with a higher risk of breast cancer in postmenopausal women. The present study investigated the perceived relationship (multivariable-adjusted linear regression analyses) between Cd exposure [blood Cd (B-Cd) and urinary Cd (U-Cd)], and serum levels of androstenedione, testosterone, estradiol, and sex-hormone binding globulin (SHBG), in 438 postmenopausal Swedish women without hormone replacement therapy (HRT). A significant positive association between B-Cd (median 3.4 nmol/L) and serum testosterone levels, as well as a significant inverse association between B-Cd and serum estradiol levels and with the estradiol/testosterone ratio were encountered. However, U-Cd (median 0.69 nmol/mmol creatinine) was inversely associated with serum estradiol levels only. Our data may suggest that Cd interferes with the levels of testosterone and estradiol in postmenopausal women, which might have implications for breast cancer risk.
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Affiliation(s)
- Imran Ali
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Annette Engström
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Marie Vahter
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Staffan Skerfving
- Division of Occupational and Environmental Medicine, University Hospital, Lund, Sweden
| | - Thomas Lundh
- Division of Occupational and Environmental Medicine, University Hospital, Lund, Sweden
| | - Jonas Lidfeldt
- Department of Community Health, Malmö University Hospital, Malmö, Sweden
| | - Göran Samsioe
- Department of Gynecology and Obstetrics, University Hospital, Lund, Sweden
| | - Krister Halldin
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Agneta Åkesson
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
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Eriksen KT, Halkjær J, Sørensen M, Meliker JR, McElroy JA, Tjønneland A, Raaschou-Nielsen O. Dietary cadmium intake and risk of breast, endometrial and ovarian cancer in Danish postmenopausal women: a prospective cohort study. PLoS One 2014; 9:e100815. [PMID: 24963789 PMCID: PMC4071014 DOI: 10.1371/journal.pone.0100815] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 05/30/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Cadmium is a human lung carcinogen and possesses estrogen-like activity. This combination of carcinogenic and estrogenic activity makes cadmium a contaminant of high concern for hormone-related cancers. Diet and smoking are the main sources of cadmium exposure. The aim of this study was to investigate the association between dietary cadmium intake and risk of breast, endometrial and ovarian cancer in Danish postmenopausal woman. METHODS We estimated dietary cadmium intake in the Diet, Cancer and Health cohort at enrolment 1993-97. The estimates were based on food frequency questionnaires and cadmium contents in all foods. Among 23,815 postmenopausal women we identified 1390 breast, 192 endometrial, and 146 ovarian cancer cases from enrolment through December 31, 2010 using the Danish Cancer Registry. Cox regression was used to analyse the association between dietary cadmium intake and cancer risk. RESULTS Mean dietary cadmium intake was 14 µg/day. Cadmium was not associated with breast cancer, incidence rate ratio (IRR) = 0.99, 95% confidence interval (CI): 0.87-1.13 per 10 µg higher dietary cadmium intake/day; endometrial cancer, IRR = 1.08, 95% CI: 0.76-1.53; or ovarian cancer, IRR = 1.15, 95% CI: 0.78-1.70. We found a positive association between cadmium and endometrial cancer for the women with BMI<25 (IRR = 1.50, 95% CI: 0.94-2.39), whereas an inverse association was seen for the women with BMI≥25 (IRR = 0.69, 95% CI: 0.42-1.12); p value for interaction = 0.02. CONCLUSIONS Our study does not indicate that our estimated dietary cadmium intake is associated with hormone-related cancers in women.
