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Cathey AL, Nguyen VK, Colacino JA, Woodruff TJ, Reynolds P, Aung MT. Exploratory profiles of phenols, parabens, and per- and poly-fluoroalkyl substances among NHANES study participants in association with previous cancer diagnoses. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:687-698. [PMID: 37718377 PMCID: PMC10541322 DOI: 10.1038/s41370-023-00601-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Some hormonally active cancers have low survival rates, but a large proportion of their incidence remains unexplained. Endocrine disrupting chemicals may affect hormone pathways in the pathology of these cancers. OBJECTIVE To evaluate cross-sectional associations between per- and polyfluoroalkyl substances (PFAS), phenols, and parabens and self-reported previous cancer diagnoses in the National Health and Nutrition Examination Survey (NHANES). METHODS We extracted concentrations of 7 PFAS and 12 phenols/parabens and self-reported diagnoses of melanoma and cancers of the thyroid, breast, ovary, uterus, and prostate in men and women (≥20 years). Associations between previous cancer diagnoses and an interquartile range increase in exposure biomarkers were evaluated using logistic regression models adjusted for key covariates. We conceptualized race as social construct proxy of structural social factors and examined associations in non-Hispanic Black, Mexican American, and other Hispanic participants separately compared to White participants. RESULTS Previous melanoma in women was associated with higher PFDE (OR:2.07, 95% CI: 1.25, 3.43), PFNA (OR:1.72, 95% CI: 1.09, 2.73), PFUA (OR:1.76, 95% CI: 1.07, 2.89), BP3 (OR: 1.81, 95% CI: 1.10, 2.96), DCP25 (OR: 2.41, 95% CI: 1.22, 4.76), and DCP24 (OR: 1.85, 95% CI: 1.05, 3.26). Previous ovarian cancer was associated with higher DCP25 (OR: 2.80, 95% CI: 1.08, 7.27), BPA (OR: 1.93, 95% CI: 1.11, 3.35) and BP3 (OR: 1.76, 95% CI: 1.00, 3.09). Previous uterine cancer was associated with increased PFNA (OR: 1.55, 95% CI: 1.03, 2.34), while higher ethyl paraben was inversely associated (OR: 0.31, 95% CI: 0.12, 0.85). Various PFAS were associated with previous ovarian and uterine cancers in White women, while MPAH or BPF was associated with previous breast cancer among non-White women. IMPACT STATEMENT Biomarkers across all exposure categories (phenols, parabens, and per- and poly- fluoroalkyl substances) were cross-sectionally associated with increased odds of previous melanoma diagnoses in women, and increased odds of previous ovarian cancer was associated with several phenols and parabens. Some associations differed by racial group, which is particularly impactful given the established racial disparities in distributions of exposure to these chemicals. This is the first epidemiological study to investigate exposure to phenols in relation to previous cancer diagnoses, and the first NHANES study to explore racial/ethnic disparities in associations between environmental phenol, paraben, and PFAS exposures and historical cancer diagnosis.
