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We identified patient and healthcare system factors related to receipt of screening results and attendance to colposcopy among patients with positive screening results in a cervical cancer screening program in Mexico City, Mexico. We analyzed data from 1,351 patients with high-risk human papillomavirus (HPV)-positive results from two screening demonstration studies conducted between 2017 and 2018. Factors associated with receipt of screening results and with adherence to a colposcopy appointment were identified using multivariable logistic regression. Participants had a median age of 40 years (IQR = 32-48), 60% had less than high school education, and 74% had a previous Pap screening in the last 5 years. Fifty-five percent of participants retrieved their screening results at the healthcare facility (HCF) without any reminder. Providing an email address for contact information, attending a HCF with family medicine, and receiving care from experienced nurses were associated with greater adherence to obtaining screening test results. Fifty-seven percent of participants attended their first scheduled colposcopy appointment. Providing a phone number improved adherence to colposcopy, whereas longer travel times between the HCF and the colposcopy clinic was associated with a decrease in colposcopy adherence. Having a Pap test in the last 5 years was positively associated with better compliance with both outcomes. Securing contact information may help to overcome barriers to future follow-up. Additional research is necessary on strategies for obtaining screening test results and scheduling appointments, which may help address barriers to access, such as limited staff availability, distance from the clinic, and travel costs.
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OBJECTIVE: To evaluate if selected phthalate exposure and flavonoid intake interact on breast cancer (BC) risk. MATERIAL AND METHODS: Interviews and urine samples were obtained from 233 women with histologically confirmed BC and 221 healthy controls matched by age and place of residence, from various states of northern Mexico. Urinary metabolites concentrations of diethyl phthalate (DEP), butyl benzyl phthalate (BBzP) and dioctyl phthalate (DOP) were determined by solid-phase extraction coupled with high-performance liquid chromatography/isotope dilution/tandem mass spectrometry. Using a semiquantitative food frequency questionnaire, consumption of five types of flavonoids (anthocyanidins, flavan-3-ols, flavanones, flavones and flavonols) was estimated according to three food groups: vegetables, fruits and legumes-oil seeds. RESULTS: A higher intake of anthocyanidins and flavan-3-ols (from vegetables), synergistically increased the negative association between BBzP and BC. No other significant flavonoid-phthalate multiplicative interactions on the risk for BC were found. CONCLUSION: The consumption of some flavonoids may interact with exposure to phthalates on the risk of BC. Epidemiological and underlying mechanisms information is still insufficient and requires further investigations.
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Neoplasias de la Mama/inducido químicamente , Neoplasias de la Mama/prevención & control , Flavonoides/administración & dosificación , Ácidos Ftálicos/toxicidad , Estudios de Casos y Controles , Cromatografía Líquida de Alta Presión , Dietilhexil Ftalato/toxicidad , Exposición a Riesgos Ambientales/efectos adversos , Femenino , Frutas/química , Humanos , México , Persona de Mediana Edad , Ácidos Ftálicos/orina , Riesgo , Verduras/químicaRESUMEN
OBJECTIVE: To evaluate whether the presence of polymorphisms of peroxisome proliferator-activated receptor gamma PPARγ (Pro 1 2Ala) and PPARGC1B (Ala203Pro) modifies the association between the inorganic arsenic (iAs) methylation capacity and breast cancer (BC). MATERIALS AND METHODS: Mexican women were interviewed, and blood and urine samples were collected from them (cases/controls= 197/220). The concentration of urinary arsenic species and the polymorphisms of interest were determined by high-performance liquid chromatography with inductively coupled plasma mass spectrometry (HPLC-ICP-MS) and polymerase chain reaction (PCR), respectively. RESULTS: In women with a high %MMA (urinary monomethyl arsenic) and high primary methylation ratio (PM = MMA/iAs), the risk of BC was increased (odds ratio [OR]%MMA T3 vs.T1= 3.60: 95% confidence interval [CI] 2.02-6.41, ORPMI T3 vs.T1= 3.47: 95%CI 1.95-6.17), which was maintained after adjusting for polymorphisms. No significant interactions were observed between the polymorphisms and the arsenic variables on the risk of BC. CONCLUSION: Pro 12Ala and Ala203Pro polymorphisms did not modify the association between the iAs methylation capacity and BC.
