Prenatal hormone exposure may affect future breast cancer risk
DES Follow-up Study Summary
Fetal exposure to maternal pregnancy hormones may influence future breast cancer risk and cigarette smoking is among the factors believed to alter pregnancy hormone levels. Specifically, total pregnancy estrogen levels are slightly decreased among pregnant women who smoke relative to women who do not. More pronounced reductions of pregnancy estiol (E3) and estradiol (E2) were observed among smoking women. Possibly, women prenatally exposed to maternal cigarette smoke may have reduced breast cancer risk as an adult. The National Cooperative DES Adenosis (DESAD) Project was a prospective study of the effects of prenatal Diethylstilbestrol (DES) exposure. When women were enrolled in the study from 1975 through 1981, their mothers were questioned about their health habits including cigarette smoking during their pregnancy with the study participant. Using responses to this question provided by the mothers at the start of the study, investigators were able to compare the breast cancer rates among women who were and were not prenatally exposed to maternal cigarette smoke. Investigators observed a 51% decrease in breast cancer rates among women whose mothers smoked while pregnant with them compared to women who were not prenatally exposed to maternal cigarette smoke. Daughters of women who smoked 15 or fewer cigarettes per day during the pregnancy appeared to have a 65% reduction in breast cancer rates compared to women whose mothers did not smoke during pregancy. The adverse effects of prenatal cigarette smoke exposure far outweigh any benefit from possible reduction of breast cancer risk. These study results do, however, provide further evidence supporting the hypothesis that prenatal hormone exposure may affect future breast cancer risk.
2005 Study Abstract
Clinical studies show that maternal cigarette smoking reduces pregnancy estrogen levels. Women prenatally exposed to maternal cigarette smoke may, therefore, have a lower breast cancer risk because the fetal mammary gland’s exposure to maternal estrogen is decreased. Associations between prenatal maternal cigarette smoke exposure and breast cancer, however, have not been observed in previous case-control studies that relied on exposure assessment after the onset of cancer. At the start of this study, cigarette smoking history was obtained directly from the mother.
The National Cooperative DES Adenosis project was a follow-up study of health outcomes in women prenatally exposed to diethylstilbestrol (DES). At the start of the study, women’s mothers provided information about cigarette smoking habits during the time they were pregnant with the study participant. In the current study, the breast cancer rates are compared among 4031 women who were or were not prenatally exposed to maternal cigarette smoke. The resultant relative rate (RR) is adjusted for potential confounding by other breast cancer risk factors using Poisson regression modeling.
Fetal exposure to maternal cigarette smoke appeared to be inversely associated with breast cancer incidence (RR = 0.49; 95% confidence interval [CI] = 0.24-1.03). The inverse association was more apparent among women whose mothers smoked 15 cigarettes or fewer per day than among daughters of heavier smokers. There were, however, too few cases to precisely estimate a possible dose-response relationship.
These results support the hypothesis that in utero exposure to maternal cigarette smoke reduces breast cancer incidence.
Breast cancer incidence in women prenatally exposed to maternal cigarette smoke, NCBI, PMID: 15824550, 2005 May;16(3):342-5.
Eleven locations across England have been chosen to deliver the 100,000 Genomes Project
The 3-year project, launched by the Prime Minister earlier this year, aims to improve diagnosis and treatment for patients with cancer and rare diseases.
The initiative involves collecting and decoding 100,000 human genomes – complete sets of people’s genes – that will enable scientists and doctors to understand more about specific conditions.
The project has the potential to improve our ability to predict and prevent disease. It may also lead to new and more precise diagnostic tests, and the ability to more accurately personalise drugs and other treatments to specific genetic variants.
It is anticipated that over 75,000 people will be involved, which will include some patients with life threatening and debilitating disease.
After samples are collected, they will be sent securely to Illumina who have been procured by Genomics England to sequence the whole genome and to analyse it. Results will be sent back to the NHS for validation and clinical action.
The 11 designated Genomic Medicine Centres (GMCs) in this first selection process are based across the country covering areas including Greater Manchester, the North West coast, Oxford, Birmingham and the West Midlands, Southampton, London, Cambridge and the East of England, Exeter and the South West Peninsula, and the North East.
Over the lifetime of the project NHS England’s ambition is to secure more than 100 participating NHS trusts.
Designated Genomic Medicine Centres
East of England NHS GMC – designated for both cancer and rare disease.
Led by Cambridge University Hospitals NHS Foundation Trust;
South London NHS GMC – designated for both cancer and rare disease.
Led by Guy’s and St Thomas’ NHS Foundation Trust.
North West Coast NHS GMC – designated for both cancer and rare disease.
Led by Liverpool Women’s NHS Foundation Trust.
Greater Manchester NHS GMC – designated for both cancer and rare disease.
