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Review article
Non-dietary environmental risk factors in prostate cancer
Factores de riesgo ambientales no dietéticos en el cáncer de próstata
J. Ferrís-i-Tortajadaa,
Corresponding author
ferris_jos@gva.es

Corresponding author.
, O. Berbel-Tornerob, J. Garcia-i-Castellc, J.A. López-Andreud, E. Sobrino-Najule, J.A. Ortega-Garcíaf
a Unidad de Salud Medioambiental Pediátrica, Unidad de Oncología Pediátrica, Hospital Infantil Universitario La Fe, Valencia, Spain
b Centro de Salud de Chella, Chella, Valencia, Spain
c Sección de Anatomía Patológica, Hospital de Sagunt, Valencia, Spain
d Sección de Neumología Pediátrica, Hospital Infantil Universitario La Fe, Valencia, Spain
e Mount Sinai International Exchange Program, Department Medicine Preventive, Nueva York, United States
f Unidad de Salud Medioambiental Pediátrica, Hospital Materno-Infantil Universitario Virgen de la Arrixaca, Murcia, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">In Western countries prostate cancer is a major medical problem due to its high incidence and significant mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> For these reasons&#44; primary prevention reduces not only the considerable economic burden of diagnosis and treatment but it also the enormous emotional stress of patients and their family and social environment&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> To this end&#44; we must progress in our current understanding of the risk factors involved in its etiopathogenesis&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In this paper&#44; we carry out an updated review of the main non-dietary environmental risk factors associated with prostate cancer&#44; with varying degrees of scientific consistency&#44; in accordance with our bibliographic research&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Smoking</span><p id="par0015" class="elsevierStylePara elsevierViewall">Active and passive exposures to smoke from burning tobacco are considered a carcinogen for many human cancers&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In spite of this&#44; the process for establishing its causal association with prostate cancer has been slow&#46; With respect to its incidence&#44; most epidemiological studies<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> have not established a causal relationship between tobacco and the disease&#46; Case&#8211;control studies have not found a relationship between the various variables of smoking and the incidence of the disease&#46; However&#44; some cohort studies documented a 2&#8211;3 times higher risk in smokers of more than a pack a day compared with nonsmokers&#46; However&#44; these studies have not demonstrated a convincing dose&#8211;response relationship&#44; neither have they evaluated the influence of possible dietary risk factors that are confusing&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Regarding mortality&#44; the association has been more consistently documented&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#8211;6</span></a> Several cohort studies have established a direct relationship between smoking and higher mortality due to prostate cancer&#46; Smoking patients double the risk of dying from the disease compared to nonsmokers&#46; Most authors found a gradual risk in relation to the number of cigarettes smoked daily and years one has been smoking&#46; However&#44; a convincing article documented a dose&#8211;response relationship between the number of packs per year of the smoker 10<span class="elsevierStyleHsp" style=""></span>years before diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Although in several studies ex-smokers did not seem to have a higher risk of dying from prostate cancer&#44; one study documented adverse effects on mortality until a decade after cessation of smoking&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">A recently published meta-analysis provides convincing data and statistically significant causal association between exposure to tobacco smoke and the increased incidence and mortality of prostate cancer&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Analyzing 24 epidemiological cohort studies including 21&#44;579 patients&#44; it was found that when stratified by number of cigarettes smoked&#44; current smokers had a higher risk of between 11&#37; and 22&#37; compared to those who had never smoked&#44; and of 9&#37; compared to ex-smokers&#59; these differences were statistically significant&#46; Mortality in active smokers showed statistically significant differences&#44; with an increased risk of 14&#37; compared to those who had never smoked&#44; which increased to 24&#37; and 30&#37; for the most addicted&#46; The authors commented that probably because of their lower case material&#44; studies carried out previous underestimated the true influence of smoking on the incidence and mortality of prostate cancer&#46; They also recommended the need to design studies to review prognosis variables &#40;tumor stage and grade&#41; and medical history of smoking&#44; both in smokers and former smokers&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The causal association with prostate cancer is biologically plausible because smoke carcinogens from tobacco act directly&#44; causing DNA mutations&#44; and indirectly&#44; causing alterations in hormone metabolism&#46; Some authors have found interactions between smoking and certain genetic polymorphisms associated with increased risk of prostate cancer&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Prostatic infectious-inflammatory factors</span><p id="par0035" class="elsevierStylePara elsevierViewall">Substantial epidemiological&#44; genetic&#44; histological and molecular biology data shows the influence of prostate infection and consequent chronic inflammation in the pathogenesis and progression of prostate cancer&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4&#44;8</span></a> Potentially&#44; infectious agents can influence carcinogenesis through the following mechanisms&#58; &#40;a&#41; incorporation of viral oncogenes in the genome of the carrier&#44; &#40;b&#41; inhibition of tumor suppressor genes&#44; &#40;c&#41; stimulation of proliferative signals&#44; and &#40;d&#41; by suppression of the immune surveillance system&#46; Although chronic prostatitis caused by sexually transmitted diseases is associated with increased prostate cancer risk and poorer outcome in treatment&#44; to date&#44; no specific infectious agent has been convincingly associated as a causal agent of the disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;8</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Human papillomavirus &#40;HPV&#41; has received greater attention due to its association with genitourinary cancers&#44; but its real contribution to prostate cancer is controversial&#46; While some authors have found no association&#44; others have implicated type 16&#44; which corresponds to the variety most linked to anogenital cancers&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Trichomonas vaginalis</span> infection causes adherence of the protozoan to epithelial cells by decreasing the expression of anti-apoptotic genes&#59; it also alters the production of interleukin 6 and monocyte chemotaxis proteins&#46; An extensive case&#8211;control study documented that HIV-positive persons had a statistically significant increase of 43&#37; of prostate cancer &#40;95&#37; CI 1&#46;00&#8211;2&#46;03&#41; and a 76&#37; increase in high histological grade &#40;95&#37; CI 2&#46;97&#8211;3&#46;18&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">A gammarretrovirus denominated XMRV has recently been identified in radical prostatectomy specimens&#46; Its persistence in mesenchymal stromal cells adjacent to the neoplastic