Anselin, L. (2005). Exploring spatial data with GeoDa: A workbook. Revised version March 6, 2005. Center for Spatially Integrated Social Science. University of Illinois, Urbana-Champaign. Available in: http://www.csiss.org
Arnold, S.F., D.M. Klotz, B.M. Collins, P.M. Vonier, L.J. Guillete Jr., and J.A. McLachlan. (1996). Synergistic activation of estrogen receptor with combinations of environmental chemicals. Science 272: 1489-1492.
Aschengrau, A, P.F. Coogan, M.M. Quinn, and L.J. Cashins. (1998). Occupational exposure to estrogenic chemicals and the occurrence of breast cancer: An exploratory analysis. American Journal of Industrial Medicine 34: 6-14.
Band, P.R., N.D. Le, R. Fang, M. Deschamps, R.P. Gallagher, and P. Yang. (2000). Identification of occupational cancer risks in British Columbia. A population based case-control study of 995 incident breast cancer cases by menopausal status, controlling for confounding factors. Journal of Occupational and Environmental Medicine 42 (3): 284-310.
Beral, V., E. Banks, G. Reeves, P. Appleby. (1999). Use of HRT and the subsequent risk of cancer. Journal of Epidemiology and Biostatistics 4 (3):191-210.
Bernstein, L., and R. Ross. (1993). Endogenous hormones and breast cancer risk. Epidemiologic Reviews 15(1): 48-65.
Birnbaum, L.S. and S.F. Fenton. (2003). Cancer and developmental exposure to endocrine disruptors. Environmental Health Perspectives 111 (4): 389-394.
Bray, F., P. McCarron, and D.M. Parkin. (2004). The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Research 6 (6): 229-239.
Brody, J.G., A. Aschengrau, W. McKelvey, R.A. Rudel, C.H. Swartz, and T. Kennedy. (2004) Breast cancer risk and historical exposure to pesticides from wide-area applications assessed with GIS. Environmental Health Perspectives 112 (8): 889-897.
Brody, J.G. and R.A. Rudel. (2003). Environmental pollutants and breast cancer. Environmental Health Perspectives 111 (8): 1007-1019.
Brown, P., S.M. Zavestoski, S. McCormick, J. Mendelbaum, and T. Luebke. (2001). Print media coverage of environmental causes of breast cancer. Sociology of Health and Illness 23 (6): 747–75.
Castillo, L.E., E. De la Cruz, and C. Ruepert. (1997). Ecotoxicology and pesticides in tropical aquatic ecosystems of Central America. Environmental Toxicology and Chemistry 16 (1): 41-51.
Charlier, C., A. Albert, P. Herman, E. Hamoir, M. Gaspard, M. Meurisse, and G. Plomteux. (2003). Breast cancer and serum organochlorine residues. Occupational Environmental Journal 60: 348-351.
Davis, D.L. and H.L. Bradlow. (1995). Can environmental estrogens cause breast cancer? Scientific American October: 166-172.
De Bermudez, D.G. (1985). The National Tumor Registry in Costa Rica. Pan American Health Organization Epidemiological Bulletin 6: 10-13.
DeBruin, L.S. and P.D. Josephy. (2002). Perspectives on the chemical etiology of breast cancer. Environmental Health Perspectives 110 Supplement 1: 119-128.
Dolapsakis, G., I.G. Vlachonikolis, C. Varveris, and A.M. Tsatsakis. (2001). Mammographic findings and occupational exposure to pesticides currently in use on Crete. European Journal of Cancer 37: 1531- 1536.
Donabedian, A. (1973). Aspects of medical care administration. Harvard University Press. Cambridge, Massachusetts.
Dorgan, J.F., J.W. Brock, N. Rothman, L.L. Needham, R. Miller, H.E. Stephenson Jr., N. Schussler, and P.R. Taylor. (1999). Serum organochlorine pesticides and PCBs and breast cancer risk: results from a prospective analysis (USA). Cancer Causes and Control 10: 1-11.
Easton, D., D. Bishop, and D. Ford. (1993). Genetic linkage analysis in familial breast and ovarian cancer: result from 214 families. The breast cancer linkage consortium. American Journal of Human Genetics 52: 678-701.
Falck, F., A. Ricci, M. Wolff, J. Godbold, and P. Deckers. (1992). Pesticides and polychlorinated biphenyl residues in human breast lipids and their relation to breast cancer. Archives of Environmental Health 47 (2): 143-146.
