Association between urinary phthalate metabolites and risk of breast cancer and uterine leiomyoma

•This is the first study to assess the association between urinary phthalate metabolites and risk of breast cancer and uterine leiomyoma.•The positive association between urinary DEHP metabolites and risk of breast cancer and uterine leiomyoma was first proposed.•P53, PPAR, ATM signaling pathway and apoptotic signaling in response to DNA damage might be involved to account for the association. The objective of this study was to systematically assess the association between urinary phthalate metabolites and risk of breast cancer and uterine leiomyoma. Standard meta-analysis and bioinformatics analysis were conducted based on electronic databases. No significant association was observed between total urinary phthalate metabolites and risk of breast cancer or uterine leiomyoma. However, MECPP was positively associated with breast cancer risk, and DEHP metabolites were associated with increased risk of breast cancer as well as uterine leiomyoma. Enrichment pathway analysis suggested p53 signaling pathway, mechanism of gene regulation by PPARα, apoptotic signaling in response to DNA damage and ATM signaling pathway might be involved to account for the association. Significantly positive association was observed between DEHP metabolites and risk of breast cancer and uterine leiomyoma, especially for MECPP in breast cancer.