Epidemiological Studies and Effects of Environmental Estrogens

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Abstract
Increases in cancer of the testis, breast, and prostate have been noted recently, and these increases have often been attributed to a ubiquitous exposure to endocrine-modulating substances. In an effort to either prove or refute these associations, morbidities of (and mortalities from) certain hormonally responsive organs are reviewed. Cancer of the breast, ovary, uterus, cervix, prostate, and testis were selected for comparison and analysis of trends in incidence and mortality. The incidences of cryptorchidism and hypospadias were selected as birth defects representative of possible effects from in utero exposure to excessive estrogens. Sperm counts and endom etriosis were selected as other possible indicators of environmental estrogen effects. Wide, sometimes orders of magnitude, variability exists between incidences in some indicators between different geographical areas and between ethnic groups. Some explanations unrelated to environmental exposures are apparent, and some observations contradict a universal exposure to the same endocrine-modulating substance. In addition, wide differences in incidences exist among virtually adjacent geographical areas and between ethnic groups living in the same geographic area. The data available at present do not lead to the conclusion that endocrine-modulating substances account for worldwide trends in these epidem iological studies.