Ferrante, J.M., E.C. Gonzalez, N. Pal, and R.G. Roetzheim. (2000). Effects of Physician Supply on Early Detection of Breast Cancer. Journal of the American Board of Family Practice 13: 408–14.
Ford, D., D.F. Easton, and J. Peto (1995). Estimates of the gene frequency of BRCA1 and its contribution to breast and ovarian cancer incidence. American Journal of Human Genetics 57: 1457–1462.
Gammon, M.D., R.M. Santilla, A.I. Neugut, S.M. Eng, S.L. Teitelbaum, A. Paykin et al. (2002). Environmental toxins and breast cancer on Long Island. I. Polycyclic aromatic hydrocarbon DNA adducts. Cancer Epidemiology, Biomarkers and Prevention 11: 677-685.
González M. E. (2004). Índice de rezago social. In: Costa Rica a la luz del Censo del 2000. Centro Centroamericano de Población de la Universidad de Costa Rica. Proyecto Estado de la Nación. Instituto Nacional de Estadística y Censo. Imprenta Nacional. Costa Rica.
Gordis, L. (2004). Epidemiology. Third edition. Elsevier Saunders.
Greene, W.H. (2000). Econometric analysis. Fourth Edition. Prentice Hall. New Jersey, USA.
Hopenhayn-Rich, C., M.L. Stump, and S.R. Browning. (2002). Regional Assessment of atrazine exposure and incidence of breast and ovarian cancers in Kentucky. Archives of Environmental Contamination and Toxicology 42 (1): 127-136.
Høyer, A.N., A.M. Gedes, T. Jørgensen, F. Rank, and H.B. Hartvig. (2002). Organochlorines, p53 mutations in relation to breast cancer risk and survival. A Danish cohort-nested case-control study. Breast Cancer Research and Treatment 71: 59-65.
Høyer, A.N., P. Grandjean, T. Jørgensen, J.W. Brock, and H.B. Hartvig. (2000). Repeated measures of organochlorine exposure and breast cancer risk (Denmark). Cancer Causes and Control 11: 117-184.
Høyer, A.N., T. Jørgensen, P. Grandjean, and H.B. Hartvig. (1998). Organochlorine exposure and risk of breast cancer. Lancet 352: 1816-1820.
Hulka, B., and A. Stark. (1995). Breast cancer: cause and prevention. The Lancet. London 346 (8979): 883-888.
Kelsey, J., M. Gammon, and E. John. (1993). Reproductive factors and breast cancer. Epidemiologic Reviews 15(1): 36-47.
Kennedy, P. (1998). A guide to econometrics. Fourth edition. The MIT Press. Cambridge, Massachusetts.
Kettles, M.A., S.R. Browning, T.S. Prince, and S.W. Horstman. (1997). Triazine herbicide exposure and breast cancer incidence: An ecologic study of Kentucky counties. Environmental Health Perspectives 105: 1222-1227.
Kulldorff, M., E.J. Feuer, B.A. Miller, and L.S. Freedman. (1997). Breast cancer clusters in the Northeast United States: A geographic analysis. American Journal of Epidemiology 146 (2): 161-170.
Lacey, J.V., S.S. Devesa, and L.A. Brintion. (2002). Recent trends in breast cancer incidence and mortality. Environmental and molecular mutagenesis 39: 82-88.
Laden, F., G. Collman, K. Iwamoto, A.J. Alberg, G.S. Berkowitz, J.L. Freudenheim, S.E. Hankinson, K.J. Helzouer, T.R. Holford, H. Huang, K.B. Moysich, J.D. Tessari, M.S. Wolf, T. Zheng, and D.J. Hunter. (2001a). 1,1-Dichloro-2,2-bis(p-chloro-phenyl)ethylene and polychlorinated biphenyls and breast cancer: Combined analysis of five US studies. Journal of the National Cancer Institute 93 (10): 768-776.
Laden, F., S.E. Hankinson, M.S. Wolf, G.A. Colditz, W.C. Willett, F.E. Speizer, and D.J. Hunter. (2001b). Plasma organochlorine levels and the risk of breast cancer: An extended follow-up in the nurses’ health study. International Journal of Cancer 91: 568-574.
Lee, N.C., L. Rosero-Bixby, M.W. Oberle, C. Grimaldo, A.S. Whatley, and E.Z. Rovira. (1987). A case-control study of breast cancer and hormonal contraception in Costa Rica. Journal of the National Cancer Institute 79 (6): 1247-1254.