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Affiliation(s)
- Amber L Cathey
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Vy K Nguyen
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Justin A Colacino
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Peggy Reynolds
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Max T Aung
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
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Gui SY, Chen YN, Wu KJ, Liu W, Wang WJ, Liang HR, Jiang ZX, Li ZL, Hu CY. Association Between Exposure to Per- and Polyfluoroalkyl Substances and Birth Outcomes: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:855348. [PMID: 35400049 PMCID: PMC8988915 DOI: 10.3389/fpubh.2022.855348] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/23/2022] [Indexed: 12/17/2022] Open
Abstract
Background A large body of emerging evidence suggests that per- and polyfluoroalkyl substances (PFAS) affect birth outcomes in various pathways, but the evidence is inconsistent. Therefore, this study aimed to systematically review the epidemiological evidence on PFAS exposure and birth outcomes. Methods Three electronic databases were searched for epidemiological studies through February 13, 2021. We used random-effects meta-analysis for eight birth outcome indicators to calculate summary effect estimates for various exposure types. The risk of bias and the overall quality and level of evidence for each exposure-outcome pair were assessed. Results The initial search identified 58 potentially eligible studies, of which 46 were ultimately included. Many PFAS were found to have previously unrecognized statistically significant associations with birth outcomes. Specifically, birth weight (BW) was associated with PFAS, with effect sizes ranging from −181.209 g (95% confidence interval (CI) = −360.620 to −1.798) per 1 ng/ml increase in perfluoroheptanesulfonate (PFHpS) to −24.252 g (95% CI = −38.574 to −9.930) per 1 ln (ng/ml) increase in perfluorodecaoic acid (PFDA). Similar patterns were observed between other PFAS and birth outcomes: perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) with birth length (BL) and ponderal index (PI), PFOS and perfluorododecanoic acid (PFDoDA) with head circumference (HC), PFHpS with gestational age (GA), and perfluorononanoic acid (PFNA) and PFHpS with preterm birth (PTB). Additionally, PFDA showed a statistically significant association with small for gestational age (SGA). The level of the combined evidence for each exposure-outcome pair was considered to be “moderate”. Conclusion This study showed that PFAS exposure was significantly associated with increased risks of various adverse birth outcomes and that different birth outcome indicators had different degrees of sensitivity to PFAS. Further studies are needed to confirm our results by expanding the sample size, clarifying the effects of different types or doses of PFAS and the time of blood collection on birth outcomes, and fully considering the possible confounders.
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Affiliation(s)
- Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Yue-Nan Chen
- Department of Pharmacy, School of Clinical Pharmacy, Anhui Medical University, Hefei, China
| | - Ke-Jia Wu
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Wen Liu
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Wen-Jing Wang
- Department of Pharmacy, School of Clinical Pharmacy, Anhui Medical University, Hefei, China
| | - Huan-Ru Liang
- Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ze-Lian Li
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Ze-Lian Li
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, Hefei, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Cheng-Yang Hu
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Yu P, Guo S, Xu R, Ye T, Li S, Sim MR, Abramson MJ, Guo Y. Cohort studies of long-term exposure to outdoor particulate matter and risks of cancer: A systematic review and meta-analysis. Innovation (N Y) 2021; 2:100143. [PMID: 34557780 PMCID: PMC8454739 DOI: 10.1016/j.xinn.2021.100143] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/11/2021] [Indexed: 11/11/2022] Open
Abstract
Robust evidence is needed for the hazardous effects of outdoor particulate matter (PM) on mortality and morbidity from all types of cancers. To summarize and meta-analyze the association between PM and cancer, published articles reporting associations between outdoor PM exposure and any type of cancer with individual outcome assessment that provided a risk estimate in cohort studies were identified via systematic searches. Of 3,256 records, 47 studies covering 13 cancer sites (30 for lung cancer, 12 for breast cancer, 11 for other cancers) were included in the quantitative evaluation. The pooled relative risks (RRs) for lung cancer incidence or mortality associated with every 10-μg/m3 PM2.5 or PM10 were 1.16 (95% confidence interval [CI], 1.10–1.23; I2 = 81%) or 1.22 (95% CI, 1.02–1.45; I2 = 96%), respectively. Increased but non-significant risks were found for breast cancer. Other cancers were shown to be associated with PM exposure in some studies but not consistently and thus warrant further investigation. Updated evidence for the association between PM and lung cancer risk has been provided Associations between PM and cancer risks from 13 sites were summarized Further studies should be conducted to fill the research gaps
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Affiliation(s)
- Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Suying Guo
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology (National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention), Shanghai 200025, China
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Tingting Ye
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Malcolm R Sim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
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Abudu R, Bouche G, Bourougaa K, Davies L, Duncan K, Estaquio C, Font AD, Hurlbert MS, Jackson P, Kroeskop-Bossenbroek L, Lewis I, Mitrou G, Mutabbir A, Pettigrew CA, Turner L, Weerman A, Wojtanik K. Trends in International Cancer Research Investment 2006-2018. JCO Glob Oncol 2021; 7:602-610. [PMID: 33909474 PMCID: PMC8162963 DOI: 10.1200/go.20.00591] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The International Cancer Research Partnership (ICRP) is an active network of cancer research funding organizations, sharing information about funded research projects in a common database. Data are publicly available to enable the cancer research community to find potential collaborators and avoid duplication. This study presents an aggregated analysis of projects funded by 120 partner organizations and institutes in 2006-2018, to highlight trends in cancer research funding. Overall, the partners’ funding for cancer research increased from $5.562 billion (bn) US dollars (USD) in 2006 to $8.511bn USD in 2018, an above-inflation increase in funding. Analysis by the main research focus of projects using Common Scientific Outline categories showed that Treatment was the largest investment category in 2018, followed by Early Detection, Diagnosis, and Prognosis; Cancer Biology; Etiology; Control, Survivorship, and Outcomes; and Prevention. Over the 13 years covered by this analysis, research funding into Treatment and Early Detection, Diagnosis, and Prognosis had increased in terms of absolute investment and as a proportion of the portfolio. Research funding in Cancer Biology and Etiology declined as a percentage of the portfolio, and funding for Prevention and Control, Survivorship and Outcomes remained static. In terms of cancer site–specific research, funding for breast cancer and colorectal cancer had increased in absolute terms but declined as a percentage of the portfolio. By contrast, investment for brain cancer, lung cancer, leukemia, melanoma, and pancreatic cancer increased both in absolute terms and as a percentage of the portfolio.