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Arsenicales/metabolismo , Neoplasias de la Mama/epidemiología , Proteínas Portadoras/genética , PPAR gamma/genética , Polimorfismo de Nucleótido Simple , Adulto , Anciano , Arsénico/toxicidad , Arsenicales/orina , Neoplasias de la Mama/genética , Estudios de Casos y Controles , Cromatografía Líquida de Alta Presión , Exposición a Riesgos Ambientales , Femenino , Predisposición Genética a la Enfermedad , Humanos , Espectrometría de Masas , Metilación , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Proteínas de Unión al ARN , Riesgo , Adulto JovenRESUMEN
Abstract Objective: To evaluate whether the presence of polymorphisms of peroxisome proliferator-activated receptor gamma PPARγ (Pro 1 2Ala) and PPARGC1B (Ala203Pro) modifies the association between the inorganic arsenic (iAs) methylation capacity and breast cancer (BC). Materials and methods: Mexican women were interviewed, and blood and urine samples were collected from them (cases/controls= 197/220). The concentration of urinary arsenic species and the polymorphisms of interest were determined by high-performance liquid chromatography with inductively coupled plasma mass spectrometry (HPLC-ICP-MS) and polymerase chain reaction (PCR), respectively. Results: In women with a high %MMA (urinary monomethyl arsenic) and high primary methylation ratio (PM = MMA/iAs), the risk of BC was increased (odds ratio [OR]%MMA T3 vs.T1= 3.60: 95% confidence interval [CI] 2.02-6.41, ORPMI T3 vs.T1= 3.47: 95%CI 1.95-6.17), which was maintained after adjusting for polymorphisms. No significant interactions were observed between the polymorphisms and the arsenic variables on the risk of BC. Conclusion: Pro 12Ala and Ala203Pro polymorphisms did not modify the association between the iAs methylation capacity and BC.
Resumen Objetivo: Evaluar si la presencia de polimorfismos de PPARγ (Pro 1 2Ala) y PPARGC1B (Ala203Pro) modifica la asociación entre la capacidad de metilación del arsénico inorgánico (Asi) y el cáncer de mama (CM). Material y métodos: Se entrevistaron mujeres mexicanas y recolectaron muestras de sangre y orina de (casos/controles=197/220). La concentración de especies de arsénico urinario y los polimorfismos de interés se determinaron mediante cromatografía líquida de alta resolución acoplada a espectrometría de masas (HPLC-ICP-MS) y reacción en cadena de la polimerasa (PCR), respectivamente. Resultados: En mujeres con %MMA (monometilarsénico urinario) y razón de primera metilación altas (PM=MMA/Asi) se incrementó el riesgo de CM (RM%MMAT3vsT1=3.60: intervalo de confianza [IC]95%2.02-6.41, RMPMT3vs.T1=3.47:IC95%1.95-6.17), que se mantuvo, respectivamente, al ajustar por polimorfismos. No se observaron interacciones significativas entre los polimorfismos y las variables arsenicales sobre el riesgo de CM. Conclusión: Los polimorfismos Pro 12Ala y Ala203Pro no modificaron la asociación entre la capacidad de metilación del Asi y el CM.
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Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Arsenicales/metabolismo , Neoplasias de la Mama/epidemiología , Proteínas Portadoras/genética , Polimorfismo de Nucleótido Simple , PPAR gamma/genética , Arsénico/toxicidad , Arsenicales/orina , Espectrometría de Masas , Neoplasias de la Mama/genética , Estudios de Casos y Controles , Reacción en Cadena de la Polimerasa , Riesgo , Cromatografía Líquida de Alta Presión , Proteínas de Unión al ARN , Predisposición Genética a la Enfermedad , Exposición a Riesgos Ambientales , MetilaciónRESUMEN
Objetivo. Identificar las características asociadas con la prevalencia de utilización correcta de la autoexploración manual (AE), el examen clínico (EC) y la mamografía (MA) para la detección de cáncer mamario (CaMa). Material y métodos. Se entrevistó a 1 030 mujeres mexicanas, sanas, de entre 20 y 88 años sobre su historia reproductiva y sociodemográfica. Con base en la forma y frecuencia de realización de estas técnicas de detección, se construyó un índice de utilización correcta. Resultados. La prevalencia de utilización correcta de la AE fue de 11% y del EC de 5.4%. El 7.6% de las mujeres entre 40 y 49 años y 31.6% de las mujeres con 50 años o más se realizaron una MA de acuerdo con la norma vigente al momento del estudio. El aseguramiento por parte del Instituto Mexicano del Seguro Social, del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado o del Seguro Popular fue el principal determinante de la utilización de la MA. Conclusiones. Se evidencia la necesidad de incrementar la correcta utilización de la AE, el EC y la MA.