Lichtenstein, P., N.V. Holm, P.K. Verkasalo, A. Iliadou, J. Kaprio, M. Koskenvuo, E. Pukkala, A. Skytthe, and K. Hemminki.(2000). Environmental and heritable factors in the causation of cancer. Analyses of cohorts of twins from Sweden, Denmark, and Finland. The New England Journal of Medicine 343 (2): 78-85.
López-Cervantes, M., L. Torres-Sánchez, A. Tobías, and L. López-Carrillo. (2004). Dichlorodiphenyldichloroethane burden and breast cancer risk: A meta-analysis of the epidemiologic evidence. Environmental Health Perspectives 112 (2): 207-214.
Malone, K.E., J.R. Daling, and N.S. Weiss. (1993). Oral contraceptives in relation to breast cancer. Epidemiologic Reviews 15 (1): 81-98.
Muir, K., S. Rattanamongkolgul, M. Smallman-Raynor, M. Thomas, S. Downer, and C. Jenkinson. (2004). Breast cancer incidence and its possible spatial association with pesticide application in two counties of England. Public Health. Journal of the Royal Institute of Public Health 118: 513-520.
Parkin, D.M., F.I. Bray, and S.S. Devesa. (2001). Cancer burden in the year 2000. The global picture. European Journal of Cancer 37: S4-S66.
Parkin, D.M., S.L. Whelan, and J. Ferlay. (1997).Cancer incidence in five continents. Vol. III Lyon, France: IARC Scientific Publication.
Petralia, S.A., W. Chow, J. McLaughlin, F. Jin, Y. Gao, and M. Dosemeci. (1998). Occupational risk factors for breast cancer among women in Shanghai. American Journal of Industrial Medicine 31: 477-483.
Pike, M.C., D.V. Spicer, L. Dahmoush, and M.F. Press. (1993). Estrogens, progestogens, normal cell proliferation, and breast cancer risk. Epidemiologic Reviews 15(1): 17-35.
Pisani, P., D.M. Parkin, F. Bray, and J. Ferlay. (1999). Estimates of the worldwide mortality from 25 cancers in 1990. International Journal of Cancer 83: 18-29.
Pollner, F. (1993). A holistic approach to breast cancer research. Environmental Health Perspectives 101 (2): 116-120.
Population Reference Bureau. (2005). 2005 World Population Data Sheet. Washington, DC. Population Reference Bureau.
Potts, Laura K. (2004). An epidemiology of women’s lives: the environmental risk of breast cancer. Critical Public Health: 14 (2): 133–147.
Preston, S., P. Heuveline and M. Guillot. (2001). Demography. Measuring and modeling population processes. Blackwell Publishers.
Programa Estado de la Nación. (2004). Décimo Informe Estado de la Nación en Desarrollo Humano Sostenible. San José, Costa Rica: Proyecto Estado de la Nación.
Ramírez, V and P. Cuenca. (2002). Daño del ADN en trabajadoras bananeras expuestas a plaguicidas in Limón, Costa Rica. Revista de Biología Tropical 50 (2): 507-518.
Reeves, G. (1996). Breast cancer and oral contraceptives—the evidence so far. Cancer Causes Control 7: 495–496.
Reynolds, P., S. Hurley, D. Goldberg, S. Yerabati, R. Gunier, A. Hertz, H. Anton-Culver, L. Bernstein, D. Deapen, P. Horn-Ross, D. Peel, R. Pinder, R. Ross, D. West, W. Wright, and A. Ziogas. (2004). Residential proximity to agricultural pesticide use and incidence of breast cancer in the California Teachers Study cohort. Environmental Research 96: 206-218.
Rosero-Bixby, L. (1991). Socioeconomic development, health interventions, and mortality decline in Costa Rica. Scandinavian Journal of Social Medicine Supplement N 46: 33-42.
Rosero-Bixby, L. (2004). Spatial access to health care in Costa Rica and its equity: a GIS-based study. Social Science & Medicine 58: 1271–1284.
Rosero-Bixby, L., M.W. Oberle, and N.C. Lee. (1987). Reproductive history and breast cancer in a population of high fertility, Costa Rica, 1984-85. International Journal of Cancer 40: 747-754.
