Bulletin électronique de veille Cancer Environnement N°12 du 18/10/2014

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Bulletin électronique de veille Cancer Environnement
N°12 du 18/10/2014
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
Ambient particulate matter and lung cancer incidence and mortality: a meta-analysis of
prospective studies.
Interrogations sur particules ambiantes et incidence et mortalité du cancer du poumon : une méta-analyse
d'études prospectives.
Cui P et al., Eur J Public Health. 2014 Sep
Chronic exposure to ambient particulate matter (PM) has been suggested to be associated with an increased risk
of lung cancer, but the results were inconsistent. We performed a systematic review and meta-analysis of
prospective studies to assess the association between exposure to PM and the incidence and mortality of lung
cancer in adults.
METHODS: We searched PUBMED and EMBASE databases for prospective cohort studies that evaluated the
association between PM2.5 (diameter < 2.5 μm), PM10 (diameter < 10 μm) and lung cancer incidence and
mortality. Relative risks (RRs) and 95% confidence interval (CI) were calculated using fixed-effect or random-
effects models when appropriate.
RESULTS: We initially identified 1987 citations, and 19 prospective cohort studies were finally included in our
meta-analysis. The pooled adjusted RRs for lung cancer mortality were 1.09 (95% CI: 1.06-1.11; I2 = 18.3%, P
= 0.26) for 10 µg/m3 increase in the concentration of PM2.5 (12 studies), and 1.05 (95% CI: 1.03-1.07; I2 =
41.9%, P = 0.11) for 10 µg/m3 increase in the concentration of PM10 (seven studies). The increased risk of lung
cancer mortality associated with PM2.5 and PM10 was consistent across most subgroups. PM10 (three studies)
and PM2.5 (two studies) were not found to be significantly associated with lung cancer incidence.
CONCLUSIONS: Ambient PM2.5 and PM10 pollutions are prospectively associated with a significantly
increased risk of lung cancer mortality. More studies addressing the association between PM and lung cancer
incidence are required.

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Understanding narrative effects in physical activity promotion: the influence of breast cancer
survivor testimony on exercise beliefs, self-efficacy, and intention in breast cancer patients
Comprendre les moyens de communication pour la promotion de l'activité physique: l’influence du
témoignage de patientes ayant eu un cancer du sein sur les croyances, les bienfaits et l’implication des
malades atteintes de cancer du sein vis-à-vis de l’activité physique
Falzon C et al., Support Care Cancer. 2014 Sep
Research in health communication has shown that narratives contribute more positively to changing health
behaviors than informational messages. The main purposes of this study were to examine and to compare the
effects of two messages promoting physical activity, one narrative and the other informational, on the
perceptions and behavioral intentions of cancer patients.
METHODS: A total of 158 women with breast cancer, undergoing chemotherapy and sedentary, were assigned
to read the testimony of a breast cancer survivor who had been physically active during and after treatment (TE
group), a content-equivalent message composed of expert recommendations about physical activity in breast
cancer patients (RE group), or no message (control group).
RESULTS: Source trust was higher in TE group than RE group (p < 0.001). Exercise self-efficacy and exercise
intention were higher in TE group than RE and control groups (p < 0.001). However, scores in RE group were
higher than those of TE group for beliefs about exercise benefits (p < 0.001) and lower than those of TE and
control groups for beliefs about exercise risks (p < 0.001). Source trust, exercise self-efficacy, and beliefs about
exercise benefits and risks mediated the relationship between the message and exercise intention.
CONCLUSIONS: The results suggest that narratives may be more effective in improving perceived physical
abilities and involvement in physical activity, whereas informational messages seem to be more appropriate to
convey the benefits and the absence of risks related to physical activity.
Effect of exercise on cancer-related fatigue: a meta-analysis.
Effet de l’activité physique sur la fatigue liée au cancer : une méta-analyse
Tomlinson D et al., Am J Phys Med Rehabil. 2014 Aug
Numerous randomized controlled trials have been conducted to determine efficacy of exercise on cancer-related
fatigue. However, many trials lacked sufficient power to demonstrate significant differences, and little is known
about how the effect of exercise differs depending on patient- and intervention-level characteristics. A meta-
analysis was performed to determine whether exercise reduces fatigue compared with usual care or nonexercise
control intervention in patients with cancer. The authors searched Ovid MEDLINE, EMBASE, PsycINFO, The
Cochrane Central Register of Controlled Trials, and CINAHL. Two authors independently extracted the data.
Randomized controlled trials comparing exercise with control intervention in cancer patients in which fatigue
was quantified were eligible. Seventy-two randomized controlled trials were identified, 71 in adults and 1 in
children. Exercise had a moderate effect on reducing fatigue compared with control intervention. Exercise also
improved depression and sleep disturbance. Type of exercise did not significantly influence the effect on fatigue,
depression, or sleep disturbance. Exercise effect was larger in the studies published 2009 or later. There was only
one pediatric study. The results of this study suggest that exercise is effective for the management of cancer-
related fatigue.