Objective. Identify the characteristics associated with correct utilization of self examination (SE), clinical exam (CE) and mammography (MA) for breast cancer (BC) early detection. Materials and methods. Interviews were undertaken with 1 030 Mexican women (n=1 030), 20 to 88 years of age, regarding their reproductive and sociodemographic characteristics. An index of correct utilization was constructed based on the form and frequency practice of those techniques. Results. The prevalence of correct utilization of SE was 11% and 5.4% for CE. Further, 7.6% of women 40-49 years of age with 2 or more BC risk factors had MA during the two years prior to the interview, and for 31.6% among women ≥50 years of age the MA was annually. The main determinant of MA utilization was having financial protection from either IMSS, ISSSTE or Seguro Popular. Conclusions. It is necessary to improve the correct utilization of BC detection techniques in Mexico.
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Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Antídotos/administración & dosificación , Antineoplásicos/administración & dosificación , Neoplasias Colorrectales/tratamiento farmacológico , Floxuridina/administración & dosificación , Leucovorina/administración & dosificación , Administración Oral , Antineoplásicos/efectos adversos , Neoplasias Colorrectales/mortalidad , Neoplasias Colorrectales/patología , Floxuridina/efectos adversos , Infusiones Intravenosas , Tasa de SupervivenciaRESUMEN
El cáncer gástrico (CG) es la cuarta causa de muerte por cáncer a nivel global. La dieta y el consumo de alcohol y tabaco, además de la infección por Helicobacter pylori determinan un gran número de casos de esta neoplasia. Algunos alimentos contienen sustancias que podrían influir en el proceso de carcinogénesis gástrica, aunque los mecanismos subyacentes no están completamente dilucidados. En México y el mundo, la disminución en el consumo de frutas, vegetales no feculentos y allium, leguminosas y alimentos fuente de selenio, así como el aumento en el consumo de sal, alimentos salados, salmuera y ahumados, chile, carnes procesadas y asadas o a la parrilla se han asociado respectivamente con un aumento de riesgo de CG. Con la evidencia disponible, se podrían desarrollar y evaluar programas para la prevención y control del CG.
Gastric cancer (GC) is the fourt leading cause of cancer death at global level. Diet, alcohol and tobacco, in addition to Helicobacter pylori infection, account for a large number of cases. Some substances contained in foods may influence GC carcinogenesis process; however, the underlying mechanisms have not been fully elucidated. In Mexico and worldwide, a low intake of fruits, non-starchy and allium vegetables, pulses, and foods containing selenium, as well as high intake of salt, salty, salted and smoked foods, chili pepper, processed and grilled/barbecued meats, have been respectively associated with an increased risk of GC. Based on the available evidence, programs for GC prevention and control could be developed and evaluated.
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Animales , Masculino , Ratas , Compuestos Epoxi/toxicidad , Glicoles/toxicidad , Pruebas de Micronúcleos/métodos , Mutágenos/toxicidad , Espermátides/efectos de los fármacos , Butadienos/metabolismo , Butadienos/toxicidad , Relación Dosis-Respuesta a Droga , Compuestos Epoxi/metabolismo , Glicoles/metabolismo , Meiosis/efectos de los fármacos , Ratas Sprague-DawleyRESUMEN
Multiple epidemiological studies have evaluated the relationship between diet and gastric cancer (GC), focusing on individual foods and nutrients. However, some studies have estimated the association between dietary patterns and GC risk. To identify the dietary patterns of residents of Mexico City and to assess the association of these patterns with GC, a population-based case-control study with 248 histologically confirmed GC cases and 478 controls paired by age and sex was carried out. The dietary patterns were characterized from 22 food groups through factorial analysis. Three major dietary patterns were identified. Pattern 1 was characterized by the consumption of vegetables, fruits, and white meat; subjects in the highest quintile of this pattern had a lower GC risk than those in the lowest quintile [odds ratio (OR(Q5 vs. Q1)) = 0.43; 95% confidence interval (95%CI): 0.24-0.77; P trend = 0.010]. A comparison between the extreme quintiles of the third pattern (which included major consumption of refined grains and desserts), resulted in the following: OR(Q5 vs. Q1) = 4.80; 95%CI: 2.56-8.98; P-trend < 0.001). Additionally, we found no significant association between the second pattern (characterized by high consumption of Mexican food) and GC risk. This is the first study of associations between dietary patterns and GC in Mexico to confirm that GC risk is lower in individuals with healthy dietary patterns.
