Bulletin électronique de veille Cancer Environnement

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Bulletin électronique de veille Cancer Environnement
N°« Spécial été » du 31/07/2014
Ce bulletin de veille signale mensuellement une sélection de documents identifiés dans le cadre de la
veille cancer environnement. La méthodologie mise en œuvre est présentée dans la fiche du site cancer
environnement : http://www.cancer-environnement.fr/334-Veille-scientifique.ce.aspx
Publications récentes
Associations of daily walking and television viewing time with liver cancer mortality: findings
from the Japan Collaborative Cohort Study.
Associations entre la mortalité par cancer du foie et le temps de marche quotidienne versus le temps
d’écoute de la télévision : résultats de l'étude de cohorte Collaborative Japonaise
Ukawa S et al, Cancer Causes Control, Jul. 2014
Several studies have suggested that daily vigorous physical activity reduces the risk of liver cancer, whereas
sedentary behavior increases the risk of several cancers. However, the link between liver cancer and low-
intensity physical activity (walking) and sedentary behavior is unclear. Therefore, we explored the links between
liver cancer mortality and daily walking time/television (TV) viewing time in Japanese adults aged 40-79 years
in a large-scale nationwide cohort study.
METHODS:
We excluded participants with a history of liver disease, cancer, stroke, or myocardial infarction at baseline
(1988-1990) and those who died within the first 5 years of follow-up. A total of 69,752 adults (28,642 men and
41,110 women) were enrolled and followed for a median of 19.4 years. The Cox proportional hazards model was
used to calculate hazard ratios (HRs) and 95 % confidence intervals (CI) for liver cancer mortality adjusted for
age, sex, and other possible confounding factors.
RESULTS:
During the study period, 267 participants died of liver cancer. The HRs of participants who walked for
>0.5 h/day and watched TV for 2-4 versus <2 h/day were 0.58 (95 % CI 0.39-0.89) and 0.58 (95 % CI 0.35-
0.98), respectively, compared with those who walked for <0.5 h/day and watched TV for >4 h/day.
CONCLUSIONS:
Our findings suggest that longer walking times and shorter TV viewing times may reduce the risk of liver cancer.

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Anthropometric measures and bladder cancer risk: A prospective study in the EPIC cohort.
Mesures anthropométriques et risque de cancer de la vessie: une étude prospective de la cohorte EPIC.
Roswall N et al, Int J Cancer. Apr 2014
Anthropometric measures have been related to risk of several cancers. For bladder cancer, however, evidence is
sparse. Comparability of existing studies is hampered by use of different obesity-measures, inadequate control
for smoking, and few female cases. This study examined associations between height, weight, waist and hip
circumference, waist-hip ratio, waist-height ratio, body mass index (BMI), recalled weight at age 20 and bladder
cancer, and investigated effect modification by age, tumor aggressiveness and smoking. The study was
conducted in the European Prospective Investigation into Cancer and Nutrition cohort, in 390,878 participants.
Associations were calculated using Cox Proportional Hazards Models. During follow-up, 1,391 bladder cancers
(1,018 male; 373 female) occurred. Height was unrelated to bladder cancer in both genders. We found a small
but significant positive association with weight [1.04 (1.01-1.07) per 5 kilo], BMI [1.05 (1.02-1.08) per 2 units],
waist circumference [1.04 (1.01-1.08) per 5 cm], waist-hip ratio (1.07 (1.02-1.13) per 0.05 unit] and waist-height
ratio [1.07 (1.01-1.13) per 0.05 unit] in men. Stratification by smoking status confined associations in men to
former smokers. In never smokers, we found no significant associations, suggesting residual confounding by
smoking. Results did not differ with tumor aggressiveness and age. Residual analyses on BMI/waist
circumference showed a significantly higher disease risk with BMI in men (p = 0.01), but no association with
waist circumference. In conclusion, in this large study, height was unrelated to bladder cancer, whereas
overweight was associated with a slightly higher bladder cancer risk in men. This association may, however, be
distorted by residual confounding by smoking.
