Bulletin électronique de veille du portail Cancer-Environnement.fr N°23 du 28/06/2017

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Bulletin électronique de veille du portail Cancer-Environnement.fr
N°23 du 28/06/2017
Ce bulletin de veille bibliographique sélectionne mensuellement des publications scientifiques
identifiées dans le cadre de la veille du portail cancer- environnement.fr. La méthodologie de mise en
œuvre de cette veille est présentée dans la fiche « Système de veille scientifique » : http://www.cancer-
environnement.fr/334-Veille-scientifique.ce.aspx
Publications récentes
The information needs of adult cancer survivors across the cancer continuum: A scoping review.
Besoins d’information de l’adulte ayant survécu à un cancer dans les étapes de sa maladie : une revue
exploratoire.
Fletcher et al., Patient Educ Couns. 2017 Mar
OBJECTIVE:
To provide an updated synthesis of the literature that investigates the self-reported information needs of people
diagnosed with cancer across the cancer continuum.
METHODS:
We conducted a scoping review of the literature published from August 2003 to June 2015 and expanded an
existing typology summarizing the information needs of people diagnosed with cancer.
RESULTS:
The majority of the included studies (n=104) focused on questions relevant to the diagnosis/active treatment
phase of the cancer continuum (52.9%) and thus the most frequently identified information needs related to this
phase (33.4%). Information needs varied across the continuum and the results highlight the importance of
recognising this fact.
CONCLUSION:
People diagnosed with cancer experience discrete information needs at different points from diagnosis to
survival. Much of the research conducted in this area has focused on their information needs during the diagnosis
and treatment of cancer, and literature relating to information needs following completion of treatment is sparse.
PRACTICE IMPLICATIONS:
Further research is needed to discern the specific nature of the treatment concerns and identify the information
needs that survivors experience during recurrence of cancer, metastasis or changes in diagnosis, and the end of
life phase of the cancer continuum.

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Pesticide exposure and liver cancer: a review.
Exposition aux pesticides et cancer du foie : une revue de la littérature.
VoPham T and al., Cancer Causes Control. 2017 Mar
PURPOSE:
To review the epidemiologic literature examining pesticide exposure and liver cancer incidence.
METHODS:
A search of the MEDLINE and Embase databases was conducted in October 2015. Eligibility criteria included
examining hepatocellular carcinoma (HCC) or primary liver cancer, pesticides as an exposure of interest, and
individual-level incidence. The review was performed according to Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS:
Forty-eight papers were assessed for eligibility and 15 studies were included in the review. The majority of
studies were conducted in China and Egypt (n = 8), used a case-control design (n = 14), and examined HCC
(n = 14). Most studies showed no association between self-reported and/or occupational exposure to pesticides
and liver cancer risk. Six studies demonstrated statistically significant positive associations, including three
biomarker-based studies (two using pre-diagnostic sera) that reported higher serum levels of
dichlorodiphenyltrichloroethane (DDT) were associated with increased HCC risk. Studies indirectly measuring
pesticide exposure using self-reported exposure, occupation, job-exposure matrices, or geographic residence
demonstrated inconsistent results. These studies were limited by exposure assessment methods, lack of
confounder information, minimal case confirmation, selection bias, and/or over-adjustment.
CONCLUSIONS:
There is mixed evidence suggesting a possible association between specific pesticides and HCC risk, with the
strongest evidence observed in biomarker-based studies. In particular, organochlorine pesticides, including DDT,
may increase HCC risk. Future research should focus on improved pesticide exposure assessment methods,
potentially incorporating multiple approaches including biomonitoring while considering the chemicals of
interest, historical exposure to address latency periods, and examining specific chemicals and exposure
pathways.
The association between the incidence of postmenopausal breast cancer and concentrations at
street-level of nitrogen dioxide and ultrafine particles
L'association entre l'incidence du cancer du sein post-ménopausique et les niveaux de dioxyde d'azote et
des particules ultrafines émises au niveau de la voie public
Goldberg MS et al., Environ Res. 2017 Jun
BACKGROUND:
There is scant information as to whether traffic-related air pollution is associated with the incidence of breast
cancer. Nitrogen dioxide (NO2) and ultrafine particles (UFPs, <0.1µm), are two pollutants that capture intra-
urban variations in traffic-related air pollution and may also be associated with incidence.
METHODS:
We conducted a population-based, case-control study of street-level concentrations of NO2 and UFPs and
incident postmenopausal breast cancer in Montreal, Canada. Incident cases were identified between 2008 and
2011 from all but one hospital that treated breast cancer in the Montreal area. Population controls were identified
from provincial electoral lists of Montreal residents and frequency-matched to cases using 5-year age groups.
Concentrations of NO2 and UFPs were estimated using two separate land-use regression models. Exposures
were assigned to residential locations at the time of recruitment, and we identified residential histories of women
who had lived in these residences for 10 years or more. Odds ratios (OR) and 95% confidence intervals (CI)
were estimated using logistic regression models adjusting for individual-level and ecological covariates. We
assessed the functional form of NO2 and UFP exposures using natural cubic splines.
RESULTS:
We found that the functional form of the response functions between incident postmenopausal breast cancer and
concentrations of NO2 and UFPs were consistent with linearity. For NO2, we found increasing risks of breast
cancer for all subjects combined and stronger associations when analyses were restricted to those women who
had lived at their current address for 10 years or more. Specifically, the OR, adjusted for personal covariates, per
increase in the interquartile range (IQR=3.75 ppb) of NO2 was 1.08 (95%CI: 0.92-1.27). For women living in
their homes for 10 years or more, the adjusted OR was 1.17 (95%CI: 0.93-1.46; IQR=3.84 ppb); for those not
living at that home 10 years before the study, it was 0.93 (95%CI: 0.64, 1.36; IQR=3.65 ppb). For UFPs, the