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Conducta Alimentaria , Neoplasias Gástricas/etiología , Anciano , Estudios de Casos y Controles , Grano Comestible , Femenino , Frutas , Infecciones por Helicobacter/complicaciones , Helicobacter pylori/patogenicidad , Humanos , Masculino , México , Persona de Mediana Edad , Factores de Riesgo , Neoplasias Gástricas/microbiología , VerdurasRESUMEN
Gastric cancer (GC) is the fourth leading cause of cancer death at global level. Diet, alcohol and tobacco, in addition to Helicobacter pylori infection, account for a large number of cases. Some substances contained in foods may influence GC carcinogenesis process; however, the underlying mechanisms have not been fully elucidated. In Mexico and worldwide, a low intake of fruits, non-starchy and allium vegetables, pulses, and foods containing selenium, as well as high intake of salt, salty, salted and smoked foods, chili pepper, processed and grilled/barbecued meats, have been respectively associated with an increased risk of GC. Based on the available evidence, programs for GC prevention and control could be developed and evaluated.
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Dieta , Neoplasias Gástricas/epidemiología , Consumo de Bebidas Alcohólicas/epidemiología , Capsicum/efectos adversos , Dieta/efectos adversos , Manipulación de Alimentos , Frutas , Predisposición Genética a la Enfermedad , Salud Global , Infecciones por Helicobacter/epidemiología , Humanos , Carne , México/epidemiología , Fumar/epidemiología , Cloruro de Sodio Dietético/efectos adversos , Neoplasias Gástricas/etiología , Neoplasias Gástricas/genética , Neoplasias Gástricas/prevención & control , VerdurasRESUMEN
OBJECTIVE: Identify the characteristics associated with correct utilization of self examination (SE), clinical exam (CE) and mammography (MA) for breast cancer (BC) early detection. MATERIALS AND METHODS: Interviews were undertaken with 1 030 Mexican women (n=1 030), 20 to 88 years of age, regarding their reproductive and sociodemographic characteristics. An index of correct utilization was constructed based on the form and frequency practice of those techniques. RESULTS: The prevalence of correct utilization of SE was 11% and 5.4% for CE. Further, 7.6% of women 40-49 years of age with 2 or more BC risk factors had MA during the two years prior to the interview, and for 31.6% among women ≥50 years of age the MA was annually. The main determinant of MA utilization was having financial protection from either IMSS, ISSSTE or Seguro Popular. CONCLUSIONS: It is necessary to improve the correct utilization of BC detection techniques in Mexico.
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Neoplasias de la Mama/diagnóstico , Detección Precoz del Cáncer , Cooperación del Paciente , Adulto , Anciano , Anciano de 80 o más Años , Autoexamen de Mamas/psicología , Autoexamen de Mamas/estadística & datos numéricos , Estudios Transversales , Detección Precoz del Cáncer/psicología , Detección Precoz del Cáncer/estadística & datos numéricos , Femenino , Humanos , Mamografía/psicología , Mamografía/estadística & datos numéricos , México , Persona de Mediana Edad , Examen Físico/psicología , Examen Físico/estadística & datos numéricos , Adulto JovenRESUMEN
The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide and diverse environmental and genetic risk factors are well recognized. Single nucleotide polymorphisms (SNPs) in the calpain-10 gene (CAPN-10), which encodes a protein involved in the secretion and action of insulin, and chronic exposure to inorganic arsenic (iAs) through drinking water have been independently associated with an increase in the risk for T2DM. In the present work we evaluated if CAPN-10 SNPs and iAs exposure jointly contribute to the outcome of T2DM. Insulin secretion (beta-cell function) and insulin sensitivity were evaluated indirectly through validated indexes (HOMA2) in subjects with and without T2DM who have been exposed to a gradient of iAs in their drinking water in northern Mexico. The results were analyzed taking into account the presence of the risk factor SNPs SNP-43 and -44 in CAPN-10. Subjects with T2DM had significantly lower beta-cell function and insulin sensitivity. An inverse association was found between beta-cell function and iAs exposure, the association being more pronounced in subjects with T2DM. Subjects without T2DM who were carriers of the at-risk genotype SNP-43 or -44, also had significantly lower beta-cell function. The association of SNP-43 with beta-cell function was dependent on iAs exposure, age, gender and BMI, whereas the association with SNP-44 was independent of all of these factors. Chronic exposure to iAs seems to be a risk factor for T2DM in humans through the reduction of beta-cell function, with an enhanced effect seen in the presence of the at-risk genotype of SNP-43 in CAPN-10. Carriers of CAPN-10 SNP-44 have also shown reduced beta-cell function.
