细颗粒物和可吸入颗粒物对乳腺癌发病率及死亡率影响的系统评价

Effects of Fine Particulate Matter and Particulate Matter on the Incidence and Mortality of Breast Cancer:a Systematic Review

背景近年来,空气污染物的健康损害效应和女性乳腺癌的发病及死亡情况逐渐受到关注。目的搜集可通过电子数据库检索到的关于细颗粒物(PM2.5)、可吸入颗粒物(PM10)与乳腺癌的相关性研究,评价长期暴露于PM2.5、PM10对乳腺癌发病率和死亡率的影响。方法计算机检索Pub Med、EMBase、Cochrane Library、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据知识服务平台、维普期刊资源整合服务平台(VIP),搜集有关PM2.5、PM10与乳腺癌相关性的研究,检索年限均从建库至2017年4月。按照纳入与排除标准进行文献筛选、资料提取和评价纳入研究的风险偏倚后,进行系统评价。结果共纳入9篇文献,8篇文献描述了PM2.5对乳腺癌发病率或死亡率的影响,其中4篇文献显示暴露于PM2.5与乳腺癌发病率或死亡率有关(3篇文献的研究地点为亚洲地区),4篇文献表明无关(3篇文献的研究地点为北美地区)。5篇文献描述了PM10对乳腺癌发病率或死亡率的影响,其中4篇文献显示暴露于PM10与乳腺癌发病率或死亡率无关,1篇文献显示暴露于高浓度PM10的时候有关。结论基于目前的文献,暴露于PM2.5、PM10对乳腺癌患者发病率或死亡率影响的结论不统一,可能存在着地区差异性和剂量反应关系,需要在未来进行更多的研究以便进行定量合成。

Background In recent years,the association between the harmful effects of air pollutants and the incidence and mortality of breast cancer in women has received increasing attention.Objective To explore the effects of longterm exposure to fine particulate matter(PM2.5)and particulate matter(PM10)on the incidence and mortality of breast cancer based on the review of the studies about the correlation of PM2.5 and PM10 exposure with breast cancer collected from some databases.Methods We searched PubMed,EMBase,Cochrane Library,CNKI,CMB,Wanfang Data Knowledge Service Platform and VIP Journal Integration Service Platform(VIP)for studies about the correlation of PM2.5 and PM10 exposure with breast cancer published as of April 2017.The systematic review was conducted posterior to the selection of articles according to the inclusion and exclusion criteria,data extraction and evaluation of potential bias of the included studies.Results Among the 9 studies included,8 explored the effects of PM2.5 exposure on the incidence or mortality of breast cancer,of which 4(3 were carried out in Asian)indicated that exposure to PM2.5 was associated with the incidence or mortality of breast cancer,but other 4(3 were conducted in north America)gave the opposite results;5 studies investigated the effects of PM10 exposure on the incidence or mortality of breast cancer,of which 4 failed to establish an association between exposure to PM10 and the incidence or mortality of breast cancer,the other 1 study established this association only when population were exposed to high concentration of PM10.Conclusion The results of currently available studies were inconsistent and thus inconclusive in the correlation between exposure to PM2.5 or PM10 and the incidence or mortality of breast cancer,which may be due to regional differences and dose-response effects.Therefore,there is a need for more studies used in quantitative synthesis.