Scientific Evidence

From Pink to Prevention has compiled a list of the scientific evidence and action on prevention

You can download Scientific Evidence as PDF here.

Download latest summary of new evidence 2017 as PDF here.

Download latest summary of new evidence 2018 as PDF here.

Breast Cancer: An Environmental Disease – the Case for Primary Prevention
Summary – Breast cancer: an environmental disease

The first UK document to pull together all the evidence to date  linking environmental risk and breast cancer was produced by the UK Working Group on Breast Cancer in 2005 (lead author and From Pink to Prevention co-founder, Diana Ward). Its evidence remains relevant and the case it argues even more so.

State of the Science of Endocrine Disrupting Chemicals  The World Health Organisation assessment of the state of the science of endocrine disruptors prepared by a group of experts for the United Nations Environment Programme (UNEP) and WHO 2012.

The Connection between Breast Cancer and the Environment
State of Evidence 2017 Paper. Gray et al. 2017. Environmental Health.

State of the Art Assessment of Endocrine Disrupters
Kortenkamp A. et al. 2011

Breast Cancer and Exposure to Hormonally Active Chemicals: An appraisal of the scientific evidence Chemtrust 2008

Reports aimed at taking action on environmental and occupational cancer risks

Reducing Environmental Cancer Risk – What we can do now. Presidents Cancer Panel Annual Report 2010

Breast Cancer and the Environment: Prioritizing Prevention
Interagency Breast Cancer and Environmental Research Coordinating Committee
(IBCERCC) February 2013

Work Cancer Prevention Kit Hazards Magazine

Late Lessons from Early Warnings – science, precaution, innovation
European Environment Agency 2013

Working Women and Breast Cancer – Review uncovers more than 20 occupations associated with considerably increased risk of breast cancer compared to the risk for the general population, including nurses, teachers, first responders and more.
Breast Cancer Fund 2015


‘Newer synthetic chemicals that have entered world markets in the past 2–3 decades and that, like their predecessors, have undergone little pre-market evaluation threaten to repeat this history. They include developmental neurotoxicants, endocrine disruptors, chemical herbicides, novel insecticides, pharmaceutical wastes, and nanomaterials. Evidence for the capacity of these emerging chemical pollutants to cause harm to human health and the environment is beginning to become evident’.

Cancer and Work Understanding occupational cancers and taking action to eliminate them (Nov 2018)
A new book from the European Trade Union Institute finds that work-related cancers costs between €270 and €610 billion a year in the EU-28. Occupational cancers are the primary cause of work-related deaths in industrialised societies, with more than 100,000 people losing their lives each year through being exposed to carcinogens in their workplace.

Occupational Health: a world of false promises
New research paper from
Joseph LaDou, Leslie London and Andrew Watterson. The WHO and ILO have limited capacity to make the necessary changes occupational health and safety demand. The UN could strengthen the national and global civil society voice in WHO and ILO structures, and by keeping conflict of interest out of policy decisions, ensure greater freedom to operate without interference.

Declarations of Note

The WHO Asturias Declaration
Environmental and Occupational Determinants of Cancer  2011

Endocrine Societies Statement

Endocrine Disrupting Chemicals in the European Union
The Collegium Ramazzini

The Berlaymont Declaration on EDCs

Resolution on Breast Cancer and Occupation – Resolution calls for action to make a national priority of promoting and supporting research on occupational and other environmental causes of breast cancer.  American Public Health Association 2014

Useful papers on the issues – including occupational risk

Breast Cancer Risk in Relation to Occupations with Exposure to Carcinogens and Endocrine Disruptors: A Canadian Case Control Study
Brophy J.T. et al. Environmental Health 11(87) (2012): 1-17

California Breast Cancer Prevention Initiatives: Setting a Research Agenda for Prevention
Sutton et al. Reproductive Toxicology 54 (2015) 11–18.

Environmental and Occupational Causes of Cancer: New Evidence 2005 – 2007
Richard Clapp, Molly Jacobs, Edward Loechler

Environmental and Occupational Interventions for Primary Prevention of Cancer: A Cross-Sectorial Policy Framework. Espina C, & Porta M, et al. Environmental Health Perspectives

Chemical Exposures of Women Working in the Plastics Industry with Particular Reference to Breast Cancer and Reproductive Hazards De Matteo et al.

Preventing Cancer through Environmental Policy Change Health and Environment Alliance (HEAL).

Endocrine Disrupting Chemicals – economic analysis – Exposure to EDCs will likely cost the EU €157 billion a year in actual health care expenses and lost earning potential.
The Endocrine Society – 2015

Assessing the carcinogenic potentail of low-dose exposures to chemcial mixtures in the environment: the challenge ahead –Understanding of the role of low-dose exposure of chemicals with disruptive potential could help us refine our approach to cancer risk assessment.   Getting to Know Cancer 2015.

