Tài liệu Environmental and Occupational Causes of Cancer doc

Environmental and Occupational

Causes of Cancer

New Evidence, 2005–2007

Richard W. Clapp, DSc, MPH

Boston University School of Public Health

and University of Massachusetts Lowell

Molly M. Jacobs, MPH

University of Massachusetts Lowell

Edward L Loechler, PhD

Boston University

Prepared for

Cancer Working Group of

the Collaborative on Health

and the Environment

October 2007

A publication of

the Lowell Center for

Sustainable Production

University of Massachusetts Lowell

One University Avenue

Lowell, MA 01854

978.934.2980

Acknowledgements

The authors gratefully acknowledge the following individuals and organizations in the creation of

this report:

• The Cancer Working Group of the Collaborative on Health & the Environment for

initiating this paper;

• The Jenifer Altman Foundation for its financial support; and

• David Kriebel, Rachel Massey and Rob Dubrow for their thoughtful scientific review.

The Lowell Center for Sustainable Production

The Lowell Center for Sustainable Production (LCSP) uses rigorous science, collaborative research,

and innovative strategies to promote communities, workplaces, and products that are healthy,

human and respectful of natural systems. LCSP is comprised of faculty, staff and graduate students

at the University of Massachusetts Lowell who work collaboratively with citizen groups, workers,

businesses, institutions, and government agencies to build healthy work environments, thriving

communities, and viable businesses that support a more sustainable world.

This paper was produced by the LCSP’s Environmental Health Initiative, which seeks to better

understand the relationships between environmental exposures and human health in order to

prevent exposures that may be harmful and to reverse rates of chronic disease.

Lowell Center for Sustainable Production

University of Massachusetts Lowell

One University Avenue

Lowell, MA 01854

978-934-2980

www.sustainableproduction.org

This document is available at www.sustainableproduction.org and www.cheforhealth.org

Copyright 2007. The Lowell Center for Sustainable Production, University of Massachusetts Lowell

TABLE OF CONTENTS

EXECUTIVE SUMMARY .........................................................................................................................................1

INTRODUCTION .......................................................................................................................................................2

SECTION I: STATE OF THE SCIENCE.................................................................................................................3

TABLE 1: EVIDENCE UNCHANGED SINCE 2005 REVIEW.................................................................................................4

Bladder Cancer....................................................................................................................................................4

Brain and Other Central Nervous System Cancer ...............................................................................................5

Breast Cancer ......................................................................................................................................................7

Colon cancer........................................................................................................................................................8

Esophageal cancer...............................................................................................................................................9

Kidney cancer ......................................................................................................................................................9

Leukemia..............................................................................................................................................................9

Liver and biliary cancer.....................................................................................................................................11

Laryngeal cancer ...............................................................................................................................................11

Lung cancer .......................................................................................................................................................11

Multiple myeloma...............................................................................................................................................13

Nasal/Nasopharyngeal cancer ...........................................................................................................................14

Non-Hodgkin’s lymphoma .................................................................................................................................14

Ovarian cancer ..................................................................................................................................................15

Pancreatic cancer ..............................................................................................................................................16

Prostate cancer ..................................................................................................................................................16

Rectal cancer .....................................................................................................................................................18

Skin cancer.........................................................................................................................................................19

Stomach cancer..................................................................................................................................................20

Testicular cancer................................................................................................................................................20

TABLE 2: SUMMARY OF ENVIRONMENTAL AND OCCUPATIONAL LINKS WITH CANCER.................................................21

SECTION II: UNDERSTANDING CRITICAL ELEMENTS OF CANCER CAUSATION ...........................24

TOXICOLOGICAL EVIDENCE IS CRUCIAL FOR CONNECTING EARLY-LIFE EXPOSURES AND CANCER ............................24

THE MULTI-FACTORIAL PROCESS OF CANCER CAUSATION..........................................................................................25

Steps in Tumor Formation .................................................................................................................................26

Self-Sufficiency in Growth Signals.....................................................................................................................26

Insensitivity to Anti-Growth Signals ..................................................................................................................26

Evading Programmed Cell Death (Apoptosis)...................................................................................................27

Limitless Replication Potential ..........................................................................................................................27

Sustained Angiogenesis......................................................................................................................................27

Tissue Invasion and Metastasis..........................................................................................................................27

IMPLICATIONS FOR CANCER TREATMENTS...................................................................................................................27

SECTION III: SHIFTING OUR CANCER PREVENTION PARADIGM .........................................................29

FAILING TO ACT ON WHAT WE KNOW.........................................................................................................................29

ATTRIBUTABLE FRACTIONS: HINDERING COMPREHENSIVE CANCER PREVENTION ......................................................30

THE POLITICS AND ECONOMICS OF CANCER PREVENTION ...........................................................................................30

CONCLUSION ..........................................................................................................................................................32

BIBLIOGRAPHY .......................................................................................................................................................33