Evidence-based identification of breast cancer and associated ovarian and uterus cancer risk components in source waters from high incidence area in the Pearl River Basin, China

Shuhan Peng; Shengkun Dong; Chang Gong; Xiaohong Chen; Hongyu Du; Yuehao Zhan; Zhifeng Yang

doi:10.1016/j.scitotenv.2023.166060

Evidence-based identification of breast cancer and associated ovarian and uterus cancer risk components in source waters from high incidence area in the Pearl River Basin, China

Sci Total Environ. 2023 Dec 10:903:166060. doi: 10.1016/j.scitotenv.2023.166060. Epub 2023 Aug 4.

Authors

Shuhan Peng¹, Shengkun Dong¹, Chang Gong², Xiaohong Chen³, Hongyu Du⁴, Yuehao Zhan⁴, Zhifeng Yang⁵

Affiliations

¹ School of Civil Engineering, Sun Yat-sen University, Guangzhou 510275, China; Guangdong Engineering Technology Research Center of Water Security Regulation and Control for Southern China, Sun Yat-sen University, Guangzhou 510275, China; Key Laboratory of Water Cycle and Water Security in Southern China of Guangdong High Education Institute, Sun Yat-sen University, Guangzhou 510275, China.
² Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
³ School of Civil Engineering, Sun Yat-sen University, Guangzhou 510275, China; Guangdong Engineering Technology Research Center of Water Security Regulation and Control for Southern China, Sun Yat-sen University, Guangzhou 510275, China; Key Laboratory of Water Cycle and Water Security in Southern China of Guangdong High Education Institute, Sun Yat-sen University, Guangzhou 510275, China. Electronic address: eescxh@mail.sysu.edu.cn.
⁴ School of Civil Engineering, Sun Yat-sen University, Guangzhou 510275, China.
⁵ State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing 100875, China.

PMID: 37543346
DOI: 10.1016/j.scitotenv.2023.166060

Abstract

Breast cancer, ovarian cancer, and uterus cancer are among the most common female cancers. They are suspected to associate with exposures to specific environmental pollutants, which remain unidentified in source waters. In this work, we focused on the Pearl River Basin region in China, which experienced a high incidence of breast, ovarian, and uterus cancers. Combining cancer patient data, mammalian cell cytotoxicity analyses, and exhaustive historical and current chemical assessments, we for the first time identified source water components that promoted proliferation of mammalian cells, and confirmed their association with these female cancers via the estrogen receptor mediated pathway. Therefore, the components that have previously been found to enhance the proliferation of estrogen receptor-containing cells through endocrine disruption could be the crucial factor. Based on this, components that matched with this toxicological characteristic (i.e., estrogen-like effect) were further identified in source waters, including (1) organic components: phthalates, bisphenol A, nonylphenols, and per-/polyfluoroalkyls; (2) inorganic components: Sb, Co, As, and nitrate. Moreover, these identified water components were present at levels comparable to other regions with high female cancer prevalence, suggesting that the potential risk of these components may not be exclusive to the study region. Together, multiple levels of evidence suggested that long-term co-exposures to source water estrogenic components may be important to the development of breast, ovarian, and uterus cancers.

Keywords: Breast cancer; Endocrine-disrupting compound; Estrogen receptor; Source water; Water component.