title: Breast cancer and pesticides in Hawaii: the need for further study.
abstract: Only 30% of all breast cancer can be explained by known risk factors. Increases in breast cancer incidence rates in Hawaii over the past few decades cannot be attributed solely to improvements in screening and detection. Avoidable environmental factors may contribute to a proportion of the unexplained cases. Emerging evidence on endocrine disruption suggests that environmental chemicals may play a role in the development of breast cancer. Agricultural chemicals, including endocrine disruptors, have been used intensively in Hawaii's island ecosystem over the past 40 years leaching into groundwater, and leading to unusually widespread occupational and general population exposures. This paper discusses breast cancer patterns in Hawaii in the context of documented episodes of exposure to two endocrine-disrupting chemicals, chlordane/heptachlor and 1,2-dibromo-3-chloropropane (DBCP), at levels that sometimes exceeded federal standards by several orders of magnitude. In light of this history, detailed geographic-based studies should be undertaken in Hawaii to elucidate the potential role of environmental factors in the development of breast cancer and other diseases.
authors.affiliation: Extramural Epidemiology and Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892-7105, USA. allenr@epndce.nci.nih.gov
authors.forename: R H
authors.initials: RH
authors.lastname: Allen
authors.forename: M
authors.initials: M
authors.lastname: Gottlieb
authors.forename: E
authors.initials: E
authors.lastname: Clute
authors.forename: M J
authors.initials: MJ
authors.lastname: Pongsiri
authors.forename: J
authors.initials: J
authors.lastname: Sherman
authors.forename: G I
authors.initials: GI
authors.lastname: Obrams
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D002706:Chlordan / Q000633:toxicity; D004702:Endocrine Glands / Q000187:drug effects; D004781:Environmental Exposure; D004782:Environmental Health; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006533:Heptachlor / Q000633:toxicity; D006801:Humans; D007306:Insecticides / Q000633:toxicity; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000453:epidemiology / Q000209:etiology; D010575:Pesticides / Q000633:toxicity*; D011407:Propane / Q000031:analogs & derivatives / Q000633:toxicity; D012307:Risk Factors; D014874:Water Pollutants, Chemical / Q000633:toxicity
chemical_list: D007306:Insecticides; D010575:Pesticides; D014874:Water Pollutants, Chemical; D002706:Chlordan; D006533:Heptachlor; C007318:1,2-dibromo-3-chloropropane; D011407:Propane