Exposure to dichlorodiphenyltrichloroethane and the risk of breast cancer: A systematic review and meta-analysis

Objectives: This study extended and updated a meta-analysis of the association between exposure to dichlorodiphenyltrichloroethane (DDT) and the risk of breast cancer. Methods: We reviewed the published literature on exposure to DDE and breast cancer risk to update a meta-analysis from 2004. The total of 35 studies included 16 hospital-based case-control studies, 11 population-based case-control studies, and 10 nested case-control studies identified through keyword searches in the PubMed and EMBASE databases. Results: The summary odds ratio (OR) for the identified studies was 1.03 (95% confidence interval 0.95-1.12) and the overall heterogeneity in the OR was observed (I² = 40.9; p = 0.006). Subgroup meta-analyses indicated no significant association between exposure to DDE and breast cancer risk by the type of design, study years, biological specimen, and geographical region of the study, except from population-based case-control studies with estimated DDE levels in serum published in 1990s. Conclusion: Existing studies do not support the view that DDE increases the risk of breast cancer in humans. However, further studies incorporating more detailed information on DDT exposure and other potential risk factors for breast cancer are needed.