Table 3.

Bisphenol A (BPA) and endometrial cancer: mechanisms of action and correlated published studies.

Chemical	Pathways of Exposure	Mechanism of Action	Authors (Year)	Results
Bisphenol A (BPA)	Food chain (e.g., plastics in contact with food), consumer products (e.g., dental sealant, plastic additive, etc.)	Estrogen agonists-ER alpha, epigenetic mutations	Wang, K.H. et al. 2015 [61]	The results show that BPA increased growth rate and colony-forming efficiency in a dose-dependent manner, induced EMT and COX-2 gene expression and promoted the migration and invasion ability of RL95-2 cells.
			Gibson, D.A. et al. 2014 [9]	Review that summarizes how BPA is identified as an estrogenic substance and may activate both ERα and ERβ but that activation would be both cell-type- and concentration-dependent.
			Rochester, J.R. et al. 2013 [19]	Review shows the associations between BPA exposure and adverse perinatal, childhood, and adult health outcomes, including reproductive and developmental effects, metabolic disease, and other health effects.
			Gertz, et al. 2012 [63]	In vitro study where it was demonstrated that BPA and genistein induce thousands of estrogen receptor1 (ESR1) binding sites and change the expression of a subset of genes (more often up-regulated) affected by E2, representing 26% and 6% respectively.
			Boehme, et al. 2009 [22]	It was showed a divergent gene expression patterns of the phytoestrogens, as well as weaker estrogenic gene expression regulation determined for the anthropogenous chemicals BPA and o,p’-DDT.
			Newbold, R.R. 2007 [59]	There was a statistically significant increase in cystic ovaries and cystic endometrial hyperplasia (CEH) in the BPA-100 group as compared to Controls, suggesting that BPA causes long-term adverse effects if exposure occurs during critical periods of differentiation.
			Singleton, D.W. et al. 2006 [25]	It has been relevant how a number of growth- and development-related genes, such as HOXC1 and C6, Wnt5A, Frizzled, TGFbeta-2, and STAT inhibitor 2, were found to be affected exclusively by BPA.
			Hiroi, H. 2004 et al. [73]	Human in vivo study suggests the presence of associations between BPA exposure and complex endometrial hyperplasia and endometrial cancer.
			Kurosawa, T. et al. 2002 [66]	In vitro study where was performed a luciferase assay on three independent cell lines derived from different tissues transfected with either human ERα cDNA or ERbeta cDNA, indicating that BPA only acts as an agonist of estrogen via ERbeta whereas it has dual actions as an agonist and antagonist in some types of cells via ERα. Thus, the activity of BPA may depend on the ER subtype and the tissue involved.
			Bergeron, et al. 1999 [62]	BPA was able to bind to the human uterine ER and to induce both mRNA and protein to levels similar to E2.