Weight change in middle adulthood and breast cancer risk in the EPIC-PANACEA study.
Le changement de poids chez la femme d’âge moyen et le risque de cancer du sein dans l'étude EPIC-
PANACEA.
Ermaus MJ et al, Int J Cancer. Apr 2014
Long-term weight gain (i.e., weight gain since age 20) has been related to higher risk of postmenopausal breast
cancer, but a lower risk of premenopausal breast cancer. The effect of weight change in middle adulthood is
unclear. We investigated the association between weight change in middle adulthood (i.e., women aged 40-50
years) and the risk of breast cancer before and after the age of 50. We included female participants of the
European Prospective Investigation into Cancer and Nutrition cohort, with information on anthropometric
measures at recruitment and after a median follow-up of 4.3 years. Annual weight change was categorized using
quintiles taking quintile 2 and 3 as the reference category (-0.44 to 0.36 kg/year). Multivariable Cox proportional
hazards regression analysis was used to examine the association. 205,723 women were included and 4,663
incident breast cancer cases were diagnosed during a median follow-up of 7.5 years (from second weight
assessment onward). High weight gain (Q5: 0.83-4.98 kg/year) was related to a slightly, but significantly higher
breast cancer risk (HRQ5_versus_Q2/3: 1.09, 95% CI: 1.01-1.18). The association was more pronounced for
breast cancer diagnosed before or at age 50 (HRQ5_versus_Q2/3 : 1.37, 95% CI: 1.02-1.85). Weight loss was
not associated with breast cancer risk. There was no evidence for heterogeneity by hormone receptor status. In
conclusion, high weight gain in middle adulthood increases the risk of breast cancer. The association seems to be
more pronounced for breast cancer diagnosed before or at age 50. Our results illustrate the importance of
avoiding weight gain in middle adulthood.

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Dietary protein sources in early adulthood and breast cancer incidence: prospective cohort
study.
L’apport protéique d’origine alimentaire dans les premières années de l'âge adulte et l’incidence du
cancer du sein : étude de cohorte prospective
Farvid MS et al, BMJ. Jun 2014
OBJECTIVE: To investigate the association between dietary protein sources in early adulthood and risk of breast
cancer.
DESIGN: Prospective cohort study.
SETTING: Health professionals in the United States.
PARTICIPANTS: 88 803 premenopausal women from the Nurses' Health Study II who completed a
questionnaire on diet in 1991.
MAIN OUTCOME MEASURE:
Incident cases of invasive breast carcinoma, identified through self report and confirmed by pathology report.
RESULTS:
We documented 2830 cases of breast cancer during 20 years of follow-up. Higher intake of total red meat was
associated with an increased risk of breast cancer overall (relative risk 1.22, 95% confidence interval 1.06 to
1.40; Ptrend=0.01, for highest fifth v lowest fifth of intake). However, higher intakes of poultry, fish, eggs,
legumes, and nuts were not related to breast cancer overall. When the association was evaluated by menopausal
status, higher intake of poultry was associated with a lower risk of breast cancer in postmenopausal women
(0.73, 0.58 to 0.91; Ptrend=0.02, for highest fifth v lowest fifth of intake) but not in premenopausal women
(0.93, 0.78 to 1.11; Ptrend=0.60, for highest fifth v lowest fifth of intake). In estimating the effects of exchanging
different protein sources, substituting one serving/day of legumes for one serving/day of red meat was associated
with a 15% lower risk of breast cancer among all women (0.85, 0.73 to 0.98) and a 19% lower risk among
premenopausal women (0.81, 0.66 to 0.99). Also, substituting one serving/day of poultry for one serving/day of
red meat was associated with a 17% lower risk of breast cancer overall (0.83, 0.72 to 0.96) and a 24% lower risk
of postmenopausal breast cancer (0.76, 0.59 to 0.99). Furthermore, substituting one serving/day of combined
legumes, nuts, poultry, and fish for one serving/day of red meat was associated with a 14% lower risk of breast
cancer overall (0.86, 0.78 to 0.94) and premenopausal breast cancer (0.86, 0.76 to 0.98).