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Affiliation(s)
- Rachel Abudu
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Lynne Davies
- International Cancer Research Partnership, Cardiff, United Kingdom
| | | | - Carla Estaquio
- Institut National du Cancer, Boulogne-Billancourt, France
| | - Anna Diaz Font
- World Cancer Research Fund International, London, United Kingdom
| | | | | | | | - Ian Lewis
- National Cancer Research Institute, London, United Kingdom
| | - Giota Mitrou
- World Cancer Research Fund International, London, United Kingdom
| | - Abdul Mutabbir
- National Cancer Research Institute, London, United Kingdom
| | | | - Lynn Turner
- Worldwide Cancer Research HQ, Edinburgh, United Kingdom
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Anthis NJ, Kavanaugh-Lynch MHE. The Global Challenge to Prevent Breast Cancer: Surfacing New Ideas to Accelerate Prevention Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041394. [PMID: 32098181 PMCID: PMC7068498 DOI: 10.3390/ijerph17041394] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 02/17/2020] [Indexed: 12/22/2022]
Abstract
Despite increases in screening and advances in treatment, breast cancer continues to be the most common cancer and cause of cancer deaths among women worldwide, and breast cancer rates have remained steady for decades. A new focus on population-level primary prevention is needed to tackle this disease at the most fundamental level. Unfortunately, only a small fraction of breast cancer research funds currently go to prevention. The California Breast Cancer Research Program (CBCRP) seeks to change this. In order to accelerate breast cancer primary prevention efforts, in 2018, CBCRP launched the Global Challenge to Prevent Breast Cancer, a prize competition to foster and disseminate new and innovative prevention research ideas. This Special Issue highlights the results of the Global Challenge and other CBCRP primary prevention efforts.
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Kavanaugh-Lynch MHE. The environment, windows of susceptibility, and breast cancer. Reprod Toxicol 2020; 92:1-3. [PMID: 32035112 DOI: 10.1016/j.reprotox.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Cohn BA, La Merrill MA, Krigbaum NY, Wang M, Park JS, Petreas M, Yeh G, Hovey RC, Zimmermann L, Cirillo PM. In utero exposure to poly- and perfluoroalkyl substances (PFASs) and subsequent breast cancer. Reprod Toxicol 2019; 92:112-119. [PMID: 31323350 DOI: 10.1016/j.reprotox.2019.06.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 05/08/2019] [Accepted: 06/28/2019] [Indexed: 01/09/2023]
Abstract
We tested the hypothesis that maternal perinatal serum levels of poly and perfluoroalkyl substances (PFASs) predict risk for breast cancer in daughters in a 54-year follow-up of 9300 daughters born 1959-1967 in the Child Health and Development Studies pregnancy cohort. Total cholesterol and PFASs were measured in archived maternal perinatal serum for 102 daughter breast cancer cases diagnosed by age 52, and 310 controls matched on birth year and blood draw trimester. High maternal N-ethyl-perfluorooctane sulfonamido acetic acid (EtFOSAA), a precursor of perfluorooctane sulfonic acid (PFOS), in combination with high maternal total cholesterol predicted a 3.6-fold increased risk of breast cancer (pinteraction<0.05). Conversely, maternal PFOS was associated with decreased daughters' breast cancer risk. Predictions were robust to alternative modeling and independent of other maternal factors. Future generations continue to be exposed to ubiquitous, persistent PFASs. These findings are relevant to breast cancer prevention if confirmed experimentally and where possible, in additional epidemiology studies of internal doses of PFASs and other chemical mixtures especially during vulnerable windows in early life.