glands is associated with genetic polymorphism R426Q RNASEL&#46; Possible etiopathogenic action would relate to signs and cell transduction pathways between the stroma and the epithelium&#46; If it were ultimately categorized as an oncogenic virus&#44; obtaining a specific vaccine would prevent the number of cases of prostate cancers associated with XMRV&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Cadmium</span><p id="par0055" class="elsevierStylePara elsevierViewall">During the decades of the 70s and 80s in the twentieth century&#44; some researchers provided evidence on the increased risk of prostate cancer among men occupationally exposed to cadmium &#40;Cd&#41;&#46; Subsequently&#44; a review of the International Agency for Research on Cancer and a meta-analysis of 29 epidemiological studies documented a slight&#44; not statistically significant increase in the incidence of prostate cancer associated with exposure to Cd&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a> Toxicologically&#44; a higher tissular concentration of Cd has been found in prostate cancer compared with benign prostatic hypertrophy&#44; with greater amounts in cancers of a higher histological grade&#46; The potentially carcinogenic effect of Cd can be modified by zinc&#44; since both have antagonistic effects on the prostate&#46; Neoplastic tissue has a lower ratio of zinc&#47;Cd than a normal prostate&#44; suggesting that&#58; &#40;a&#41; a high content of zinc in the prostate may protect against carcinogenesis&#44; &#40;b&#41; Cd can act as a weak prostatic carcinogen and is enhanced by a zinc deficiency and&#44; &#40;c&#41; the inability of the prostate to maintain appropriate zinc homeostasis may favor Cd-induced carcinogenesis&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Herbicides</span><p id="par0060" class="elsevierStylePara elsevierViewall">These are active chemical compounds that are used to fight plant pests&#46; Agent Orange is a mixture of two herbicides that were used as a defoliant between 1962 and 1971 in the Vietnam War&#46; In 1998&#44; the National Academy of Science of the USA recognized a positive association between herbicide exposure and many human cancers&#44; but its association with prostate cancer was considered limited and not conclusive&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> More recent studies suggest a more consistent association&#46; In a review published in 2008&#44; in which 6214 veterans of the Vietnam War were exposed to the herbicide and compared with 6930 non-exposed veterans&#44; the authors found twice as many cases of prostate cancer among the exposed veterans &#40;239 vs&#46; 124&#41;&#44; with earlier diagnostic ages&#44; as well as an increased risk of presenting a Gleason score of 8&#8211;10 &#40;21&#46;8&#37; vs&#46; 10&#46;5&#37;&#41; and greater likelihood of metastatic disease among exposed veterans &#40;13&#46;4&#37; vs&#46; 4&#37;&#41;&#46; Additionally&#44; the authors found no differences between the groups with respect to age&#44; smoking&#44; body mass index&#44; exposure to finasteride and PSA levels&#46; In a multivariate logistic regression model&#44; Agent Orange was the most predictive factor not only of developing prostate cancer but also of a higher histological grade and a greater probability of metastatic disease at diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Pesticides</span><p id="par0065" class="elsevierStylePara elsevierViewall">They are chemical compounds used to fight animal pests&#46; The difficulties in interpreting the risks associated with prostate cancer lie in the existence of hundreds of different active principles&#44; as well as in the direct chronic and multiple exposure to them in low doses&#44; and particularly indirect exposure&#44; through food&#44; water&#44; air and the environment&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Since the end of the 60s&#44; ecological studies based on deaths showed mortality rates for some cancers&#44; including prostate cancer&#44; which were significantly higher in rural areas of North America&#44; whereas the overall cancer mortality rates were lower in urban areas&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In the decade of the 90s&#44; three meta-analyses<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#8211;19</span></a> documented increased risk&#44; 7&#37;&#44; 8&#37; and 12&#37; respectively&#44; both in the incidence and mortality of prostate cancer in rural areas with high agricultural activity in the U&#46;S&#46; compared with the general population in other areas&#46; However&#44; living in a rural area is not synonymous with the use of pesticides&#44; as potentially&#44; many risk factors related to lifestyle&#44; exposures to other chemicals and biological contaminants are involved&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">In the last decade&#44; three meta-analyses have analyzed the use of pesticides in the professional environment&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#8211;22</span></a> One of them focused on both agricultural and nonagricultural pesticide users&#44; except workers in production facilities&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> Overall&#44; they found a statistically significant and 13&#37; higher risk in pesticide applicators &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;13&#44; 95&#37; CI 1&#46;04&#8211;1&#46;22&#41;&#46; The second meta-analysis<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> focused on pesticide applicators and also found a statistically significant and 12&#37; higher risk of prostate cancer &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;12&#44; 95&#37; CI 1&#46;03&#8211;1&#46;22&#41;&#46; The third meta-analysis<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> focused on production facility workers and demonstrated a statistically significant and 28&#37; higher risk of developing the disease &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;28&#44; 95&#37; CI 1&#46;05&#8211;1&#46;58&#41;&#46; Moreover&#44; after grouping pesticides by chemical group&#44; they found consistent increases in all the groups&#44; however without statistically significant differences&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">Agricultural Health Study</span><a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> conducted in the U&#46;S&#46; between 1993 and 2002&#44; is one of the largest prospective cohort studies &#40;89&#44;658 people&#41;&#46; It reported a 14&#37; higher risk of prostate cancer among men who used pesticides&#44; as well as three other significant associations between pesticide use and the risk of prostate cancer&#46; On the one hand&#44; a relationship was found between the application of methyl bromide&#44; an alkylating agent classified as a potential occupational carcinogen by the National Institute for Occupational Safety and Health and the risk of prostate cancer&#44; both in well-differentiated and poorly differentiated tumors&#46; Moreover&#44; a direct relationship was found with the use of organochlorine pesticides&#44; including DDT and heptachlor&#44; but only in those over aged 50<span class="elsevierStyleHsp" style=""></span>years&#46; A statistically significant association was found with the use of various pesticides only men with a family history of prostate cancer&#46; All this data suggest that exposure to certain pesticides must interact with genetic risk factors&#44; and for several decades&#44; in order to promote prostate carcinogenesis&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Vasectomy</span><p id="par0085" class="elsevierStylePara elsevierViewall">Case&#8211;control and cohort studies that have analyzed the association between vasectomy and prostate cancer risk have produced conflicting results&#46; Some