CONCLUSION:
Higher red meat intake in early adulthood may be a risk factor for breast cancer, and replacing red meat with a
combination of legumes, poultry, nuts and fish may reduce the risk of breast cancer.
Residential radon and lung cancer in never smokers. A systematic review.
Exposition résidentielle au radon et cancer du poumon chez les non-fumeurs. Une revue systématique
Torres-Duran M et al, Cancer Lett. Apr 2014
Radon exposure is considered the second cause of lung cancer and the first in never smokers. We aim to assess
the effect of residential radon exposure on the risk of lung cancer in never smokers through a systematic review
applying predefined inclusion and exclusion criteria. 14 Studies were included. Some of them point to a
relationship between residential radon and lung cancer while others show no association. Further studies are
necessary to test this association and to assess if other risk factors such as environmental tobacco smoke could
modify the effect of residential radon exposure on lung cancer.

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Occupational exposure to extremely low frequency magnetic fields and brain tumour risks in the
INTEROCC study.
Exposition aux champs magnétiques d'extrêmes basses fréquences en milieu professionnel et risques de
tumeur cérébrale dans l'étude INTEROCC.
Turner MC et al, Cancer Epidemiol Biomarkers Prev. 2014 Jun 16.
Background: Occupational exposure to extremely low frequency magnetic fields (ELF) is a suspected risk factor
for brain tumours, however the literature is inconsistent. Few studies have assessed whether ELF in different
time windows of exposure may be associated with specific histologic types of brain tumours. This study
examines the association between ELF and brain tumours in the large-scale INTEROCC study. Methods: Cases
of adult primary glioma and meningioma were recruited in seven countries (Australia, Canada, France,
Germany, Israel, New Zealand, United Kingdom) between 2000 and 2004. Estimates of mean workday ELF
exposure based on a job exposure matrix assigned. Estimates of cumulative exposure, average exposure,
maximum exposure, and exposure duration were calculated for the lifetime, and 1-4, 5-9, and 10+ years prior to
the diagnosis/reference date. Results: There were 3,761 included brain tumour cases (1,939 glioma, 1,822
meningioma) and 5,404 population controls. There was no association between lifetime cumulative ELF
exposure and glioma or meningioma risk. However, there were positive associations between cumulative ELF 1-
4 years prior to the diagnosis/reference date and glioma (odds ratio (OR) ≥ 90th percentile vs < 25th percentile =
1.67, 95% confidence interval (CI) 1.36-2.07, p < 0.0001 linear trend), and, somewhat weaker associations with
meningioma (OR ≥ 90th percentile vs < 25th percentile = 1.23, 95% CI 0.97-1.57, p = 0.02 linear trend).
Conclusions: Results showed positive associations between ELF in the recent past and glioma. Impact:
Occupational ELF exposure may play a role in the later stages (promotion and progression) of brain
tumourigenesis.
Alcohol drinking and risk of leukemia-A systematic review and meta-analysis of the dose-risk
relation.
Consommation d'alcool et risque de leucémie – Une revue systématique et une méta analyse sur la relation
dose-risque.
Rota M et al, Cancer Epidemiol. Jun 2014
The association between alcohol and leukemia risk has been addressed in several studies in the past two decades,
but results have been inconsistent. Therefore, we conducted a systematic review and meta-analysis to quantify
the dose-risk relation. Through the literature search up to August 2013, we identified 18 studies, 10 case-control
and 8 cohorts, carried out in a total of 7142 leukemia cases. We derived pooled meta-analytic estimates using
random-effects models, taking into account the correlation between estimates, and we performed a dose-risk
analysis using a class of nonlinear random-effects meta-regression models. Stratified analyses were carried out
on leukemia subtypes and groups, in order to identify possible etiologic differences. Compared with nondrinkers,
the relative risks (RRs) for all leukemia were 0.94 [95% confidence interval (CI), 0.85-1.03], 0.90 (95% CI,
0.80-1.01) and 0.91 (95% CI, 0.81-1.02) for any, light (≤1 drink/day) and moderate to heavy (>1 drink/day)
alcohol drinking, respectively. The summary RRs for any alcohol drinking were 1.47 (95% CI, 0.47-4.62) for
acute lymphoblastic leukemia, 0.94 (95% CI 0.77-1.15) for chronic lymphocytic leukemia, 1.02 (95% CI, 0.86-
1.21) for acute myeloid leukemia and 0.93 (95% CI 0.75-1.14) for chronic myeloid leukemia. The subgroup
analysis on geographical area for all leukemia combined showed RRs of 0.84 (95% CI, 0.76-0.93), 0.92 (95%
CI, 0.83-1.01) and 1.32 (95% CI, 1.02-1.70) for studies conducted in America, Europe and Asia, respectively.