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ORs were lower than for NO2, with little evidence of association in any of the models or sub-analyses and little
variability in the ORs (about 1.02 for an IQR of ~3500cm-3). On the other hand, we found higher ORs amongst
cases with positive oestrogen and progesterone receptor status; namely for NO2, the OR was 1.13 (95%CI: 0.94-
1.35) and for UFPs it was 1.05 (95%CI: 0.96-1.14).
CONCLUSIONS:
Our findings suggest that exposure to ambient NO2 and UFPs may increase the risk of incident postmenopausal
breast cancer especially amongst cases with positive oestrogen and progesterone receptor status.
Breast cancer and exposure to tobacco smoke during potential windows of susceptibility
Cancer du sein et exposition à la fumée de tabac dans les potentielles fenêtres de susceptibilité
White AJ et al., Cancer Causes Control 2017 May
PURPOSE:
An association between smoking and breast cancer is unresolved, although a higher risk from exposure during
windows of susceptibility has been proposed. The objective of this prospective study was to evaluate the
association between tobacco smoke and breast cancer with a focus on timing of exposure, especially during early
life.
METHODS:
Sister study participants (n = 50,884) aged 35-74 were enrolled from 2003 to 2009. Women in the United States
and Puerto Rico were eligible if they were breast cancer-free but had a sister with breast cancer. Participants
completed questionnaires on smoking and environmental tobacco smoke (ETS) exposure. Cox regression was
used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for breast cancer risk.
RESULTS:
During follow-up (mean = 6.4 years), 1,843 invasive breast cancers were diagnosed. Neither active smoking nor
adult ETS was associated with breast cancer risk. However, never smoking women exposed to ETS throughout
their childhood had a 17% higher risk of breast cancer (95% CI 1.00-1.36) relative to those with no exposure. In
utero ETS exposure was also associated with breast cancer (HR = 1.16, 95% CI 1.01-1.32) and the HR was most
elevated for women born in earlier birth cohorts (<1940, HR = 1.44, 95% CI 1.02-2.02; 1940-1949, HR = 1.28,
95% CI 1.01-1.62).
CONCLUSION:
In utero ETS and ETS exposure during childhood and adolescence were associated with increased risk of breast
cancer and associations varied by birth cohort.
Alcohol consumption and breast cancer risk by family history of breast cancer and folate intake
in younger women
Consommation d'alcool et risque de cancer du sein chez les jeunes femmes avec antécédents familiaux de
cancer du sein et apport en folates
Ja Kim H et al., Am J Epidemiol 2017 May
To evaluate the association between alcohol consumption and breast cancer risk in younger women, and by
family history of breast cancer and folate intake, we prospectively followed 93,835 U.S. women aged 27-44
years with alcohol consumption data in 1991 in the Nurses' Health Study II. Alcohol and folate intake was
measured by food frequency questionnaire repeated every 4 years. We documented 2,866 incident invasive
breast cancer cases between 1991 and 2011. Alcohol consumption was not associated with breast cancer risk
overall (multivariate hazard ratio = 1.07, 95% confidence interval: 0.94, 1.22 for ≥ 10 g/d intake vs.
nondrinkers). When the association was stratified by family history and folate intake, a positive association
between alcohol consumption and breast cancer was found among those with a family history and folate intake
of < 400 μg/d (multivariate hazard ratio = 1.82; 95% confidence interval: 1.06, 3.12; P-trend = 0.08). Alcohol
intake was not associated with breast cancer in other categories of family history and folate intake (P-interaction
= 0.55). In conclusion, in this population of younger women, higher alcohol consumption was associated with
increased risk of breast cancer among those with both family history of breast cancer and lower folate intake.