authors found increased risks of 40&#37;&#44; 60&#37; and 70&#37; with vasectomy&#44; but others found a lesser risk of developing prostate cancer among vasectomized men&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;24&#44;25</span></a> In the latter&#44; there is a greater risk among those who were vasectomized before the age of 20<span class="elsevierStyleHsp" style=""></span>years prior to the study and those who were vasectomized under the age of 35&#8211;40<span class="elsevierStyleHsp" style=""></span>years of age&#46; A meta-analysis in this regard documents an OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;1 &#40;95&#37; CI 0&#46;9&#8211;1&#46;4&#41; for cancer risk with vasectomy&#44; but suggested increased risk among those with a positive family history and those who were operated at earlier ages&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> On the other hand&#44; in a very well designed study conducted in New Zealand&#44; the country with the highest global prevalence of vasectomy&#44; the authors found no relationship with these subgroups&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Socioeconomic factors</span><p id="par0090" class="elsevierStylePara elsevierViewall">All social factors&#44; including economic&#44; lifestyle and educational and academic factors&#44; do not&#44; <span class="elsevierStyleItalic">per se</span>&#44; seem to directly influence the risk of developing prostate cancer&#46; Notwithstanding&#44; they are indirectly involved by influencing dietary factors&#44; occupational exposure and access to health systems&#44; both for early detection and appropriate treatment&#44; and they undoubtedly influence the incidence and mortality of this disease&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Sexual activity and marital status</span><p id="par0095" class="elsevierStylePara elsevierViewall">The influence of sexual activity and marital status in the development of prostate cancer has been studied extensively&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Probably&#44; their hypothetical relationship would be subject to the influence of inherent hormonal&#44; infectious and cultural factors&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Several studies have found increased risk of prostate cancer in men with multiple sexual partners and early commencement of sexual activity&#46; However&#44; other authors have documented a lower risk with high sexual activity and early commencement of it&#46; Marital status is not associated with an increased mortality risk of the disease&#44; but some authors have found increased risk among young married couples compared with older couples&#44; as well as increased risk among married couples in comparison with single men&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Other occupational exposures</span><p id="par0105" class="elsevierStylePara elsevierViewall">A cohort study conducted on workers exposed to polychlorinated biphenyls &#40;PCBs&#41; showed a positive trend between incidence and mortality of prostate cancer&#44; with dose and cumulative duration of exposure&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> Another study that examined the levels of PCBs in adipose tissue revealed an association with prostate cancer &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;15&#44; 95&#37; CI 1&#46;04&#8211;9&#46;54&#41;&#44; which was higher &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#46;3&#44; 95&#37; 3&#46;24&#8211;284&#41; among men with PSA levels<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>16&#46;5<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a><span class="elsevierStyleItalic">The Netherlands Cohort Study</span><a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> revealed a slight increase of the disease in relation to exposure to metal fumes &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;11&#44; 95&#37; CI 0&#46;80&#8211;1&#46;54&#41;&#44; which findings are similar to those obtained in a case&#8211;control study in Australia&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> The association between exposure to mineral oils and the risk of the disease has also been analyzed&#46; Increased risk has been reported after exposure exceeding 5<span class="elsevierStyleHsp" style=""></span>years&#44; and was statistically significant in workers exposed from puberty&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">In a case&#8211;control study focused on exposure to polycyclic aromatic hydrocarbons &#40;PAHs&#41;&#44; there was no evidence of any significant increase prostate cancer risk in relation to cumulative exposure to different occupational exposures&#44; although the risk was high in exposure due to inhalation of PAHs in petroleum &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;12&#44; 95&#37; CI 0&#46;73&#8211;1&#46;73&#41; or coal &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;29&#44; 95&#37; CI 0&#46;73&#8211;2&#46;30&#41; and in skin exposure to coal &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;48&#44; 95&#37; CI 0&#46;68&#8211;3&#46;20&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> However&#44; in this study&#44; an interaction was identified between genetic and environmental factors&#44; showing that men over 60 who had the GSTP1 Val genetic polymorphism&#44; who were exposed to high levels of PAHs&#44; had a significantly higher risk &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;52&#44; 95&#37; CI 1&#46;96&#8211;10&#46;41&#41;&#46; Evidence from other studies on exposure to PAHs and prostate cancer is less convincing&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;32</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Evidence on the risk associated with solvents is limited&#46; A case&#8211;control study found a significant dose&#8211;response trend of prostate cancer among workers with low to moderate exposure &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;3 95&#37; CI 0&#46;8&#8211;2&#46;1&#41; and high levels of trichlorethylene &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;1&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Other authors that analyzed various occupations and occupational exposure in relation to the risk of prostate cancer found significant increases in firefighters &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;22&#44; 95&#37; CI 1&#46;12&#8211;1&#46;33&#41;&#44; oil workers and workers at semiconductor facilities&#47;laboratories&#46; A meta-analysis found increased risk among commercial pilots&#46; Other studies have associated the risk of prostate cancer with paints&#44; varnishes&#44; soaps and perfumes&#44; leather manufacture&#44; exposure to electromagnetic fields&#44; electricity workers&#44; teachers&#44; police and forestry workers&#44; although other studies did not obtain the same results&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> Some authors have analyzed the vibrations that the body experiences when certain jobs are performed and in relation to different modes of transport&#44; but have not found a convincing association&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Chemoprevention</span><p id="par0125" class="elsevierStylePara elsevierViewall">The administration of drugs to reduce the risk of prostate cancer is a subject of much study and great interest&#46; Chemoprevention must be safe&#44; maintain quality of life&#44; decrease the incidence&#44; impact and severity of the disease and be economically feasible&#46; Of the drugs that have demonstrated greater scientific evidence in clinical trials&#44; worth mention are inhibitors of the enzyme 5-&#945; reductase&#44; which converts testosterone into dihydrotestosterone and of which two isoforms exist&#44; type 1 and type 2&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">In