We did not find an increased risk of leukemia among alcohol drinkers. If any, a modest favorable effect emerged
for light alcohol drinking, with a model-based risk reduction of approximately 10% in regular drinkers.

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Children's personal exposure to PM10 and associated metals in urban, rural and mining activity
areas.
Expositions individuelles aux PM10 et métaux associés chez l’enfant vivant dans des zones urbaines,
rurales et d'activités minières.
Hinwood A et al, Chemosphere. Aug 2014
There has been limited study of children's personal exposure to PM10 and associated metals in rural and iron ore
mining activity areas where PM10 concentrations can be very high. We undertook a small study of 70 children
where 13 children were recruited in an area of iron ore mining processing and shipping, 15 children from an area
in the same region with no mining activities, and 42 children in an urban area. Each child provided a 24h
personal exposure PM10 sample, a first morning void urine sample, a hair sample, time activity diary, and self
administered questionnaire. Children's 24h personal PM10 concentrations were low (median of 28 μg m(-3) in
the mining area; 48 μg m(-3) in the rural area and 45 μg m(-3) in the urban area) with corresponding outdoor
PM10 concentrations also low. Some very high personal PM10 concentrations were recorded for individuals
(>300 μg m(-3)) with the highest concentrations recorded in the mining and rural areas in the dry season. PM10
concentrations were highly variable. Hair aluminium, cadmium and manganese concentrations were higher in the
iron ore activity area, while hair mercury, copper and nickel concentrations were higher in the urban area.
Factors such as season and ventilation appear to be important but this study lacked power to confirm this. These
results need to be confirmed by a larger study and the potential for absorption of the metals needs to be
established along with the factors that increase exposures and the potential for health risks arising from exposure.
CAREX Canada: an enhanced model for assessing occupational carcinogen exposure.
CAREX Canada: un modèle performant pour l’évaluation des expositions aux cancérogènes en milieu
professionnel.
Peters CE et al, Occup Environ Med. 2014 Jun
To estimate the numbers of workers exposed to known and suspected occupational carcinogens in Canada,
building on the methods of CARcinogen EXposure (CAREX) projects in the European Union (EU).
METHODS:
CAREX Canada consists of estimates of the prevalence and level of exposure to occupational carcinogens.
CAREX Canada includes occupational agents evaluated by the International Agency for Research on Cancer as
known, probable or possible human carcinogens that were present and feasible to assess in Canadian workplaces.
A Canadian Workplace Exposure Database was established to identify the potential for exposure in particular
industries and occupations, and to create exposure level estimates among priority agents, where possible.
CAREX EU data were reviewed for relevance to the Canadian context and the proportion of workers likely to be
exposed by industry and occupation in Canada was assigned using expert assessment and agreement by a
minimum of two occupational hygienists. These proportions were used to generate prevalence estimates by
linkage with the Census of Population for 2006, and these estimates are available by industry, occupation, sex
and province.
RESULTS:
CAREX Canada estimated the number of workers exposed to 44 known, probable and suspected carcinogens.
Estimates of levels of exposure were further developed for 18 priority agents. Common exposures included night
shift work (1.9 million exposed), solar ultraviolet radiation exposure (1.5 million exposed) and diesel engine
exhaust (781 000 exposed).
CONCLUSIONS:
A substantial proportion of Canadian workers are exposed to known and suspected carcinogens at work.