Medication-Associated Phthalate Exposure and Childhood Cancer Incidence

被引:14
作者
Ahern, Thomas P. [1 ,2 ,3 ]
Spector, Logan G. [4 ]
Damkier, Per [5 ,6 ]
Esen, Buket Ozturk [3 ,7 ]
Ulrichsen, Sinna P. [3 ,7 ]
Eriksen, Katrine [3 ,7 ]
Lash, Timothy L. [3 ,7 ,8 ]
Sorensen, Henrik Toft [3 ,7 ]
Cronin-Fenton, Deirdre P. [3 ,7 ]
机构
[1] Univ Vermont, Dept Surg, Larner Coll Med, 89 Beaumont Ave,Given Bldg D317A, Burlington, VT 05405 USA
[2] Aarhus Univ, Dept Oncol, Aarhus, Denmark
[3] Aarhus Univ Hosp, Aarhus, Denmark
[4] Univ Minnesota, Dept Pediat, Minneapolis, MN 55455 USA
[5] Univ Southern Denmark, Dept Clin Pharmacol, Odense, Denmark
[6] Univ Southern Denmark, Dept Clin Res, Odense, Denmark
[7] Aarhus Univ, Dept Clin Epidemiol, Aarhus, Denmark
[8] Emory Univ, Dept Epidemiol, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA
来源
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2022年 / 114卷 / 06期
关键词
POOLED ANALYSIS; PARENTAL AGE; RISK; POPULATION; LEUKEMIA; HEALTH; EPIDEMIOLOGY; CHILDREN; SYSTEM; ORDER;
D O I
10.1093/jnci/djac045
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Human phthalate exposure is widespread through contact with myriad consumer products. Exposure is particularly high through medications formulated with phthalates. Phthalates disrupt normal endocrine signaling and are associated with reproductive outcomes and incidence of some cancers. We measured associations between gestational and childhood medication-associated phthalate exposures and the incidence of childhood cancers. Methods We identified all live births in Denmark between 1997 and 2017, including both children and birth mothers. Using drug ingredient data merged with the Danish National Prescription Registry, we measured phthalate exposure through filled prescriptions for mothers during pregnancy (gestational exposure) and for children from birth until age 19 years (childhood exposure). Incident childhood cancers were ascertained from the Danish Cancer Registry, and associations were estimated with Cox regression models. Results Among 1 278 685 children, there were 2027 childhood cancer cases diagnosed over 13.1 million person-years of follow-up. Childhood phthalate exposure was strongly associated with incidence of osteosarcoma (hazard ratio [HR] = 2.78, 95% confidence interval [CI] = 1.63 to 4.75). We also observed a positive association with incidence of lymphoma (HR = 2.07, 95% CI = 1.36 to 3.14), driven by associations with Hodgkin and non-Hodgkin lymphoma but not Burkitt lymphoma. Associations were apparent only for exposure to low-molecular phthalates, which have purportedly greater biological activity. Conclusions Childhood phthalate exposure was associated with incidence of osteosarcoma and lymphoma before age 19 years. Lingering questions include which specific phthalate(s) are responsible for these associations, by what mechanisms they occur, and to what extent childhood cancer cases could be avoided by reducing or eliminating the phthalate content of medications and other consumer products.
引用
收藏
页码:885 / 894
页数:10
相关论文
共 60 条
  • [1] Phthalate Exposure and Breast Cancer Incidence: A Danish Nationwide Cohort Study
    Ahern, Thomas P.
    Broe, Anne
    Lash, Timothy L.
    Cronin-Fenton, Deirdre P.
    Ulrichsen, Sinna Pilgaard
    Christiansen, Peer M.
    Cole, Bernard F.
    Tamimi, Rulla M.
    Sorensen, Henrik Toft
    Damkier, Per
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2019, 37 (21) : 1800 - +
  • [2] Retire statistical significance
    Amrhein, Valentin
    Greenland, Sander
    McShane, Blake
    [J]. NATURE, 2019, 567 (7748) : 305 - 307
  • [3] The Danish Medical Birth Register
    Bliddal, Mette
    Broe, Anne
    Pottegard, Anton
    Olsen, Jorn
    Langhoff-Roos, Jens
    [J]. EUROPEAN JOURNAL OF EPIDEMIOLOGY, 2018, 33 (01) : 27 - 36
  • [4] Population Exposure to Phthalate-containing Drugs
    Broe, Anne
    Ennis, Zandra Nymand
    Pottegard, Anton
    Hallas, Jesper
    Ahern, Thomas
    Damkier, Per
    [J]. BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY, 2017, 121 (03) : 153 - 158
  • [5] Misuse of blood serum to assess exposure to bisphenol A and phthalates
    Calafat, Antonia M.
    Koch, Holger M.
    Swan, Shanna H.
    Hauser, Russ
    Goldman, Lynn R.
    Lanphear, Bruce P.
    Longnecker, Matthew P.
    Rudel, Ruthann A.
    Teitelbaum, Susan L.
    Whyatt, Robin M.
    Wolff, Mary S.
    [J]. BREAST CANCER RESEARCH, 2013, 15 (05):
  • [6] GH and IGF System: The Regulatory Role of miRNAs and lncRNAs in Cancer
    Catellani, Cecilia
    Ravegnini, Gloria
    Sartori, Chiara
    Angelini, Sabrina
    Street, Maria E.
    [J]. FRONTIERS IN ENDOCRINOLOGY, 2021, 12
  • [7] Phthalate exposure and prostate cancer in a population-based nested case-control study
    Chuang, Shu-Chun
    Chen, Hui-Chi
    Sun, Chien-Wen
    Chen, Yuh-An
    Wang, Yin-Han
    Chiang, Chun-Ju
    Chen, Chu-Chih
    Wang , Shu-Li
    Chen, Chien-Jen
    Hsiung, Chao A.
    [J]. ENVIRONMENTAL RESEARCH, 2020, 181
  • [8] LONG-TERM NEOPLASIA RISK AFTER AZATHIOPRINE TREATMENT IN INFLAMMATORY BOWEL-DISEASE
    CONNELL, WR
    KAMM, MA
    DICKSON, M
    BALKWILL, AM
    RITCHIE, JK
    LENNARDJONES, JE
    [J]. LANCET, 1994, 343 (8908) : 1249 - 1252
  • [9] Danish Medicines Agency, COUNT MED
  • [10] Exposure to phthalate-containing prescription drugs and the risk of colorectal adenocarcinoma: A Danish nationwide case-control study
    Ennis, Zandra Nymand
    Pottegard, Anton
    Ahern, Thomas Patrick
    Hallas, Jesper
    Damkier, Per
    [J]. PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 2019, 28 (04) : 528 - 535