English Abstract The incidence of breast cancer, testicular cancer and
prostate cancer is increasing in Western societies. Concern has been
expressed that human exposure to environmental xenobiotic compounds coupled
with endocrine activity may play a role in these cancers, but supporting
evidence for the existence of such a relationship is lacking. On the other
hand, the twentieth century has seen profound changes in lifestyle, which
have undoubtedly influenced the incidence of diseases. This report
summarises present knowledge on the relationship between hormone-dependent
cancers in humans and lifestyle determinants. Major lifestyle determinants
related to reproductive cancer appear to be found in eating and reproductive
behaviour. Specific determinants within these areas include caloric intake,
physical activity, alcohol consumption, parity, exogenous hormone
treatments, sexual activity and hygiene. Dramatic changes in eating
patterns in the twentieth century with increased caloric intake in the
presence of decreased physical activity, and increased alcohol intake and
increased female smoking are thought to have promoted reproductive cancers.
In addition, profound changes in reproductive behaviour with decreased
parity, increased maternal age, increased sexual activity, wide application
of various types of sex hormone therapy and contraceptive measures are
thought to have contributed to increased reproductive cancer incidences.
Current knowledge on determinants of reproductive cancer suggests that
lifestyle determinants may play a more prominent role in determining trends
in reproductive cancer incidences than exposure to environmental xenobiotic
compounds acting on the endocrine. However, data on human exposure to
environmental endocrine-active compounds are needed to allow an analysis of
the actual risk of exposure to these compounds in relation to reproductive
organ cancer.
Rapport in het kort
De incidenties van borstkanker, testiskanker en
prostaatkanker nemen in de westerse wereld toe. Er is sprake van zorg dat
blootstelling van de mens aan stoffen in het leefmilieu met endocriene
activiteit betrokken zouden kunnen zijn bij deze trends, maar ondersteunend
bewijs voor een dergelijke relatie ontbreekt tot dusverere. Anderzijds
heeft de twintigste eeuw diepgaande veranderingen in leefstijl te zien
gegeven, die ongetwijfeld invloed hebben gehad op de incidenties van ziekten
en aandoeningen. Het rapport vat huidige kennis samen omtrent de relatie
tussen hormoon-afhankelijke kankers bij de mens en leefstijldeterminanten.
Belangrijke leefstijldeterminanten betrokken bij deze kankers worden
gevonden op de gebieden van consumptief en sexueel gedrag. Specifieke
determinanten daarbinnen zijn calorische inname, lichamelijke activiteit,
alcoholconsumptie, kindertal, hormoonmedicatie, sexuele activiteit en
hygiene.