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Circadian disrupting exposures and breast cancer risk: a meta-analysis.
Perturbations du rythme circadien et risque de cancer du sein: une méta-analyse.
He.C et al., Int Arch Occup Environ Health. 2014 Sep.
Shift work, short sleep duration, employment as a flight attendant, and exposure to light at night, all potential
causes of circadian disruption, have been inconsistently associated with breast cancer (BrCA) risk. The aim of
this meta-analysis is to quantitatively evaluate the combined and independent effects of exposure to different
sources of circadian disruption on BrCA risk in women.
METHODS: Relevant studies published through January 2014 were identified by searching the PubMed
database. The pooled relative risks (RRs) and corresponding 95 % confidence intervals (CIs) were estimated
using fixed- or random effects models as indicated by heterogeneity tests. Generalized least squares trend test
was used to assess dose-response relationships.
RESULTS: A total of 28 studies, 15 on shift work, 7 on short sleep duration, 3 on flight attendants, and 6 on
light at night were included in the analysis. The combined analysis suggested a significantly positive association
between circadian disruption and BrCA risk (RR = 1.14; 95 % CI 1.08-1.21). Separate analyses showed that the
RR for BrCA was 1.19 (95 % CI 1.08-1.32) for shift work, 1.120 (95 % CI 1.119-1.121) for exposure to light at
night, 1.56 (95 % CI 1.10-2.21) for employment as a flight attendant, and 0.96 (95 % CI 0.86-1.06) for short
sleep duration. A dose-response analysis showed that each 10-year increment of shift work was associated with
16 % higher risk of BrCA (95 % CI 1.06-1.27) based on selected case-control studies. No significant dose-
response effects of exposure to light at night and sleep deficiency were found on BrCA risk.
CONCLUSIONS: Our meta-analysis demonstrates that circadian disruption is associated with an increased
BrCA risk in women. This association varied by specific sources of circadian disrupting exposures, and a dose-
response relationship remains uncertain. Therefore, future rigorous prospective studies are needed to confirm
these relationships.
Parental occupational exposure and risk of childhood central nervous system tumors: a pooled
analysis of case-control studies from Germany, France, and the UK.
Exposition professionnelle des parents et risque de tumeurs du système nerveux central de l’enfant : une
analyse poolée d’études cas-témoins d'Allemagne, France et Royaume-Uni.
Huoi C et al., Cancer Causes Control 2014 Oct
To assess the risk of childhood central nervous system (CNS) tumors associated with parental occupational
exposure to polycyclic aromatic hydrocarbons (PAH), diesel motor exhaust (DME), asbestos, crystalline silica,
and metals, which are established carcinogens in adults.
METHODS: We pooled data from three population-based case-control studies from Germany, France, and the
UK. Cases were children aged up to 15 years and diagnosed with CNS tumor, and controls were frequency-
matched by age and sex. Socio-demographic data and parental occupation around conception/pregnancy and at
diagnosis were collected using standardized interviews, face-to-face or by telephone. A general population job-
exposure matrix was used to assign a level of exposure to each job. Logistic regression models were fitted to
compute odds ratios and 95 % confidence intervals.
RESULTS: Our study included 1,361 cases of CNS tumors and 5,500 controls. Paternal exposure to PAH,
asbestos, and metals around conception was associated with an increased moderate risk of CNS tumors, although
statistically non-significant. The association with exposure to asbestos around conception and diagnosis was
stronger when fathers were exposed to high levels. Paternal exposure to DME and silica, and maternal exposure
to PAH, DME, asbestos, silica, and metals, were not associated with an increased risk of CNS tumors.
CONCLUSION: Our large pooled study showed weak evidence of a modest association between paternal
occupational exposure to PAH and CNS tumor risk. Our findings need further exploration in the future studies.

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Actualités et lettres d’information des acteurs Santé Environnement
Région Rhône-Alpes
National
Agence Régionale de Santé Rhône-Alpes
Agence nationale de sécurité sanitaire, de
l’alimentation, de l’environnement et du
travail
Air Rhône-Alpes
Bulletin de veille bibliographique Nota Bene
Cancer de l’Institut National du Cancer
(INCa)
Lettre d’information de l’INCa
Espace Régional de Santé Publique Rhône-
Alpes
Institut national de recherche en sciences et
technologies pour l’environnement et
l’agriculture
Fédération Rhône-Alpes de Protection de la
Nature
Lettre d’information de l’Institut National de
Recherche et de Sécurité pour la prévention
des accidents du travail et des maladies
professionnelles
Institut de Recherche en Santé Publique
Lettre d’information “Ademe et vous”
Lettre Santé-Environnement Rhône-Alpes de
l’ORS Rhône-Alpes
Lettre d’information de l’IReSP
La lettre de la Société Française de Santé
Environnement
Société Française de Santé Publique Bulletin
Flash e-mail SFSP
Société Française de Médecine du Travail
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