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Background: Phthalates are chemical substances widely used in human consumer goods. Studies have shown that phthalates exposure can affect the physiological function of estrogen receptor (ER). However, there is no comprehensive discussion on the association between phthalates exposure and ER-related cancer risk. Objective: We conducted a cross-sectional study of urinary phthalate metabolite concentrations and self-reported ER-related cancers among 3,015 participants from two cycles of the national health and Nutrition Examination Survey (NHANES), 2003-2006. Methods: Seven compounds of phthalate metabolites were examined as expoure biomarkers. We used multivariate logistic regression to estimate odds ratio (ORs) and 95% confidence intervals (CIs), adjusting for potential confounding factors. The concentration of phthalate metabolites is non-normal distribution, so quantile and log-transformation are used for analysis. Account for urine dilution, the creatinine corrected phthalate concentration was applied in our analysis. In addition, we also conducted sensitivity analysis by gender stratification and trend test to explore whether there is a concentration increase effect, so as to explore the relationship between these seven phthalate metabolites and the risk of ER-related cancers. Results: We observed a higher prevalence of ER-related cancers in the maximal quantile of MCNP (OR=2.37; 95%Cl=1.01-5.55) in adjusted model. Meanwhile, trend test also confirmed that MCNP had a positive trend with the risk of ER-related cancer (P=0.036). In subgroup analysis, the higher concentration of MCNP, the higher the risk of breast cancer. At the same time, the trend test verified our results: the results are positive (OR=3.68;95%Cl=1.15-11.74) (P=0.014). Conclusion: We provide the main evidence that urinary phthalate metabolites concentrations are positively correlated with ER-related cancers. The positive relationship between MCNP exposure and breast cancer risk is more obvious in women. Further causal studies are needed to confirm the findings in our analysis and clarify the underlying mechanisms. |