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Arsénico/toxicidad , Calpaína/genética , Diabetes Mellitus Tipo 2/patología , Exposición a Riesgos Ambientales/efectos adversos , Células Secretoras de Insulina/citología , Células Secretoras de Insulina/patología , Polimorfismo de Nucleótido Simple , Adulto , Anciano , Diabetes Mellitus Tipo 2/etiología , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/fisiopatología , Contaminantes Ambientales/toxicidad , Femenino , Genotipo , Humanos , Insulina/metabolismo , Resistencia a la Insulina/genética , Secreción de Insulina , Células Secretoras de Insulina/efectos de los fármacos , Células Secretoras de Insulina/metabolismo , Masculino , Persona de Mediana Edad , Proyectos Piloto , Factores de RiesgoRESUMEN
Gastric cancer (GC) has been associated with a complex combination of genetic and environmental factors. In contrast to most countries, available information on GC mortality trends showed a gradual increase in Mexico. Our aim was to explore potential interactions among dietary (chili pepper consumption), infectious (Helicobacter pylori) and genetic factors (IL1B-31 genotypes) on GC risk. The study was performed in three areas of Mexico, with different GC mortality rates. We included 158 GC patients and 317 clinical controls. Consumption of capsaicin (Cap), the pungent active substance of chili peppers, was estimated by food frequency questionnaire. H. pylori CagA status was assessed by ELISA, and IL1B-31 genotypes were determined by TaqMan assays and Pyrosequencing in DNA samples. Multivariate unconditional logistic regression was used to estimate potential interactions. Moderate to high Cap consumption synergistically increased GC risk in genetically susceptible individuals (IL1B-31C allele carriers) infected with the more virulent H. pylori (CagA+) strains. The combined presence of these factors might explain the absence of a decreasing trend for GC in Mexico. However, further research on gene-environment interactions is required to fully understand the factors determining GC patterns in susceptible populations, with the aim of recommending preventive measures for high risk individuals.
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Adenocarcinoma/genética , Adenocarcinoma/microbiología , Capsaicina/efectos adversos , Genotipo , Infecciones por Helicobacter/microbiología , Helicobacter pylori/efectos de los fármacos , Interleucina-1beta/genética , Neoplasias Gástricas/genética , Neoplasias Gástricas/microbiología , Adulto , Anciano , Anticuerpos Antibacterianos/análisis , ADN/biosíntesis , ADN/genética , Dieta , Femenino , Interacción Gen-Ambiente , Infecciones por Helicobacter/complicaciones , Helicobacter pylori/inmunología , Humanos , Inmunoglobulina G/análisis , Modelos Logísticos , Masculino , México , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , RiesgoRESUMEN
BACKGROUND: Phthalates are ubiquitous industrial chemicals used as plasticizers in plastics made of polyvinyl chloride (PVC) to confer flexibility and durability. They are also present in products used for personal-care, industry and in medical devices. Phthalates have been associated with several adverse health effects, and recently it has been proposed that exposure to phthalates, could have an effect on metabolic homeostasis. This exploratory cross-sectional study evaluated the possible association between phthalate exposure and self-reported diabetes among adult Mexican women. METHODS: As part of an on-going case-control study for breast cancer, only controls were selected, which constituted 221 healthy women matched by age (±5 years) and place of residence with the cases. Women with diabetes were identified by self-report. Urinary concentrations of nine phthalate metabolites were measured by online solid phase extraction coupled to high performance liquid chromatography-isotope-dilution tandem mass spectrometry. RESULTS: Participants with diabetes had significantly higher concentrations of di(2-ethylhexyl) pththalate (DEHP) metabolites: mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) but lower levels of monobenzyl phthalate (MBzP) a metabolite of benzylbutyl phthalate, compared to participants without diabetes. A marginally significant positive associations with diabetes status were observed over tertiles with MEHHP (OR(T3 vs. T1)=2.66; 95% CI: 0.97-7.33; p for trend=0.063) and MEOHP (OR(T3 vs. T1)=2.27; 95% CI; 0.90-5.75; P for trend=0.079) even after adjusting for important confounders. CONCLUSIONS: The results suggest that levels of some phthalates may play a role in the genesis of diabetes.
