The Association of Bisphenol A and Phthalates with Risk of Breast Cancer: A Meta-Analysis

Abstract

Background: Breast cancer is the most common cancer and the second leading cause of cancer-related death amongst American women. Endocrine-disrupting chemicals (EDCs), especially bisphenol A (BPA) and phthalates, have adverse effects on human health. However, the association of BPA and phthalates with breast cancer remains conflicting. This study aims to investigate the association of BPA and phthalates with breast cancer. Methods: Correlative studies were identified by systematically searching three electronic databases, namely, PubMed, Web of Sciences, and Embase, up to November 2020. All data were analyzed using Stata 15.0. Results: A total of nine studies, consisting of 7820 breast cancer cases and controls, were included. The urinary phthalate metabolite mono-benzyl phthalate (MBzP) and mono-2-isobutyl phthalate (MiBP) were negatively associated with breast cancer (OR = 0.73, 95% CI: 0.60–0.90; OR = 0.75, 95% CI: 0.58–0.98, respectively). However, the overall ORs for BPA, mono-ethyl phthalate (MEP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-2-ethylhexyl phthalate (MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-(3-carboxypropyl) phthalate (MCPP), and mono-butyl phthalate (MBP) were 0.85 (95% CI: 0.69–1.05), 0.96 (95% CI: 0.62–1.48), 1.12 (95% CI: 0.88–1.42), 1.13 (95% CI: 0.74–1.73), 1.01 (95% CI: 0.74–1.40), 0.74 (95% CI: 0.48–1.14), and 0.80 (95% CI: 0.55–1.15), respectively, suggesting no significant association. The sensitivity analysis indicated that the results were relatively stable. Conclusion: Phthalate metabolites MBzP and MiBP were passively associated with breast cancer, whereas no associations were found between BPA, MEP, MEHHP, MEHP, MEOHP, MCPP, and MBP and breast cancer. More high-quality case-control studies or persuasive cohort studies are urgently needed to draw the best conclusions.

Phthalates and Their Impacts on Human Health

“…Women were found to be exposed at higher levels than men due to frequent use of PCPs (e.g., soaps and cosmetics) [ 26 ]. A systematic review and meta-analysis concluded that phthalates metabolites MBzP and MiBP were negatively associated with breast cancer among females [ 27 ]. Risk assessment of chemicals involves a comparison of the actual level of exposure to the acceptable level of exposure, mostly TDI values.…”

Urinary Phthalate Concentrations and Mortality Risk: A Population-Based Study

“…For example, experimental evidence suggests that neonatal exposure to Di-2-ethylhexylphthalate (DEHP) leads to dysfunction of the male reproductive system (Lee et al, 2021). DEHP metabolites have also been associated with an increased odds for breast cancer in case-control studies (Liu et al, 2021), although a prospective study did not show associations between phthalate and breast cancer risk (Reeves et al, 2019). Cross-sectional epidemiological studies further indicate associations between higher urinary phthalates levels and obesity (Song et al, 2014), insulin resistance (Stahlhut et al, 2007), diabetes (Nam et al, 2020), and cardiovascular diseases (CVD) (Zhu et al, 2021).…”

Urinary levels of parabens, phthalate metabolites, bisphenol A and plasticizer alternatives in a Belgian population: Time trend or impact of an awareness campaign?

“…The exposure to these ED has been linked to reproductive impairments and infertility, neurodevelopmental disorders, hormone-dependent cancers, obesity, diabetes, thyroid disorders, oxidative stress, genotoxicity, although the relationships with some of these health endpoints are still controversial (Bledzka at al. 2014;Dabre and Harvey, 2008;Hauser and Calafat, 2005;Heudorf et al, 2007;Katsikantami et al, 2016;Liu et al, 2021;Ma et al, 2019;Rochester, 2013;Soni et al, 2005). Because of the potential health risk related to our exposure to these chemicals, some restrictions and regulations have been progressively implemented worldwide since early 2000's.…”