Environmental Awareness at NIEHS.

Although breast cancer still represents one-third of all cases of cancer in worn affects one out of nine worn United States, the patterns o and some means of preventi cer are becoming clearer, the tenth lecturer in the annual series, named for NIEHS's first scientific director. In a meticulous overview of recent studies, the internationally recognized epidemiol-ogist disucssed the many risk factors associated with breast cancer, some familiar from mass media reports and others less well known. Hulka then reviewed possible strategies for preventing the disease, even before the benefits of mam-mography and early detection come into play. z Barb Rates of breast cancer increase dramatically with age, Hulka pointed out, with only 20% occurring before age 50, and the rate 4 are increased in women with family mem-X bers who have had the disease, especially when those family members are young women. Geography makes a marked difference in incidence, with lowest rates in Asia and Africa and highest rates in several Western nations such as the United Kingdom and the United States. Women with higher educational and professional levels have higher rates, perhaps because of later childbearing patterns among these women. Early childbearing and longer duration of breastfeeding decrease rates, as do later commencement of menstruation and earlier menopause. Other risk factors include alcohol consumption , cigarette smoking, dietary fat, oral contraception use among women diagnosed before age 45, and estrogen replacement therapy. Controversial suspected risk factors include exposures such as organo-chlorine pesticides (DDT/DDE and PCBs), electromagnetic fields, by-products of charbroiling food (heterocyclic amines), phytoestrogens from soy products, and breast implants. With such an array of established and suspected risks, at least some of the risks also provide a means of prevention; for example, simple lifestyle choices. Women have control of their alcohol consumption Ii s-__ stfeedinsX___ ore has potr out. native strategic clinical tria one apy. Clinical trials of dietary modification will include calorie and fat reduction and increased consumption of fruits, vegetables , and grains among some 60,000 women volunteers. Other studies are looking at the role of micronu-trients including retinoids and carotenoids and anrixi-dants i decreasing risk ntal at prAy mist e the \rironmea' human health has not fAoe health of its ~ k tnvircnment Thi-ked a anniversary of the Ms intitute's Environ-~ ¶ent 1ess Advisory Committee (EB employee-based organization cre respond to specific issues and pract that have a significant impact on the NIEHS and …