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Diabetes Mellitus/inducido químicamente , Diabetes Mellitus/epidemiología , Ácidos Ftálicos/toxicidad , Estudios Transversales , Femenino , Humanos , México/epidemiología , Persona de Mediana Edad , Ácidos Ftálicos/orinaRESUMEN
Sources of phthalates other than Polyvinyl chloride (PVC) related products are scarcely documented in Mexico. The objective of our study was to explore the association between urinary levels of nine phthalate metabolites and the use of personal care products. Subjects included 108 women who participated as controls in an ongoing population-based case-control study of environmental factors and genetic susceptibility to breast cancer in northern Mexico. Direct interviews were performed to inquire about sociodemographic characteristics, reproductive history, use of personal care products, and diet. Phthalate metabolites measured in urine by high performance liquid chromatography-isotope dilution tandem mass spectrometry were monoethyl phthalate (MEP), monobenzyl phthalate (MBzP), mono-n-butyl phthalate (MBP), mono-isobutyl phthalate (MiBP), mono-3-carboxypropyl phthalate (MCPP) as well as mono-2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), mono-2-ethyl-5-carboxypentyl phthalate (MECPP) that are metabolites of di-ethylhexyl phthalate (DEHP). Detectable urinary concentrations of phthalate metabolites varied from 75% (MEHP) to 100% (MEP, MBP, MEOHP, MEHHP and MECPP). Medians of urinary concentrations of some phthalate metabolites were significantly higher among users of the following personal care products compared to nonusers: body lotion (MEHHP, MECPP and sum of DEHP metabolites (ΣDEHP)), deodorant (MEHP and ΣDEHP), perfume (MiBP), anti-aging facial cream (MEP, MBP and MCPP) and bottled water (MCPP, MEHHP and MEOHP). Urinary concentrations of MEP showed a positive relationship with the number of personal care products used. Our results suggest that the use of some personal care products contributes to phthalate body burden that deserves attention due to its potential health impact.
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Cosméticos/metabolismo , Exposición a Riesgos Ambientales/estadística & datos numéricos , Contaminantes Ambientales/orina , Ácidos Ftálicos/orina , Jabones/metabolismo , Adulto , Anciano , Estudios de Casos y Controles , Cromatografía Líquida de Alta Presión , Cosméticos/química , Dietilhexil Ftalato/análogos & derivados , Dietilhexil Ftalato/orina , Exposición a Riesgos Ambientales/análisis , Femenino , Humanos , México , Persona de Mediana Edad , Factores de Riesgo , Jabones/químicaRESUMEN
BACKGROUND: Phthalates, ubiquitous environmental pollutants that may disturb the endocrine system, are used primarily as plasticizers of polyvinyl chloride and as additives in consumer and personal care products. OBJECTIVES: In this study, we examined the association between urinary concentrations of nine phthalate metabolites and breast cancer (BC) in Mexican women. METHODS: We age-matched 233 BC cases to 221 women residing in northern Mexico. Sociodemographic and reproductive characteristics were obtained by direct interviews. Phthalates were determined in urine samples (collected pretreatment from the cases) by isotope dilution/high-performance liquid chromatography coupled to tandem mass spectrometry. RESULTS: Phthalate metabolites were detected in at least 82% of women. The geometric mean concentrations of monoethyl phthalate (MEP) were higher in cases than in controls (169.58 vs. 106.78 microg/g creatinine). Controls showed significantly higher concentrations of mono-n-butyl phthalate, mono(2-ethyl-5-oxohexyl) phthalate, and mono(3-carboxypropyl) phthalate (MCPP) than did the cases. After adjusting for risk factors and other phthalates, MEP urinary concentrations were positively associated with BC [odds ratio (OR), highest vs. lowest tertile = 2.20; 95% confidence interval (CI), 1.33-3.63; p for trend < 0.01]. This association became stronger when estimated for premenopausal women (OR, highest vs. lowest tertile = 4.13; 95% CI, 1.60-10.70; p for trend < 0.01). In contrast, we observed significant negative associations for monobenzyl phthalate (MBzP) and MCPP. CONCLUSIONS: We show for the first time that exposure to diethyl phthalate, the parent compound of MEP, may be associated with increased risk of BC, whereas exposure to the parent phthalates of MBzP and MCPP might be negatively associated. These findings require confirmation.