the <span class="elsevierStyleItalic">Prostate Cancer Prevention Trial &#40;PCPT&#41;</span>&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> 18&#44;882 men aged as of 55<span class="elsevierStyleHsp" style=""></span>years&#44; with normal DRE and PSA equal to or less than 3<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#44; were assigned to receive finasteride for 7<span class="elsevierStyleHsp" style=""></span>years &#40;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41;&#44; which inhibits 5-&#945; reductase type 2&#44; or placebo&#46; Prostate cancer was detected in 803 of 4308 men in the finasteride group&#44; compared with 1147 out of 4692 in the placebo group&#44; thus showing a reduction in the risk of disease from 24&#46;8&#37; &#40;95&#37; CI 18&#46;6&#8211;30&#46;6&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Unexpectedly&#44; there was an increase in the incidence of high-grade prostate cancer in the finasteride group compared with the placebo group &#40;37&#37; vs&#46; 23&#46;2&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; although later studies have not demonstrated that hormonal changes caused by finasteride enhance the development of aggressive disease&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">In the <span class="elsevierStyleItalic">Reduction by Dutasteride of Prostate Cancer Events &#40;REDUCE&#41;</span>&#44;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> 6729 men aged from 50 to 75<span class="elsevierStyleHsp" style=""></span>years&#44; with serum PSA levels of 2&#46;5&#8211;10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#44; and prior negative biopsy&#44; were assigned to receive dutasteride for 4<span class="elsevierStyleHsp" style=""></span>years &#40;0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41; or placebo&#46; The findings&#44; published in 2010&#44; show that dutasteride &#40;0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41; reduced the risk of prostate cancer risk in a risk population by 22&#46;8&#37; &#40;95&#37; CI 15&#46;2&#8211;29&#46;8&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; compared with placebo&#46; Dutasteride is a powerful inhibitor of 5-&#945; reductase and is 45 times stronger than finasteride in inhibiting type 1 isoform and twice as strong on isoform 2&#46; No doubt that this is a promising drug in the prevention of prostate cancer on the risk population&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Based on models that show that estrogens have synergy with androgens to induce prostatic hyperplasia&#44; dysplasia and cancer&#44; the role of the modulators of these receptors has been investigated&#46; Toremifene&#44; a selective modulator of estrogen receptors&#44; is being evaluated at doses of 20<span class="elsevierStyleHsp" style=""></span>mg in a multicenter randomized double-blind&#44; placebo-controlled study in men with high grade intraepithelial neoplasia&#44; to assess the reduction in the incidence of prostate cancer at 12<span class="elsevierStyleHsp" style=""></span>months after initiation of the study &#40;9&#46;1 vs&#46; 17&#46;4&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">Initial studies with statins &#40;inhibitors of the enzyme 3-hydroxy-3-methylglutaryl coenzyme A&#41; suggested a reduction in the risk of prostate cancer&#59; however&#44; different subsequent meta-analyses did not find this reduction&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a> Better-designed studies are required to assess the true effect of these agents&#46; Likewise&#44; trials carried out with inhibitors of cyclooxygenase &#40;COX-2&#41; have not documented an actual reduction in risk&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a> COX-2 enzyme is involved in inflammatory processes&#59; it promotes angiogenesis and modulates apoptosis&#46; The significant side effects of these drugs at cardiac and cerebrovascular levels make it unlikely that further studies be carried out with these agents&#46; Other studies performed with supplements with selenium and vitamin E &#40;SELECT study&#41;&#44; vitamin C or folic acid&#44; compared with placebo showed no significant reduction in the risk of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Electromagnetic radiation</span><p id="par0150" class="elsevierStylePara elsevierViewall">Although it presented greater relative risks than expected in unexposed controls&#44; the association between ionizing radiation and prostate cancer&#44; there were no statistically significant increases&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">Exposure to solar UV radiation is inversely associated with both the incidence and mortality of prostate cancer&#46; The biological explanation of this fact is based on the synthesis and physiological actions of vitamin D&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">39&#44;40</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Final comments</span><p id="par0160" class="elsevierStylePara elsevierViewall">Prostate cancer represents the ideal prototype of the slow process of carcinogenesis and the necessary coexistence of constitutional risk factors with environmental risk factors for developing the disease environment&#46; The fact that multiple factors are necessary means that when we analyze a single factor&#44; most of the times we obtain contradictory results or increased risk without statistical significance&#46; We see the most tangible example in exposure to tobacco smoke&#44; given that numerous studies published with disparate results would need a meta-analysis to be performed using extensive patient case material to be able to convincingly determine its causal role&#46; The same occurs with occupational exposure to pesticides&#44; which&#44; in order to obtain statistically significant data&#44; has required large case studies&#46; Even then&#44; its association has only been able to be documented in men aged over 50<span class="elsevierStyleHsp" style=""></span>years with a family history of prostate cancer&#46; Finally&#44; we would like to point out the promising results that are being obtained with chemoprevention and which heralds its future administration to healthy population subgroups as primary prevention&#44; and to prostrate cancer patients for tertiary prevention&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span></span>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The aim is to update and disclose the main environmental risk factors&#44; excluding dietary factors&#44; involved in the etiopathology of prostate cancer&#46;</p> <span class="elsevierStyleSectionTitle">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Bibliographic review of the last 25<span class="elsevierStyleHsp" style=""></span>years of non-dietary environmental risk factors associated with prostate cancer between 1985 and 2010&#44; obtained from <span class="elsevierStyleItalic">MedLine</span>&#44; <span class="elsevierStyleItalic">CancerLit</span>&#44; <span class="elsevierStyleItalic">Science Citation Index</span> and <span class="elsevierStyleItalic">Embase</span>&#46; The search profiles were <span class="elsevierStyleItalic">Environmental Risk Factors&#47;Tobacco&#47;Infectious-Inflammatory Factors&#47;Pesticides&#47;Vasectomy&#47;Occupational Exposures&#47;Chemoprevention Agents&#47;Radiation and Prostate Cancer</span>&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">While some non-dietary environmental risk factors increase the risk of acquiring the disease&#44; others decrease it&#46; Of the former&#44; it is worth mentioning exposal to tobacco smoke&#44; chronic infectious-inflammatory prostatic processes and occupational exposure to cadmium&#44; herbicides and pesticides&#46; The first factors that reduce the risk are the use of chemopreventive drugs &#40;Finasterida&#44; Dutasteride&#41; and