Introduction Agricultural populations tend to have lower rates of mortality than in the general population but farming exposures have been regularly associated with an increased risk of some cancers. Our aim was to evaluate cancer incidence in the AGRICAN cohort.

Methods AGRICAN is a prospective cohort including 181,842 active and retired, male and female participants, affiliated for at least 3 years to the French agricultural health insurance, and living in one of the 11 areas covered by a cancer registry at the time of enrolment. Incident cancers were identified through linkage with cancer registries from enrolment (2005–2007) to 2011. Age and sex standardised incidence Ratios (SIRs) were calculated for comparison with the general population of each area.

Results A total of 11,067 incident cancer cases (7,304 men, 3,763 women) were identified. Overall cancer incidence was comparable in the cohort and in the general population. However, SIRs were significantly reduced for tobacco-related cancers (respiratory and urinary cancers) and conversely significant excesses were observed for i) multiple myeloma both in men (SIR = 1.38) and in women (SIR = 1.26), ii) skin melanoma (SIR = 1.23) among women, iii) prostate cancer (SIR = 1.07) and iv) non-Hodgkin lymphoma (SIR = 1.09) among men. Lip cancer incidence was also elevated among men (SIR = 1.38). Stratified analyses showed differences between farm workers and farm owners. Pesticide users had a greater incidence of lip cancer and multiple myeloma among men and skin melanoma among women.

Conclusion We found no overall difference between cancer incidence in the cohort and the general population but an increased incidence of prostate and lip cancers, skin melanoma and multiple myeloma. Stratified analyses made it possible to identify sub-groups of specific interest with a higher cancer incidence related to professional status and pesticide use.