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Neoplasias de la Mama/epidemiología , Ácidos Ftálicos/toxicidad , Neoplasias de la Mama/inducido químicamente , Estudios de Casos y Controles , Exposición a Riesgos Ambientales , Femenino , Humanos , México/epidemiología , Persona de Mediana Edad , Factores de RiesgoRESUMEN
N-nitroso compounds (NOC) are potent animal carcinogens and potential human carcinogens. The primary source of exposure for most individuals may be endogenous formation, a process that can be inhibited by dietary polyphenols. To estimate the risk of gastric cancer (GC) in relation to the individual and combined consumption of polyphenols and NOC precursors (nitrate and nitrite), a population-based case-control study was carried out in Mexico City from 2004 to 2005 including 257 histologically confirmed GC cases and 478 controls. Intake of polyphenols, nitrate and nitrite were estimated using a food frequency questionnaire. High intakes of cinnamic acids, secoisolariciresinol and coumestrol were associated with an approximately 50% reduction in GC risk. A high intake of total nitrite as well as nitrate and nitrite from animal sources doubled the GC risk. Odds ratios around 2-fold were observed among individuals with both low intake of cinnamic acids, secoisolariciresinol or coumestrol and high intake of animal-derived nitrate or nitrite, compared to high intake of the polyphenols and low animal nitrate or nitrite intake, respectively. Results were similar for both the intestinal and diffuse types of GC. Our results show, for the first time, a protective effect for GC because of higher intake of cinnamic acids, secoisolariciresinol and coumestrol, and suggest that these polyphenols reduce GC risk through inhibition of endogenous nitrosation. The main sources of these polyphenols were pears, mangos and beans for cinnamic acids; beans, carrots and squash for secoisolariciresinol and legumes for coumestrol.
Asunto(s)
Adenocarcinoma/epidemiología , Dieta , Flavonoides/administración & dosificación , Nitratos/administración & dosificación , Nitritos/administración & dosificación , Fenoles/administración & dosificación , Neoplasias Gástricas/epidemiología , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , PolifenolesRESUMEN
BACKGROUND: DNA methylation is an important epigenetic process for transcriptional control of human genome including those genes involved in cancer initiation and progression. Clinical studies have suggested that biological explanation to the protective effect of some nutrients could be linked with the DNA methylation. Folate is a primary methyl donor nutrient; it has been shown to play a key role in DNA methylation, repair and synthesis, by acting as co-factors and/or substrates in this metabolic pathway. Likewise, activity of a key enzyme, the methylenetetrahydrofolate reductase (MTHFR) has also been shown to influence DNA methylation. Overall, these findings support the notion that dietary intake as well as genetic factors play a role in one-carbon metabolism. AIM OF THE STUDY: This study is to evaluate the dietary intake of nutrients involved in one-carbon metabolism and the genotype of MTHFR 677 C > T with respect to GC risk. METHODS: We carried out in January 2004 a population-based case-control study in the metropolitan area of Mexico City. A total of 248 histological confirmed GC patients were recruited from nine tertiary hospitals, along with 478 age and sex-matched controls. Nutrient intake was estimated from food frequency questionnaire; the MTHFR 677C > T genotype was determined by PCR-RFLP analysis. RESULTS: A significant reduction in diffuse GC risk was observed for MTHFR 677 TT genotype among individuals with high consumption of folate (OR = 0.23; 95% CI 0.06-0.84), choline (OR = 0.55; 95% CI 0.33-0.9) and Vitamin B(6) (OR = 0.59; 95% CI 0.36-0.96) compared to MTHFR 677 CC + CT carriers. Among subjects with low consumption of methionine, a reduced risk of diffuse GC was also detected (OR = 0.40; 95% CI 0.16-0.97). In contrast, carriers of the MTHFR 677 TT genotype with a low consumption of folate had a significant increased risk of intestinal GC (OR = 1.88 95% CI 1.02-3.47). A folate-MTHFR 677 C > T interaction in the borderline of significance (P = 0.055) was detected. CONCLUSIONS: It is probable that GC prevention requires dietary recommendations according to the individual genotype; nevertheless, the available information to this respect is still very limited.