Evidence map›Paper›PMID 30995175›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2019

Phthalate Exposure and Breast Cancer Incidence: A Danish Nationwide Cohort Study.

Thomas P Ahern, Anne Broe, Timothy L Lash, Deirdre P Cronin-Fenton, Sinna Pilgaard Ulrichsen, Peer M Christiansen, Bernard F Cole, Rulla M Tamimi, Henrik Toft Sørensen, Per Damkier

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 5 pooled it
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 5 syntheses or guidelines pooled it, 124 citations in OpenAlex.

  1. Pooled it
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  4. The Association of Bisphenol A and Phthalates with Risk of Breast Cancer: A Meta-Analysis.International journal of environmental research and public health · 2021
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  18. Breast Cancer Exposomics.Life (Basel, Switzerland) · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Thomas P Ahern1 University of Vermont, Burlington, VT.
Anne Broe2 University of Southern Denmark, Odense, Denmark.
Timothy L Lash4 Emory University, Atlanta, GA.
Deirdre P Cronin-Fenton5 Aarhus University Hospital/Randers Regional Hospital, Aarhus, Denmark.
Sinna Pilgaard Ulrichsen5 Aarhus University Hospital/Randers Regional Hospital, Aarhus, Denmark.
Peer M Christiansen5 Aarhus University Hospital/Randers Regional Hospital, Aarhus, Denmark.
Bernard F Cole1 University of Vermont, Burlington, VT.
Rulla M Tamimi6 Brigham and Women's Hospital, Boston, MA.
Henrik Toft Sørensen5 Aarhus University Hospital/Randers Regional Hospital, Aarhus, Denmark.
Per Damkier2 University of Southern Denmark, Odense, Denmark.
Aarhus University Hospital · DKUniversity of Southern Denmark · DKUniversity of Vermont · USBrigham and Women's Hospital · US

Funding

Vermont Center on Behavior and HealthP20GM103644 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI SIGMON, STACEY C · 2013 to 2022
$21.3M
New and integrated perspectives on modification of tamoxifen effectivenessR01CA166825 · NCI · EMORY UNIVERSITY · PI LASH, TIMOTHY L. · 2013 to 2017
$2.8M
NCI NIH HHS R01 CA166825NIGMS NIH HHS P20 GM103644
6 · The paper itself

Abstract

purposePhthalate exposure is ubiquitous and especially high among users of drug products formulated with phthalates. Some phthalates mimic estradiol and may promote breast cancer. Existing epidemiologic studies on this topic are small, mostly not prospective, and have given inconsistent results. We estimated associations between longitudinal phthalate exposures and breast cancer risk in a Danish nationwide cohort, using redeemed prescriptions for phthalate-containing drug products to measure exposure.

methodsWe ascertained the phthalate content of drugs marketed in Denmark using an internal Danish Medicines Agency ingredient database. We enrolled a Danish nationwide cohort of 1.12 million women at risk for a first cancer diagnosis on January 1, 2005. By combining drug ingredient data with the Danish National Prescription registry, we characterized annual, cumulative phthalate exposure through redeemed prescriptions. We then fit multivariable Cox regression models to estimate associations between phthalate exposures and incident invasive breast carcinoma according to tumor estrogen receptor status.

resultsOver 9.99 million woman-years of follow-up, most phthalate exposures were not associated with breast cancer incidence. High-level dibutyl phthalate exposure (≥ 10,000 cumulative mg) was associated with an approximately two-fold increase in the rate of estrogen receptor-positive breast cancer (hazard ratio, 1.9; 95% CI, 1.1 to 3.5), consistent with in vitro evidence for an estrogenic effect of this compound. Lower levels of dibutyl phthalate exposure were not associated with breast cancer incidence.

conclusionOur results suggest that women should avoid high-level exposure to dibutyl phthalate, such as through long-term treatment with pharmaceuticals formulated with dibutyl phthalate.

Indexed as

Breast NeoplasmsCohort StudiesDenmarkFemaleHumansIncidencePhthalic Acidsphthalic acidPhthalic Acids

Identifiers

PMID30995175
PMCPMC7351345
OpenAlexW2938769931

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.