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Attentes des ARS en matière de données de surveillance épidémiologique des cancers
Catelinois O. Santé publique France
L’objectif de cette enquête est de consolider la stratégie nationale et régionale de Santé publique France en
matière de surveillance et de mise à disposition des indicateurs épidémiologiques sur les cancers. Ces indicateurs
doivent directement contribuer au pilotage, à la coordination et à l’évaluation des politiques publiques
concernant la prévention et la prise en charge des cancers.
Une enquête descriptive à caractère multicentrique a été réalisée par les Cire, en concertation avec la Direction
des maladies non transmissibles et des traumatismes de Santé publiques France, auprès de 14 ARS. L’enquête a
permis d’interroger différents interlocuteurs d’ARS, permettant de couvrir l’ensemble des champs de la santé liés
aux domaines des cancers, notamment la prévention, le dépistage, la santé environnementale, les stratégies de
santé ou encore l’offre de soins.
L’enquête montre les multiples attentes des ARS vis-à-vis des Cire et plus largement de Santé publique France
pour disposer d’informations régionales et infrarégionales afin de conduire et d’évaluer leur politique de santé.
Les ARS sont particulièrement intéressées par des données épidémiologiques sur les cancers pouvant faire
l’objet de prévention ou de dépistage (ex : cancer du poumon, cancer du sein, cancer de la prostate ou cancer du
sein). Pour Santé publique France, l’enjeu sera d’améliorer la valorisation des informations épidémiologiques sur
les cancers à une échelle temporelle et géographique adaptée tout en poursuivant les travaux innovants réalisés
dans un cadre partenarial avec Francim et les registres afin de mieux répondre aux attentes exprimées.
Une attention particulière devra être portée sur la diffusion dans les régions des informations épidémiologiques
sur les cancers, sur les nouvelles sources d’information comme le dossier communicant cancer et sur la poursuite
des développements statistiques.

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Actualités et lettres d’information des acteurs Santé Environnement
Région Rhône-Alpes
National
Agence Régionale de Santé Auvergne- Rhône-
Alpes
Agence nationale de sécurité sanitaire, de
l’alimentation, de l’environnement et du
travail
Santé Publique France
Atmo Auvergne-Rhône-Alpes
Institut National du Cancer
ORSAuvergne-Rhône-Alpes
Institut national de recherche en sciences et
technologies pour l’environnement et
l’agriculture
Lettre d’information de la recherche en santé
Publique
Lettre d’information de l’Institut National de
Recherche et de Sécurité pour la prévention
des accidents du travail et des maladies
professionnelles
Lettre d’information “Ademe et vous”
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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