The association of bisphenol-A and the risk of breast cancer among Non-Hispanic Black women living in New York, from 2023 to 2038 Kulsoom Baloch MPH(c) Faculty adviser: Dr. Chanapong Rojanaworarit Introduction
Research Design
Expected Results
Bisphenol A (BPA) is a chemical that is commonly found in many products, and more than 90% of the US population has been exposed to it. Studies suggest that exposure to BPA can disrupt the development of endocrine glands, which may increase the risk of preneoplastic or neoplastic conditions in the future when exposed to tumorinitiating or promoting regimens. 1
This will be a prospective cohort study and the outcome variable is breast cancer. Inclusion • The study population includes Non-Hispanic Black women above the age of 50 living in New York and have provided written consent. Exclusions: • Individuals with a known allergy or intolerance to bisphenol-A • Women with known BRCA gene mutation.
Breast cancer prevalence and associated bisphenol A levels
Methodology
Animal models have been used extensively in the literature to assess the health consequences of BPA, however, these researches do not lend to reach conclusions regarding a potential risk for humans, and very little information is available on exposure from consumer products.
We will first partner with primary healthcare providers and recruit participants that meet our study criteria. Patients will then be followed for 15 year for this Prospective Cohort Study.
With further research consumers could take action to lower their BPA intake and regulatory organizations such as the FDA could revise their rules and policies regarding the use of BPA in consumer products using the new information.
There will be Annual follow ups for screening mammography and urine sample collection, both done via primary healthcare provider.
Objectives and Hypotesis
79% Breast cancer positive %
Between 2007 and 2010, Black non-Hispanic women had a higher median concentration of BPA in their urine (approximately 4 µg/L) than White non-Hispanic women, Mexican-American women, and women of all other races and ethnicities.2
This study is important because there is still insufficient data from human studies to support the effects.. Therefore, the primary aim of this study is to evaluate the association of bisphenol-A and the risk of breast cancer among Non-Hispanic Black women living in New York, from 2023 to 2038. The study hypothesizes that more than 75% percent of the women screened positive for breast cancer will have levels of bisphenol A > 3 µg/L in their urine . Physicians are expected to screen for breast cancer most regularly.
Outcome / Dependent variable measurement: Breast Cancer Screening Mammograms with pathological confirmation from a physician.
• There is an association between
bisphenol-A and the risk of breast cancer among Non-Hispanic Black women living in New York. • Heat can cause BPA to leach into food or drinks, so it's best to avoid microwaving plastic containers or using plastic utensils in high-heat situations.
21% < 3 µg/L
> 3 µg/L
Bisphenol A levels in urine
• For the women with Positive Breast Cancer Outcome 79% will have urine BPA levels > 3 µg/L and only 21% with BPA levels < 3 µg/L.
79%
2X2 Table D+ = Breast D- = Breast cancer cancer + E+ = Bisphenol-A +
1472
4593
E+ = Bisphenol-A -
207 Exposure / Independent variable measurement: Bisphenol-A The concentration of BPA in a urine sample will be analyzed by using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The levels will be compared to the estimated daily intake (EDI) of 0.5 (µg/kg bw/day).
Expected Conclusion
964
• The odds of breast cancer outcome among Non-Hispanic Black women exposed to BPA is 1.49 times higher as compared to those who are not exposed [95% CI:1.27-1.75, p <0.001].
Bisphenol A exposure sources
References 1. Weber Lozada K, Keri RA. Bisphenol A Increases Mammary Cancer Risk in Two Distinct Mouse Models of Breast Cancer. Biology of Reproduction [Internet]. 2011 Jun 2 [cited 2019 Nov 16];85(3):490–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC315 9535/ 2. CDC. USCS Data Visualizations [Internet]. gis.cdc.gov. 2021. Available from: https://gis.cdc.gov/Cancer/USCS/#/AtAGlance/