exposure to ultraviolet solar radiation&#46; With the current data&#44; a vasectomy does not influence the risk of developing the disease&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The slow process of prostate carcinogenesis is the final result of the interaction of constitutional risk and environmental factors&#46; Non-dietary environmental factors play an important role in the etiopathology of this disease&#46; To appropriately assess the risk factors&#44; extensive case studies that include all the possible variables must be analyzed&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se pretende actualizar y divulgar los principales factores de riesgo ambientales&#44; excluyendo los diet&#233;ticos&#44; implicados en la etiopatogenia del c&#225;ncer de pr&#243;stata&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Revisi&#243;n bibliogr&#225;fica de los &#250;ltimos 25 a&#241;os de los factores de riesgo ambientales no diet&#233;ticos asociados a c&#225;ncer de pr&#243;stata entre 1985 y 2010&#44; obtenida del <span class="elsevierStyleItalic">MedLine&#44; CancerLit&#44; Science Citation Index</span> y <span class="elsevierStyleItalic">Embase</span>&#46; Los perfiles de b&#250;squeda han sido <span class="elsevierStyleItalic">Environmental Risk Factors&#47;Tobacco&#47;Infectious-Inlammation Factors&#47;Pesticides&#47;Vasectomy&#47;Occupational Exposures&#47;Chemoprevention Agents&#47;Radiation y</span> &#171;C&#225;ncer de Pr&#243;stata&#187;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Mientras que algunos factores de riesgo ambientales no diet&#233;ticos incrementan el riesgo de padecer la enfermedad&#44; otros lo disminuyen&#46; Entre los primeros destacan la exposici&#243;n al humo del tabaco&#59; los procesos prost&#225;ticos infecto-inflamatorios cr&#243;nicos y la exposici&#243;n profesional al cadmio&#44; herbicidas y pesticidas&#46; Los principales factores que reducen el riesgo es el empleo de f&#225;rmacos quimiopreventivos &#40;finasterida&#44; dutasterida&#41; y la exposici&#243;n a la radiaci&#243;n ultravioleta solar&#46; La vasectom&#237;a&#44; con los datos actuales&#44; no influye en el riesgo de desarrollar la enfermedad&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El lento proceso de carcinog&#233;nesis prost&#225;tica es el resultado final de la interacci&#243;n de factores de riesgo constitucionales y ambientales&#46; Los factores ambientales no diet&#233;ticos desempe&#241;an un papel importante en la etiopatogenia de esta enfermedad&#46; Para valorar apropiadamente los factores de riesgo deben analizarse grandes casu&#237;sticas que incluyan todas las variables posibles&#46;</p>"
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        0 => array:2 [
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            0 => array:3 [
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              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "World cancer report 2008&#46; World Health Organization"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Boyle"
                            1 => "B&#46; Levin"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2008"
                        "editorial" => "WHO-IARC Publ"
                        "editorialLocalizacion" => "Lyon"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment costs of prostate cancer in the first year after diagnosisis&#58; a short-term cost of illness study for France&#44; Germany&#44; Italy&#44; Spain and UK"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;O&#46; Fourcade"
                            1 => "A&#46; Benedict"
                            2 => "L&#46;K&#46; Black"
                            3 => "M&#46;E&#46; Stokes"
                            4 => "A&#46; Alcaraz"
                            5 => "R&#46; Castro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1464-410X.2009.08716.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "BJU Int"
                        "fecha" => "2010"
                        "volumen" => "105"
                        "paginaInicial" => "49"
                        "paginaFinal" => "56"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20132102"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "IARC monographs on the evaluation of carcinogenic risks in human"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "International Agency for Research on Cancer &#40;IARC&#41;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2004"
                        "editorial" => "IARC Press"
                        "editorialLocalizacion" => "Lyon&#44; Francia"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prostate Cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;A&#46; Platz"
                            1 => "E&#46; Giovannucci"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Cancer epidemiology and prevention"
                        "paginaInicial" => "1128"
                        "paginaFinal" => "1150"
                        "edicion" => "3&#46;&#170; ed&#46;"
                        "serieFecha" => "2006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of smoking&#44; body mass&#44; and physical activity with risk of prostate cancer in the Iowa 65&#43; Rural Health Study &#40;United States&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;R&#46; Cerhan"
                            1 => "J&#46;C&#46; Torner"
                            2 => "C&#46;F&#46; Lynch"
                            3 => "L&#46;M&#46; Rubenstein"
                            4 => "J&#46;H&#46; Lemke"
                            5 => "M&#46;B&#46; Cohen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Causes Control"
                        "fecha" => "1997"
                        "volumen" => "8"
                        "paginaInicial" => "229"
                        "paginaFinal" => "238"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9134247"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking and risk of total and fatal prostate cancer in United States health professionals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Giovannucci"
                            1 => "E&#46;B&#46; Rimm"
                            2 => "A&#46; Ascherio"
                            3 => "G&#46;A&#46; Colditz"
                            4 => "D&#46; Spiegelman"
                            5 => "M&#46;J&#46; Stampfer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Epidemiol Biomarkers Prev"
                        "fecha" => "1999"
                        "volumen" => "8"
                        "paginaInicial" => "277"
                        "paginaFinal" => "282"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10207628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking as a risk factor for prostate cancer&#58; a meta-analysis of 24 prospective cohort studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Huncharek"
                            1 => "K&#46;S&#46; Haddock"
                            2 => "B&#46; Kupelnick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2105/AJPH.2008.150508"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Public Health"
                        "fecha" => "2010"
                        "volumen" => "100"
                        "paginaInicial" => "693"
                        "paginaFinal" => "701"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19608952"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of inflammation and infection in the pathogenesis of prostate carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;M&#46; Wagenlehner"
                            1 => "J&#46;E&#46; Elkahwaji"
                            2 => "F&#46; Algaba"
                            3 => "T&#46; Bjerklund-Johansen"
                            4 => "K&#46;G&#46; Naber"