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Affiliation(s)
- Barbara A Cohn
- Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA.
| | - Michele A La Merrill
- Department of Environmental Toxicology, Comprehensive Cancer Center, University of California, Davis, CA, USA
| | - Nickilou Y Krigbaum
- Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA
| | - Miaomiao Wang
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, California, USA
| | - June-Soo Park
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, California, USA
| | - Myrto Petreas
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, California, USA
| | - Gregory Yeh
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, Berkeley, California, USA
| | - Russell C Hovey
- Department of Animal Science, University of California, Davis, CA, USA
| | - Lauren Zimmermann
- Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA
| | - Piera M Cirillo
- Child Health and Development Studies, Public Health Institute, Berkeley, CA, USA
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Tagliabue G, Borgini A, Tittarelli A, van Donkelaar A, Martin RV, Bertoldi M, Fabiano S, Maghini A, Codazzi T, Scaburri A, Favia I, Cau A, Barigelletti G, Tessandori R, Contiero P. Atmospheric fine particulate matter and breast cancer mortality: a population-based cohort study. BMJ Open 2016; 6:e012580. [PMID: 28076275 PMCID: PMC5129133 DOI: 10.1136/bmjopen-2016-012580] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/15/2016] [Accepted: 10/13/2016] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Atmospheric fine particulate matter (PM2.5) has multiple adverse effects on human health. Global atmospheric levels of PM2.5 increased by 0.55 μg/m3/year (2.1%/year) from 1998 through 2012. There is evidence of a causal relationship between atmospheric PM2.5 and breast cancer (BC) incidence, but few studies have investigated BC mortality and atmospheric PM2.5. We investigated BC mortality in relation to atmospheric PM2.5 levels among patients living in Varese Province, northern Italy. METHODS We selected female BC cases, archived in the local population-based cancer registry, diagnosed at age 50-69 years, between 2003 and 2009. The geographic coordinates of each woman's place of residence were identified, and individual PM2.5 exposures were assessed from satellite data. Grade, stage, age at diagnosis, period of diagnosis and participation in BC screening were potential confounders. Kaplan-Meir and Nelson-Aalen methods were used to test for mortality differences in relation to PM2.5 quartiles. Multivariable Cox proportional hazards modelling estimated HRs and 95% CIs of BC death in relation to PM2.5 exposure. RESULTS Of 2021 BC cases, 325 died during follow-up to 31 December 2013, 246 for BC. Risk of BC death was significantly higher for all three upper quartiles of PM2.5 exposure compared to the lowest, with HRs of death: 1.82 (95% CI 1.15 to 2.89), 1.73 (95% CI 1.12 to 2.67) and 1.72 (95% CI 1.08 to 2.75). CONCLUSIONS Our study indicates that the risk of BC mortality increases with PM2.5 exposure. Although additional research is required to confirm these findings, they are further evidence that PM2.5 exposure is harmful and indicate an urgent need to improve global air quality.
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Affiliation(s)
- Giovanna Tagliabue
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Borgini
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Tittarelli
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
- Harvard-Smithsonian Center for Astrophysics, Cambridge, Massachusetts, USA
| | - Martina Bertoldi
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sabrina Fabiano
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Anna Maghini
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Tiziana Codazzi
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandra Scaburri
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Imma Favia
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Cau
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giulio Barigelletti
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Paolo Contiero
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Effectiveness of Policies on Reducing Exposure to Ionizing Radiation From Medical Imaging: A Systematic Review. J Am Coll Radiol 2015; 12:1434-45. [DOI: 10.1016/j.jacr.2015.06.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/20/2015] [Accepted: 06/23/2015] [Indexed: 11/19/2022]
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