Chemical exposures

Oxford American handbook of oncology. Second Edition. Oxford University Press (2015)

Other exposures account for <5% of the cancer burden. Many chemical carcinogens have been identified.

Industrial exposure

  • Dye and textile workers (naphythylamines): bladder cancers
  • Chemical and rubber workers (benzene): hematological malignancies
  • Vinyl chloride: angiosarcoma of liver
  • A sbestos exposure: lung cancer, mesothelioma (notifiable)
  • Beryllium, chromium, nickel: lung cancer

Pharmacological exposure

  • Many chemotherapeutic agents used in the treatment of cancer are carcinogenic, e.g., alkylating agents.
  • High-dose diethylstilbesterol during pregnancy, used in the 1960s to reduce the risk of miscarriage, in the development of clear cell carcinoma of the vagina at the time of menarche in a small percentage of the offspring of exposed women.
  • Immunosuppressants have been associated with non-Hodgkin’s lymphomas.

Environmental exposure

  • Causal carcinogenic links with environmental pollutants have been difficult to establish.
  • Estimates suggest 1% of U.S. lung cancer deaths are attributable to air pollution.
  • Incidence of many cancers varies greatly between geographical areas: this includes variation between countries and between different regions within countries.
  • Variations reflect complex interactions between genetic, environmental, socioeconomic, and behavioral factors.
  • Migration between areas of contrasting incidence: a migrant population usually acquires the cancer pattern of their adopted country—i.e., environmental rather than genetic factors dominate, except in rare familial cases.
  • Cancer incidence can vary between socioeconomic groups.
  • Epidemiological studies continue to improve understanding of the etiology of different cancers and aid in development of strategies for disease prevention.

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