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Affiliation(s)
| | - Jytte Halkjær
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jaymie R. Meliker
- Department of Preventive Medicine and Graduate Program in Public Health, Stony Brook University, Stony Brook, New York, United States of America
| | - Jane A. McElroy
- Family and Community Medicine, University of Missouri, Columbia, Montana, United States of America
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Adams SV, Quraishi SM, Shafer MM, Passarelli MN, Freney EP, Chlebowski RT, Luo J, Meliker JR, Mu L, Neuhouser ML, Newcomb PA. Dietary cadmium exposure and risk of breast, endometrial, and ovarian cancer in the Women's Health Initiative. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:594-600. [PMID: 24633137 PMCID: PMC4050510 DOI: 10.1289/ehp.1307054] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 03/12/2014] [Indexed: 05/20/2023]
Abstract
BACKGROUND In vitro and animal data suggest that cadmium, a heavy metal that contaminates some foods and tobacco plants, is an estrogenic endocrine disruptor. Elevated estrogen exposure is associated with breast, endometrial, and ovarian cancer risk. OBJECTIVES We examined the association between dietary cadmium intake and risk of these cancers in the large, well-characterized Women's Health Initiative (WHI). METHODS A total of 155,069 postmenopausal women, 50-79 years of age, who were enrolled in the WHI clinical trials or observational study, participated in this study. We estimated dietary cadmium consumption by combining baseline food frequency questionnaire responses with U.S. Food and Drug Administration data on food cadmium content. Participants reported incident invasive breast, endometrial, or ovarian cancer, and WHI centrally adjudicated all cases through August 2009. We applied Cox regression to estimate adjusted hazard ratios (HRs) and 95% CIs for each cancer, comparing quintiles of energy-adjusted dietary cadmium intake. RESULTS Over an average of 10.5 years, 6,658 invasive breast cancers, 1,198 endometrial cancers, and 735 ovarian cancers were reported. We observed no statistically significant associations between dietary cadmium and risk of any of these cancers after adjustment for potential confounders including total dietary energy intake. Results did not differ in any subgroup of women examined. CONCLUSIONS We found little evidence that dietary cadmium is a risk factor for breast, endometrial, or ovarian cancers in postmenopausal women. Misclassification in dietary cadmium assessment may have attenuated observed associations.
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Affiliation(s)
- Scott V Adams
- Fred Hutchinson Cancer Research Center, Program in Cancer Prevention, Public Health Sciences Division, Seattle, Washington, USA
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Åkesson A, Barregard L, Bergdahl IA, Nordberg GF, Nordberg M, Skerfving S. Non-renal effects and the risk assessment of environmental cadmium exposure. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:431-8. [PMID: 24569905 PMCID: PMC4014752 DOI: 10.1289/ehp.1307110] [Citation(s) in RCA: 183] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 02/22/2014] [Indexed: 05/19/2023]
Abstract
BACKGROUND Exposure to cadmium (Cd) has long been recognized as a health hazard, both in industry and in general populations with high exposure. Under the currently prevailing health risk assessment, the relationship between urinary Cd (U-Cd) concentrations and tubular proteinuria is used. However, doubts have recently been raised regarding the justification of basing the risk assessment on this relationship at very low exposure. OBJECTIVES Our objective was to review available information on health effects of Cd exposure with respect to human health risk assessment. DISCUSSION The associations between U-Cd and urinary proteins at very low exposure may not be due to Cd toxicity, and the clinical significance of slight proteinuria may also be limited. More importantly, other effects have been reported at very low Cd exposure. There is reason to challenge the basis of the existing health risk assessment for Cd. Our review of the literature found that exposure to low concentrations of Cd is associated with effects on bone, including increased risk of osteoporosis and fractures, and that this observation has implications for the health risk assessment of Cd. Other effects associated with Cd should also be considered, in particular cancer, although the information is still too limited for appropriate use in quantitative risk assessment. CONCLUSION Non-renal effects should be considered critical effects in the health risk assessment of Cd.
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Affiliation(s)
- Agneta Åkesson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Cho YA, Kim J, Woo HD, Kang M. Dietary cadmium intake and the risk of cancer: a meta-analysis. PLoS One 2013; 8:e75087. [PMID: 24069382 PMCID: PMC3775812 DOI: 10.1371/journal.pone.0075087] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 08/08/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Diet is a major source of cadmium intake among the non-smoking general population. Recent studies have determined that cadmium exposure may produce adverse health effects at lower exposure levels than previously predicted. We conducted a meta-analysis to combine and analyze the results of previous studies that have investigated the association of dietary cadmium intake and cancer risk. METHODS We searched PubMed, EMBASE, and MEDLINE database for case-control and cohort studies that assessed the association of dietary cadmium intake and cancer risk. We performed a meta-analysis using eight eligible studies to summarize the data and summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a random effects model. RESULTS Overall, dietary cadmium intake showed no statistically significant association with cancer risk (RR = 1.10; 95% CI: 0.99-1.22, for highest vs. lowest dietary cadmium group). However, there was strong evidence of heterogeneity, and subgroup analyses were conducted using the study design, geographical location, and cancer type. In subgroup analyses, the positive associations between dietary cadmium intake and cancer risk were observed among studies with Western populations (RR = 1.15; 95% CI: 1.08-1.23) and studies investigating some hormone-related cancers (prostate, breast, and endometrial cancers). CONCLUSION Our analysis found a positive association between dietary cadmium intake and cancer risk among studies conducted in Western countries, particularly with hormone-related cancers. Additional experimental and epidemiological studies are required to verify our findings.