SILENT SPRING INSTITUTE:  CHEMICALS & HOUSEHOLD DUST  (summer 2017) Environmental chemicals and breast cancer: An updated review of epidemiological literature.Exposure to certain chemicals in household and industrial products is a significant risk factor for breast cancer, especially when the exposure occurs at an early age.

Work and Female Breast Cancer: The State of the Evidence 2002–2017  Research paper from Connie Engel,M. Sharima Rasanayagam, Janet M. Gray and Jeanne Rizzo.
Case–control, cohort, and meta-analytic studies suggest that women working as flight attendants, in medical professions, some production positions, sales and retail, and scientific technical staff are likely to have elevated risk of breast cancer.

Useful publications 

Environment and Breast Cancer Science Reviews
Silent Spring Institute.

Continually expanding and increasingly compelling data linking radiation and various chemicals in our environment to the current high incidence of breast cancer is reviewed.  (BCPP formerly Breast Cancer Fund USA)

CDC Blog: Dr Mary White, Chief, Epidemiology and Applied Research Branch in the Division of Cancer Prevention and Control of the US Center for Disease Control (May 2020)
Blog about  primary prevention of breast cancer and forthcoming Breast Cancer Primary Prevention Plan for California. Blog explains the combination of factors that cause Breast Cancer, and that we need not only individual actions but also policy approaches.

Linking Breast Cancer and Our Environment: Politics and Prevention
Helen Lynn 2007

Industrial Carcinogens – A need for action.
Molly Jacobs and Dick Clapp.

Endocrine Society page and guides on EDCs


Brexit, EU Regulations and cancer prevention  Existing EU laws on chemicals and pesticides have already eliminated many of the most toxic chemicals and pesticides from use through  EU chemicals regulation –notably  REACH (Regulation, Evaluation, Authorisation and Restriction of Chemicals) along with other existing legislation. The EU is the first parliament in the world to try and establish criteria to control the most harmful chemicals which can affect our hormone system, known as endocrine disrupting chemicals (EDCs). For women especially, reducing exposure to toxic chemicals and EDCs is critical, as EDCs are linked to breast and other cancers and adverse health effects.  Why we need to stay within REACH

House of Commons Environmental Audit Committee and REACH (April 2017)
MPs call for post-Brexit UK to remain as close as possible to EU’s main chemicals law REACH

What they say….

In 2011 the World Health Organisation acknowledged the environmental and occupational risk factors for cancer in the Asturias Declaration originating from its conference on Environmental and Occupational Determinants of Cancer: “Primary prevention – prevention of the exposures that cause cancer – is the single most effective means of prevention”. It goes on to state that: “Prevention of the environmental and occupational exposures that cause cancer must be an integral component of cancer control worldwide.” WHO Asturias Declaration – Environmental and Occupational Determinants of Cancer.

A recent paper on environmental and occupational interventions for cancer which has as one of its authors the WHO Director of Public Health and the Environment Maria Neira, echoed the WHO call for a precautionary and preventive approach to cancer:

“Estimations show that at least one third of all cancer cases could be prevented based on current knowledge. Although preventable risk factors such as tobacco use, alcohol consumption, unhealthy diet, and physical inactivity play a major role in the development of cancer, a range of environmental factors and occupational exposures also contribute significantly to the global cancer burden. Exposures to environmental and occupational carcinogens are often preventable.”

The same paper goes on to state: “Primary prevention of cancer of environmental and occupational origin reduces cancer incidence and mortality, and is highly cost effective; in fact, it is not just socially beneficial because it reduces medical and other costs, but because it avoids many human beings suffering from cancer.”

The Lancet Oncology – Cancer risk paradox: grand plans fall short? May 2017

“But can this insatiable desire to enhance our fundamental understanding of tumour biology overshadow the health gains that could be secured by improved environmental protection? To eradicate cancer, governments need to both identify and act not only on increased risk susceptibility, but also ensure that people are not exposed to carcinogenic materials through gross environmental mismanagement”

‘Newer synthetic chemicals that have entered world markets in the past 2–3 decades and that, like their predecessors, have undergone little pre-market evaluation threaten to repeat this history…Evidence for the capacity of these emerging chemical pollutants to cause harm to human health and the environment is beginning to become evident…and this concern is heightened by the increasing movement of chemical production to low-income and middle-income countries public health and environmental protections are often scant. ‘

EU Partnership on Cancer
The European Union Partnership on Cancer supports the need to address other risk factors rather than just lifestyle: “Cancer is caused by many factors and therefore its prevention shall address on equal footing the lifestyle, occupational and environmental causes.”

Action Against Cancer: European Partnership

MEPs Against Cancer
The Members of European Parliament Against Cancer have a cancer election manifesto for 2014 which aims to strengthen cancer prevention policies in 6 areas including: environmental pollutants: air quality control and endocrine disruptors.







Stopping Breast Cancer Before It Starts. From Pink to Prevention asks breast cancer charities, government and industry to act upon the evidence linking environmental and occupational links to breast cancer.

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