                            5 => "R&#46; Hartung"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1464-410X.2007.07091.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "BJU Int"
                        "fecha" => "2007"
                        "volumen" => "100"
                        "paginaInicial" => "733"
                        "paginaFinal" => "737"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17662075"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0045"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                          "autores" => array:1 [
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                ]
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              "referencia" => array:1 [
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                    0 => array:2 [
                      "titulo" => "XMRV is present in malignant prostatic epithelium and is associated with prostate cancer&#44; especially high-grade tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Schlaberg"
                            1 => "D&#46;J&#46; Choe"
                            2 => "K&#46;R&#46; Brown"
                            3 => "H&#46;M&#46; Thaker"
                            4 => "I&#46;R&#46; Singh"
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                        ]
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1073/pnas.0906922106"
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc Natl Acad Sci USA"
                        "fecha" => "2009"
                        "volumen" => "106"
                        "paginaInicial" => "16351"
                        "paginaFinal" => "16356"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19805305"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Plasma antibodies against Trichomonas vaginalis and subsequent risk of prostate cancer"
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                          "etal" => true
                          "autores" => array:6 [
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                            1 => "E&#46; Giovannucci"
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                            3 => "T&#46;H&#46; Chang"
                            4 => "C&#46;A&#46; Gaydos"
                            5 => "J&#46;M&#46; Zenilman"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1158/1055-9965.EPI-05-0781"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Epidemiol Biomarkers Prev"
                        "fecha" => "2006"
                        "volumen" => "15"
                        "paginaInicial" => "939"
                        "paginaFinal" => "945"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16702374"
                            "web" => "Medline"
                          ]
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              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "IARC Scientific Publication No 118&#46; Cadmium in the human environment&#58; toxicity and carcinogenicity"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "International Agency for Research on Cancer &#40;IARC&#41;"
                          ]
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                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1992"
                        "editorial" => "IARC Press"
                        "editorialLocalizacion" => "Lyon"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cadmium and prostate cancer&#58; a critical epidemiologic analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;E&#46; Sahmoun"
                            1 => "L&#46;D&#46; Case"
                            2 => "S&#46;A&#46; Jackson"
                            3 => "G&#46;G&#46; Schwartz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Invest"
                        "fecha" => "2005"
                        "volumen" => "23"
                        "paginaInicial" => "256"
                        "paginaFinal" => "263"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15945511"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cadmium burden and the risk and phenotype of prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46;C&#46; Chen"
                            1 => "Y&#46;S&#46; Pu"
                            2 => "H&#46;C&#46; Wu"
                            3 => "T&#46; Tony"
                            4 => "T&#46;T&#46; Wu"
                            5 => "M&#46;K&#46; Lai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2407-9-429"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Cancer"
                        "fecha" => "2009"
                        "volumen" => "9"
                        "paginaInicial" => "429"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20003241"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Agent orange and cancer&#58; an overview for clinicians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Frumkin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "CA Cancer J Clin"
                        "fecha" => "2003"
                        "volumen" => "53"
                        "paginaInicial" => "245"
                        "paginaFinal" => "255"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12924777"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Editorial comment on&#58; agent orange exposure&#44; vietnam war veterans&#44; and the risk of prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;R&#46; Shah"
                            1 => "M&#46;K&#46; Terris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cncr.23696"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "2008"
                        "volumen" => "113"
                        "paginaInicial" => "2382"
                        "paginaFinal" => "2384"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18661514"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clues to cancer etiology from studies of farmers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Blair"
                            1 => "S&#46;H&#46; Zahm"
                            2 => "N&#46;E&#46; Pearce"
                            3 => "E&#46;F&#46; Heineman"
                            4 => "J&#46;F&#46; Fraumeni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Scand J Work Environ Health"
                        "fecha" => "1992"
                        "volumen" => "18"
                        "paginaInicial" => "209"
                        "paginaFinal" => "215"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1411362"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meta-analyses of prostate cancer and farming"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;E&#46; Keller-Byrne"
                            1 => "S&#46;A&#46; Khuder"
                            2 => "E&#46;A&#46; Schaub"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Ind Med"
                        "fecha" => "1997"
                        "volumen" => "31"
                        "paginaInicial" => "580"
                        "paginaFinal" => "586"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9099361"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cancer among farmers&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Acquavella"
                            1 => "G&#46; Olsen"
                            2 => "P&#46; Cole"
                            3 => "B&#46; Ireland"
                            4 => "J&#46; Kaneene"
                            5 => "S&#46; Schuman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Epidemiol"
                        "fecha" => "1998"
                        "volumen" => "8"
                        "paginaInicial" => "64"
                        "paginaFinal" => "74"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9465996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Occupation related pesticide exposure and cancer of the prostate&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; Van Maele-Fabry"