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Affiliation(s)
- Young Ae Cho
- Molecular Epidemiology Branch, National Cancer Center, Goyang, Korea
| | - Jeongseon Kim
- Molecular Epidemiology Branch, National Cancer Center, Goyang, Korea
- * E-mail:
| | - Hae Dong Woo
- Molecular Epidemiology Branch, National Cancer Center, Goyang, Korea
| | - Moonsu Kang
- Department of Information Statistics, Gangneung-Wonju National University, Gangneung, Korea
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Rahim F, Jalali A, Tangestani R. Breast Cancer Frequency and Exposure to Cadmium: A Meta-Analysis and Systematic Review. Asian Pac J Cancer Prev 2013; 14:4283-7. [DOI: 10.7314/apjcp.2013.14.7.4283] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bernhoft RA. Cadmium toxicity and treatment. ScientificWorldJournal 2013; 2013:394652. [PMID: 23844395 PMCID: PMC3686085 DOI: 10.1155/2013/394652] [Citation(s) in RCA: 277] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 02/28/2013] [Indexed: 02/06/2023] Open
Abstract
Cadmium is a heavy metal of considerable toxicity with destructive impact on most organ systems. It is widely distributed in humans, the chief sources of contamination being cigarette smoke, welding, and contaminated food and beverages. Toxic impacts are discussed and appear to be proportional to body burden of cadmium. Detoxification of cadmium with EDTA and other chelators is possible and has been shown to be therapeutically beneficial in humans and animals when done using established protocols.
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Affiliation(s)
- Robin A Bernhoft
- Bernhoft Centers for Advanced Medicine, 11677 San Vicente Blvd, Suite 208/211, Los Angeles, CA 93023, USA.
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Proietti S, Cucina A, Reiter RJ, Bizzarri M. Molecular mechanisms of melatonin's inhibitory actions on breast cancers. Cell Mol Life Sci 2013; 70:2139-57. [PMID: 23007844 PMCID: PMC11113894 DOI: 10.1007/s00018-012-1161-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 09/04/2012] [Accepted: 09/05/2012] [Indexed: 02/07/2023]
Abstract
Melatonin is involved in many physiological functions and it plays an important role in many pathological processes as well. Melatonin has been shown to reduce the incidence of experimentally induced cancers and can significantly inhibit the growth of some human tumors, namely hormone-dependent cancers. The anticancer effects of melatonin have been observed in breast cancer, both in in vivo with models of chemically induced rat mammary tumors, and in vitro studies on human breast cancer cell lines. Melatonin acts at different physiological levels and its antitumoral properties are supported by a set of complex, different mechanisms of action, involving apoptosis activation, inhibition of proliferation, and cell differentiation.
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Affiliation(s)
- Sara Proietti
- Department of Clinical and Molecular Medicine, University “La Sapienza”, Rome, Italy
- Department of Surgery “P.Valdoni”, University “La Sapienza”, Rome, Italy
| | - Alessandra Cucina
- Department of Surgery “P.Valdoni”, University “La Sapienza”, Rome, Italy
| | - Russel J. Reiter
- Department of Cellular and Structural Biology, University of Texas Health Science Center, San Antonio, TX USA
| | - Mariano Bizzarri
- Systems Biology Group Laboratory, Department of Experimental Medicine, University “La Sapienza”, 14-16, Via Antonio Scarpa, Rome, 00161 Italy
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Dietary calcium intake, vitamin D levels, and breast cancer risk: a dose–response analysis of observational studies. Breast Cancer Res Treat 2012; 136:309-12. [DOI: 10.1007/s10549-012-2172-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 07/13/2012] [Indexed: 12/14/2022]
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