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P054 Lower lung cancer risks among farmers raising cattle and horses in the agrican cohort
  1. Séverine Tual1,2,3,
  2. Clémentine Lemarchand1,2,3,
  3. Mathilde Boulanger1,2,4,
  4. JC Dalphin5,
  5. Bernard Rachet6,
  6. Elisabeth Marcotullio7,
  7. Michel Velten8,
  8. AV Guizard1,3,9,
  9. Bénédicte Clin1,2,4,
  10. Isabelle Baldi10,11,12,
  11. Pierre Lebailly1,2,3
  1. 1Inserm, UMR 1086 Cancers Et Préventions, Caen, France
  2. 2Université De Caen Normandie, Caen, France
  3. 3Centre De Lutte Contre Le Cancer François Baclesse, Caen, France
  4. 4CHU De Caen, Service De Pathologie Professionnelle, Caen, France
  5. 5CHU De Besançon, Besançon, France
  6. 6Cancer Research UK Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
  7. 7Caisse Centrale De La Mutualité Sociale Agricole, Echelon National Santé Sécurité Au Travail, Bagnolet, France
  8. 8Registre Des Cancers Du Bas–Rhin, Faculté De Médecine, EA3430, Université De Strasbourg, Strasbourg, France
  9. 9Registre Général Des Tumeurs Du Calvados, Caen, France
  10. 10Université De Bordeaux, ISPED, Laboratoire Santé Travail Environnement, Bordeaux, France
  11. 11INSERM, ISPED, EPICENE Team – Centre INSERM U1219 – Bordeaux Population Health Centre, Bordeaux, France
  12. 12CHU De Bordeaux, Service De Médecine Du Travail, Bordeaux, France

Abstract

Background Epidemiological studies have repeatedly found lower risks of lung cancer in farmers. Besides a lower prevalence of tobacco-smoking, exposure to endotoxins, which is highly present in animal farming, has been offered as an explanation. However, its role remains controversial. Little is known about the agricultural activities concerned. In the AGRICAN cohort, we assessed the relationship between animal farming and lung cancer by investigating the type of animals, tasks, timing of exposure and taking smoking history into account.

Methods The AGRICAN cohort consisted of 170,834 participants affiliated to the French agricultural health insurance scheme. Linkage with cancer registries identified 487 incident lung cancers from enrolment (2005–2007) to 2011. The enrolment questionnaire provided detailed information on lifelong farming, including tasks performed with cattle, horses, pigs, poultry, sheep and/or goats with years of beginning and end, and exposure to a farm during the first year of life. Associations between lung cancer and exposure to animals were analysed using a Cox model with adjustment for smoking, using age as time scale.

Results Risk in lung cancer (especially adenocarcinoma) was inversely associated with duration of occupational exposure to cattle (≥40 years: HR = 0.60, [95% CI=0.41–0.89], p–trend = 0.04) and horse (≥20 years: 0.64 [0.35–1.17], p–trend = 0.08), but not with poultry or pig farming. Lower lung cancer risk remained associated with long–term exposure to cattle, even 25 years after cessation of exposure. More pronounced decreased risks were observed among individuals who had cared for animals, undertaken milking and who had been exposed to cattle in infancy.

Interpretation Our study provides strong evidence of an inverse association between cattle and horse farming, and lung cancer. Further research is warranted to identify the etiologic protective agents and biological mechanisms involved.

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