Rosser, S. (2000). Controversies in breast cancer research. In: Breast Cancer. Society shapes an epidemic. Edited by Kasper A. S. and Ferguson S.J. St. Martin’s Press. New York.
Starfield, B., L. Shi, and J. Macinko. (2005). Contribution of Primary Care to Health Systems and Health. The Milbank Quarterly 83 (3): 457-502.
Sasco, A. (2003). Breast cancer and the environment. Hormone Research 60 (Suppl. 3): 50.
Shryock, H., J. Siegel, and E. Stockwell. (1976). The Methods and Materials of Demography. New York, Academic Press.
Snedeker, S.M. (2001). Pesticides and breast cancer risk: a review of DDT, DDE, and dieldrin. Environmental Health Perspectives 109: 35-47.
Steingraber, S. (1998). Living Downstream: A Scientist’s Personal Investigation of Cancer and the Environment. New York: Vintage Books.
Steingraber, S. (2000). The environmental link to breast cancer. In: Breast Cancer. Society shapes an epidemic. Edited by Kasper A. S. and Ferguson S.J. St. Martin’s Press. New York.
Steingraber, S. (2001). Having Faith: An ecologist’s journey to motherhood. Perseus Publishing. Cambridge, Massachusetts.
Timander, L.M., and McLafferty S. (1998). Breast cancer in West Islip, NY: A spatial clustering analysis with covariates. Social Science & Medicine 46 (12): 1623–1635.
Tong, S. (2000). Migration bias in ecologic studies. European Journal of Epidemiology 16 (4): 365-369.
Umaña, V. and M. Constenla. (1984). Determinación de plaguicidas organoclorados en leche materna en Costa Rica. Revista de Biología Tropical 32 (2): 233-239.
U.S. Department of Health and Human Services. (2003). Cancer and the Environment. National Institutes of Health. National Cancer Institute. NIH Publication No. 03-2039.
Wesseling, C. (1997). Health effects from pesticide use in Costa Rica. An epidemiologic approach. Kongl Carolinska Medico Chirurgiska Institutet. Gotab Tryckeri, Stockholm.
Wesseling, C., D. Antich, C. Hodgsted, A.C. Rodríguez, and A. Ahlbom. (1999). Geographical differences of cancer incidence in Costa Rica in relation to environmental and occupational pesticide exposure. International Journal of Epidemiology 28: 365-374.
Writing Group for the Women’s Health Initiative Investigators. (2002). Risks and benefits of estrogen plus progestin in healthy postmenopausal women. JAMA 288 (3): 321-332.
Zheng, T., T.R. Holford, S.T. Mayne, B. Ward, D. Carter, P.H. Owens, R. Dubrow, S.H. Zahm, P. Boyle, S. Archibeque, and J. Tessari. (1999). DDE and DDT in breast adipose tissue and risk of female breast cancer. American Journal of Epidemiology 150 (5): 453-458 S1.
© Población y Salud en Mesoamérica, 2016
Candidata a PhD en Sociología/Demografía, University of Wisconsin-Madison
The Impact of Pesticide Exposure on Breast Cancer Incidence. Evidence from Costa Rica
Volumen 7, Número 1: julio-diciembre 2009
Publicado: Jul 1, 2009
Introduction: Breast cancer (BC) is the most prevalent and the leading cause of death from cancer in women worldwide. The low percentage of cases related to reproductive history risk factors and to genetics suggests that the environment may play a role in its etiology. Pesticide exposure has been hypothesized to have an important effect. Objective: This ecological study tests whether BC incidence in Costa Rica is related to pesticide environmental exposure (PEE), controlling for access to health care, fertility, age at first pregnancy, and socioeconomic status. Methods: A Poisson regression model was run. Spatial analysis techniques to test for spatial autocorrelation, and geographically weighted regressions were used. Results: PEE had a statistically significant direct association with BC for women 45 yrs+. The corresponding incidence rate ratio for PEE was 1.29. This means that after controlling for other risk factors, moving a district to the next decile of PEE was associated with 29% increase in BC incidence for women 45+. PEE was significant in some rural and agricultural areas of the country, after controlling for other risk factors. Conclusions: There seems to be an actual relation between breast cancer and pesticides. Since it is a preventable risk factor, this is an important public health issue to be debated. Paying more attention to health consequences that derivate from environmental exposure would imply a shift toward the application of the precautionary principle. Conclusions about causality can not be drawn from an ecologic approach, like the one taken in this study.