                            1 => "J&#46;L&#46; Willems"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Occup Environ Med"
                        "fecha" => "2003"
                        "volumen" => "60"
                        "paginaInicial" => "634"
                        "paginaFinal" => "642"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12937183"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prostate cancer among pesticide applicators&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; Van Maele-Fabry"
                            1 => "J&#46;L&#46; Willems"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00420-004-0548-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Arch Occup Environ Health"
                        "fecha" => "2004"
                        "volumen" => "77"
                        "paginaInicial" => "559"
                        "paginaFinal" => "570"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15688248"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Review and metaanalysis of risk estimates for prostate cancer in pesticide manufacturing workers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Van Maele-Fabry"
                            1 => "V&#46; Libotte"
                            2 => "J&#46; Willems"
                            3 => "D&#46; Lison"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10552-005-0443-y"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Causes Control"
                        "fecha" => "2006"
                        "volumen" => "17"
                        "paginaInicial" => "353"
                        "paginaFinal" => "373"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16596288"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cancer incidence in the agricultural health study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;C&#46; Alavanja"
                            1 => "D&#46;P&#46; Sandler"
                            2 => "C&#46;F&#46; Lynch"
                            3 => "C&#46; Knott"
                            4 => "J&#46;H&#46; Lubin"
                            5 => "R&#46; Tarone"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Scand J Work Environ Health"
                        "fecha" => "2005"
                        "volumen" => "31"
                        "numero" => "Sl1"
                        "paginaInicial" => "39"
                        "paginaFinal" => "45"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16190148"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vasectomy and risk of prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46; Cox"
                            1 => "M&#46;J&#46; Sneyd"
                            2 => "C&#46; Paul"
                            3 => "B&#46; Delahunt"
                            4 => "D&#46;C&#46;G&#46; Skegg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2002"
                        "volumen" => "287"
                        "paginaInicial" => "3110"
                        "paginaFinal" => "3115"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12069674"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vasectomy and the risk of prostate cancer"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;K&#46; Holt"
                            1 => "C&#46;A&#46; Salinas"
                            2 => "J&#46;L&#46; Stanford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.juro.2008.08.042"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Urol"
                        "fecha" => "2008"
                        "volumen" => "180"
                        "paginaInicial" => "2565"
                        "paginaFinal" => "2567"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18930503"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mortality and exposure response among 14&#44;458 electrical capacitor manufacturing workers exposed to polychlorinated biphenyls &#40;PCBs&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;M&#46; Prince"
                            1 => "A&#46;M&#46; Ruder"
                            2 => "M&#46;J&#46; Hein"
                            3 => "M&#46;A&#46; Waters"
                            4 => "E&#46;A&#46; Whelan"
                            5 => "N&#46; Nilsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Environ Health Perspect"
                        "fecha" => "2006"
                        "volumen" => "114"
                        "paginaInicial" => "1508"
                        "paginaFinal" => "1514"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17035134"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adipose tissue concentrations of persistent organic pollutants and the risk of prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Hardell"
                            1 => "S&#46;O&#46; Andersson"
                            2 => "M&#46; Carlberg"
                            3 => "L&#46; Bohr"
                            4 => "B&#46; van Bavel"
                            5 => "G&#46; Lindstr&#246;m"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.jom.0000205989.46603.43"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Occup Environ Med"
                        "fecha" => "2006"
                        "volumen" => "48"
                        "paginaInicial" => "700"
                        "paginaFinal" => "707"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16832227"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The influence of occupational exposure to pesticides&#44; polycyclic aromatic hydrocarbons&#44; diesel exhaust&#44; metal dust&#44; metal fumes&#44; and mineral oil on prostate cancer&#58; a prospective cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46; Boers"
                            1 => "M&#46;P&#46;A&#46; Zeegers"
                            2 => "G&#46;M&#46; Swaen"
                            3 => "I&#46; Kant"
                            4 => "P&#46;A&#46; Van den Brandt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/oem.2004.018622"
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                        "tituloSerie" => "Occup Environ Med"
                        "fecha" => "2005"
                        "volumen" => "62"
                        "paginaInicial" => "531"
                        "paginaFinal" => "537"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16046605"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0145"
              "etiqueta" => "29"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of non-Hodgkin&#39;s lymphoma associated with occupational exposure to solvents&#44; metals&#44; organic dusts and PCBs &#40;Australia&#41;"
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                        0 => array:2 [
                          "etal" => true
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                            0 => "L&#46; Fritschi"
                            1 => "G&#46; Benke"
                            2 => "A&#46;M&#46; Hues"
                            3 => "A&#46; Kricker"
                            4 => "C&#46;M&#46; Vajdic"
                            5 => "A&#46; Grulich"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10552-004-7845-0"
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                        "tituloSerie" => "Cancer Causes Control"
                        "fecha" => "2005"
                        "volumen" => "16"
                        "paginaInicial" => "599"
                        "paginaFinal" => "607"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15986116"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A biological approach to characterizing exposure to metal working fluids and risk of prostate cancer &#40;United States&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "I&#46; Agalliu"