Led by Central Manchester University Hospitals NHS Foundation Trust
University College London Partners NHS GMC – designated for both cancer and rare disease.
Led by Great Ormond Street Hospital NHS Foundation Trust
North East and North Cumbria NHS GMC – designated GMC for rare disease only.
Led by The Newcastle upon Tyne Hospitals NHS Foundation Trust.
Oxford NHS GMC – designated for both cancer and rare disease.
Led by Oxford University Hospitals Foundation Trust.
South West Peninsula NHS GMC – designated for both cancer and rare disease.
Led by Royal Devon & Exeter NHS Foundation Trust.
Wessex NHS GMC – designated for both cancer and rare disease.
Led by University Hospital Southampton NHS Foundation Trust.
Imperial College Health Partners NHS GMC – designated for both cancer and rare disease.
Led by Imperial College Healthcare NHS Trust.
West Midlands NHS GMC – designated for both cancer and rare disease.
Led by University Hospitals Birmingham NHS Foundation Trust.
Life Sciences Minister George Freeman said:
” Our understanding of genomics is transforming the landscape for disease diagnosis and medicines research. We want to make the UK the best place in the world to design and discover 21st century medicines which is why we have invested in the 100,000 Genomes Project. We also want to ensure NHS patients benefit which is why we have now selected NHS hospitals to help us sequence genomes on an unprecedented scale and bring better treatments to people with cancers and rare diseases for generations to come. ”
Professor Sir Bruce Keogh, NHS England’s National Medical Director, said:
” This is an achievable ambition which positions Britain to unlock longstanding mysteries of disease on behalf of humankind. Embracing genomics will position us at the forefront of science and make the NHS the most scientifically advanced healthcare system in the world. This is the start of a unique, exciting journey that will bring benefits for patients, for the NHS and for society at large. ”
Professor Sue Hill, the Chief Scientific Officer for England, who chaired the team evaluating the various applicant GMCs said:
” The NHS has risen to both the challenge and opportunity of delivering its contribution to the 100,000 whole genomes project in the most extraordinary and unparalleled way. Locally in the NHS, there has been clearly demonstrated engagement and involvement of senior managers, clinical teams, clinical genetic and molecular pathology laboratories and critically patients and the public, all committed to using the science of whole genome sequencing to making a real and lasting difference for patient benefit. ”
Professor Mark Caulfield, Chief Scientist at Genomics England
” The creation of the new NHS Genomic Medicine Centres will play a key role in bringing together researchers, NHS clinicians and trainees to work on whole genome data that has never been collected on this scale before. We have a clear goal of accelerating the findings from the programme back into mainstream healthcare at the fastest possible pace, meaning more rapid results for patients. ”
Sources and more information
Eleven new centres to lead genomics project, gov.uk, 22 December 2014.
NHS Genomic Medicine Centres announced for 100,000 Genomes Project, genomicsengland, December 22, 2014.
Human genome: UK to become world number 1 in DNA testing, gov.uk, 1 August 2014.
Does French government report misrepresents the challenges of replacing BPA?
The French government wants to ban the use of the chemical bisphenol A in all plastic packaging in 2015. The plastics industry has responded by saying the government is being “unrealistic” about the challenges this change will produce.
The lobby group believes that a simple ban on bisphenol A in food packaging would lead to the disappearance of a large number of products, which would become more difficult to store. The alternatives to BPA are still too little understood, they say, particularly with regard to their durability and toxicity, and the new law could put the safety of consumers at risk.
Sources and more information
French government and plastics lobby clash over Bisphenol A, euractiv, 07/12/2014.
French government report misrepresents the challenges of replacing BPA, bisphenol-a-europe, 26-11-2014.
Take a random walk through your life and you’ll find it is awash in industrial, often toxic, chemicals. Sip water from a plastic bottle and ingest bisphenol A. Prepare dinner in a non-stick frying pan or wear a layer of Gore-Tex only to be exposed to perfluorinated compounds. Hang curtains, clip your baby into a car seat, watch television—all are manufactured with brominated flame-retardants.
Cosmetic ingredients, industrial chemicals, pesticides, and other compounds enter our bodies and remain briefly or permanently. Far too many suspected toxic hazards are unleashed every day that affect the development and function of our brain, immune system, reproductive organs, or hormones. But no public health law requires product testing of most chemical compounds before they enter the market. If products are deemed dangerous, toxicants must be forcibly reduced or removed—but only after harm has been done.
In this scientifically rigorous legal analysis, Carl F. Cranor argues that just as pharmaceuticals and pesticides cannot be sold without pre-market testing, other chemical products should be subject to the same safety measures. The author shows, in terrifying detail, what risks we run, and that it is entirely possible to design a less dangerous commercial world.