Unlike family history, risk factors such as chemical exposure, obesity can be changed, experts say
TUESDAY, Feb. 12, 2013 (HealthDay News) -- Efforts to prevent breast cancer need to focus more aggressively and coherently on environmental factors.
That's the conclusion of a new report released Tuesday by a committee tasked in 2008 by the U.S. Congress to investigate the environment's impact on breast cancer.
Chemical and radiation exposure, drugs and consumer products are among environmental factors addressed in the report, but so are less obvious factors connected to lifestyle and socioeconomic resources.
If researchers could identify specific factors in the environment, they could take steps to remove them from the environment and/or help people avoid them, said Michael Gould, a member of the Interagency Breast Cancer and Environmental Research Coordinating Committee, which prepared the report.
"This area of primary prevention and taking things out of the environment that might reduce the amount of breast cancer is not as bold as it could be," Gould said.
Environment in this case is defined broadly to mean not just chemicals but also obesity and socioeconomic status, he added. Primary prevention refers to preventing the first onset of a disease, as opposed to a recurrence.
The 270-page report also states that more research is needed on how different populations, such as underrepresented minorities, might face higher exposures.
Issues of obesity and socioeconomic status, in particular, are "understudied and underappreciated," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La.
Obesity is responsible for about 20 percent of all cancers, and obesity and poverty often overlap, added Brooks, who was not involved with the report.
The American Cancer Society estimates that 232,000 women will be diagnosed with invasive breast cancer in 2013 and nearly 40,000 will die of the disease.
Given that most breast cancers occur in women with no family history of the disease, environmental factors could play significantly into prevention efforts, the report stated.
The authors reviewed the existing literature on prevention of breast cancer and came up with several recommendations, the first being that the area of environment in the primary prevention of breast cancer needs better financial support.
"The committee feels the country can do better by increasing that level of support," said Gould, who is a professor of oncology at the University of Wisconsin-Madison School of Medicine and Public Health.
In tandem with more financial investment, organizations -- both governmental and nongovernmental -- need to work together in a more coordinated and strategic manner, the report stated.
And much more research is needed into the chemical and physical causes of breast cancer. This might include low-dose radiation or compounds known as endocrine disruptors, such as bisphenol A (BPA), which are found in manufactured plastics. (There is no clear evidence yet that BPA causes breast cancer in humans.)
"We have tens of thousands of compounds produced by the chemical industry and we haven't tested all of them," Gould said.
Animal research could play an important role in filling the research gaps, he added.
When looking at these environmental factors, scientists need to focus specifically on the times of life when the breast may be most susceptible to insult from outside forces, for example, while the fetus is still in the womb.
Finally, the dialogue around cancer prevention needs to involve the public and findings need to be carefully relayed to this community.
"It is the responsibility of scientists and the government to make sure women are informed," Gould said. "We're really advocating that lines of communication be open."
For more on environmental factors and health, visit the U.S. National Institute of Environmental Health Sciences (http://www.niehs.nih.gov/ ).
SOURCES: Michael N. Gould, Ph.D., professor of oncology, University of Wisconsin-Madison School of Medicine and Public Health; Jay Brooks, M.D., chairman of hematology/oncology, Ochsner Health System, Baton Rouge, La.; Interagency Breast Cancer and Environmental Research Coordinating Committee, Feb. 12, 2013, report, Breast Cancer and the Environment: Prioritizing Prevention