                            1 => "E&#46;A&#46; Eisen"
                            2 => "D&#46; Kriebel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10552-004-4323-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Causes Control"
                        "fecha" => "2005"
                        "volumen" => "16"
                        "paginaInicial" => "323"
                        "paginaFinal" => "331"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15953975"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prostate cancer risk from occupational exposure to polycyclic aromatic hydrocarbons interacting with the GSTP1 Ile105Val polymorphism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;A&#46; Rybicki"
                            1 => "C&#46; Neslund-Dudas"
                            2 => "N&#46;L&#46; Nock"
                            3 => "L&#46;R&#46; Schultz"
                            4 => "L&#46; Eklund"
                            5 => "J&#46; Rosbolt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cdp.2006.09.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Detect Prev"
                        "fecha" => "2006"
                        "volumen" => "30"
                        "paginaInicial" => "412"
                        "paginaFinal" => "422"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17067754"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nested case&#8211;control study of occupational chemical exposures and prostate cancer in aerospace and radiation workers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Krishnadasan"
                            1 => "N&#46; Kennedy"
                            2 => "Y&#46; Zhao"
                            3 => "H&#46; Morgenstern"
                            4 => "B&#46; Ritz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ajim.20458"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Ind Med"
                        "fecha" => "2007"
                        "volumen" => "50"
                        "paginaInicial" => "383"
                        "paginaFinal" => "390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17407146"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Occupation and cancer &#8211; follow-up of 15 million people in five Nordic countries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Pukkala"
                            1 => "J&#46;I&#46; Martinsen"
                            2 => "E&#46; Lynge"
                            3 => "H&#46;K&#46; Gunnarsdottir"
                            4 => "P&#46; Spar&#233;n"
                            5 => "L&#46; Tryggvadottir"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/02841860902913546"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Oncol"
                        "fecha" => "2009"
                        "volumen" => "48"
                        "paginaInicial" => "646"
                        "paginaFinal" => "790"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19925375"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The influence of finasteride on the development of prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46;M&#46; Thompson"
                            1 => "P&#46;J&#46; Goodman"
                            2 => "C&#46;M&#46; Tangen"
                            3 => "M&#46;S&#46; Lucia"
                            4 => "G&#46;J&#46; Miller"
                            5 => "L&#46;G&#46; Ford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa030660"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2003"
                        "volumen" => "349"
                        "paginaInicial" => "215"
                        "paginaFinal" => "224"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12824459"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pharmacological approaches to reducing the risk of prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;S&#46; Rittmaster"
                            1 => "N&#46;E&#46; Fleshner"
                            2 => "I&#46;M&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.eururo.2009.01.037"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Urol"
                        "fecha" => "2009"
                        "volumen" => "55"
                        "paginaInicial" => "1064"
                        "paginaFinal" => "1073"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19200641"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of dutasteride on the risk of prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;L&#46; Andriole"
                            1 => "D&#46;G&#46; Bostwick"
                            2 => "O&#46;W&#46; Brawley"
                            3 => "L&#46;G&#46; Gomella"
                            4 => "M&#46; Marberger"
                            5 => "F&#46; Montorsi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa0908127"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2010"
                        "volumen" => "362"
                        "paginaInicial" => "1192"
                        "paginaFinal" => "1202"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20357281"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Update on chemoprevention for prostate cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;A&#46; Strope"
                            1 => "G&#46;L&#46; Andriole"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MOU.0b013e3283381966"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Urol"
                        "fecha" => "2010"
                        "volumen" => "20"
                        "paginaInicial" => "194"
                        "paginaFinal" => "197"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20216317"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "IARC Monographs on the evaluation of carcinogenic risks to humans"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2000"
                        "editorial" => "IARC Press"
                        "editorialLocalizacion" => "Lyon"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Life course sun exposure and risk of prostate cancer&#58; population-based nested case&#8211;control study and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Gilbert"
                            1 => "C&#46; Metcalfe"
                            2 => "S&#46;E&#46; Oliver"
                            3 => "D&#46;C&#46; Whiteman"
                            4 => "C&#46; Bain"
                            5 => "A&#46; Ness"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ijc.24411"
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                        "tituloSerie" => "Int J Cancer"
                        "fecha" => "2009"
                        "volumen" => "125"
                        "paginaInicial" => "1414"
                        "paginaFinal" => "1423"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19444909"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D and prostate cancer risk&#58; a review of the epidemiological literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Gupta"
                            1 => "C&#46;A&#46; Lammersfeld"
                            2 => "K&#46; Trukova"
                            3 => "C&#46;G&#46; Lis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/pcan.2009.7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Prostate Cancer Prostatic Dis"
                        "fecha" => "2009"
                        "volumen" => "12"
                        "paginaInicial" => "215"
                        "paginaFinal" => "226"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19350051"
                            "web" => "Medline"
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos