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Agricultural exposure and risk of ovarian cancer in the AGRIculture and CANcer (AGRICAN) cohort
  1. Marine Renier1,2,3,
  2. Juliette Hippert1,2,3,
  3. Louis-Bastien Weiswald1,2,3,
  4. Séverine Tual1,2,3,
  5. Matthieu Meryet-Figuiere1,2,3,
  6. Nicolas Vigneron1,2,4,
  7. Elisabeth Marcotullio5,
  8. Isabelle Baldi6,7,
  9. Pierre Lebailly1,2,3
  10. AGRICAN group
    1. 1Institut National de la Santé et de la Recherche Médicale (INSERM), Unité mixte de Recherche (UMR) 1086 ANTICIPE, Caen, France
    2. 2Centre François Baclesse Centre de Lutte Contre le Cancer, Caen, France
    3. 3Université de Caen Normandie, Caen, France
    4. 4Registre général des tumeurs du Calvados, Caen, France
    5. 5Caisse Centrale de la Mutualite Sociale Agricole, Paris, France
    6. 6INSERM, Bordeaux Population Health Research Center, Team EPICENE, UMR 1219, Université de Bordeaux, Bordeaux, France
    7. 7CHU de Bordeaux, Pôle de Santé Publique, Service de Médecine du Travail et Pathologies Professionnelles, Bordeaux, France
    1. Correspondence to Dr Marine Renier, INSERM, UMR1086 ANTICIPE, Caen 14000, France; marine.renier{at}


    Background Ovarian cancer is rare with a poor prognosis and few established risk factors. Hormones and reproductive factors significantly impact its development, suggesting a potential link with endocrine disrupters.

    Methods In the AGRICAN cohort, 59 391 female farmers completed data on lifelong agricultural exposures and reproductive life. Cox models with attained age as timescale (HR and 95% CI) were used. The role of hormonal factors as potential confounders was considered along with specific time windows for exposure (childhood, puberty and menopause). Female farmers were the reference group (for the principal analyses).

    Results Between enrolment (2005–2007) and the end of follow-up (31 December 2017), 262 incident ovarian cancers were identified. An increased risk was observed for females involved in pigs (HR=2.12 (95% CI 1.27 to 3.52)) including during puberty (HR=1.83 (95% CI 1.13 to 2.94)), fruit-growing (HR=2.17 (95% CI 1.09 to 4.30)) and potato seed treatment (HR=2.81 (95% CI 1.29 to 6.09)). Conversely, females born on farms growing grain cereals (HR=0.64 (95% CI 0.46 to 0.90)) or pig-breeding (HR=0.78 (95% CI 0.55 to 1.12)) presented a reduced risk of ovarian cancer. Triazine herbicide exposure was not associated with ovarian cancer. The effect of agricultural exposures remained unchanged in multivariate models considering contraception, parity, puberty age, menopause age and body mass index.

    Conclusion This study is the first to assess the association between specific agricultural exposures and ovarian cancer comprehensively. Some of the positive associations observed suggest that some pesticide exposure (especially during puberty) could play a role in the development of ovarian cancer. On the other hand, agricultural exposure during early life could have a protective effect, as observed for lung cancer among farmers. Finally, we did not confirm the previous putative effect of exposure to triazine herbicides.

    • Farmers
    • Agriculture
    • Pesticides

    Data availability statement

    Data are available on reasonable request. The data that supports the findings of this study is available from the corresponding author upon reasonable request.

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    Data availability statement

    Data are available on reasonable request. The data that supports the findings of this study is available from the corresponding author upon reasonable request.

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    • Correction notice This article has been corrected since it was published. The name of the author has been corrected to Louis-Bastien Weiswald.

    • Collaborators The members of the AGRICAN group are as follows: Dabakuyo-Yonli S: Registre des Cancers du Sein et Cancers Gynécologiques de Côte d’Or. Bara S: registre général des cancers de la Manche. Bouvier AM: registre bourguignon des cancers digestifs. Busquet T: MSA Gironde, Colonna M: registre général des cancers de l’Isère. Coureau G: registre général des cancers de la Gironde, Delanoé M: MSA Midi-Pyrénées Nord. Grosclaude P: registre général des cancers du Tarn. Vigneron N: registre général des tumeurs du Calvados. Herbrecht P: MSA Alsace, VALERA JP: MSA Franche Comté, Lapotre-Ledoux B: registre général des cancers de la Somme, Alves A: registre des tumeurs digestives du Calvados, Bouyssou P: MSA Bourgogne, Hammas K E: registre général des cancers du Haut-Rhin, Rigaud E: caisse centrale de la MSA, Maynadié M: registre des hémopathies malignes Côte d’Or, Molinié F: registre général de la Loire-Atlantique et Vendée, Monnereau A: registre des hémopathies malignes de la Gironde, Paumier A: MSA Picardie, Jarriges J: MSA Côtes Normandes, Laude S: MSA Alpes du Nord, Troussard X: registre régional des hémopathies malignes de Basse Normandie, Velten M: registre général des cancers du Bas-Rhin, Baussin Rabouin F: MSA Loire-Atlantique Vendée, Woronoff AS: registre général des tumeurs du Doubs.

    • Contributors PL supervised the study and is the guarantor. MR did statistical analyses and drafted the manuscript, PL and IB contributed to manuscript preparation. MR, JH, L-BW, ST, MM-F, NV, EM, IB, PL and AGRICAN group critically reviewed and revised the draft. They all read and approved the final manuscript before submission.

    • Funding This work was supported by the Ligue Contre le Cancer (Nationale and Comités du Calvados, de l’Hérault, des Landes, de la Loire, du Maine et Loire, de la Manche, de l’Orne, de Paris et des Pyrénées Atlantiques), the Mutualité Sociale Agricole (caisse centrale et caisses des Alpes du Nord, de l’Alsace, de Bourgogne, des Côtes Normandes, de Franche Comté, de Gironde, de Loire Atlantique–Vendée, de Midi Pyrénées Nord, de la Picardie), the Fondation de France (Mr Edouard Serres), the Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail (ANSES) (within the call for projects 2005, 2006 and 2010 of the program «Environnement Santé Travail» of ANSES, with funding from l’Office national de l’eau et des milieux aquatiques in support of the Ecophyto 2018 plan), the Institut National du Cancer (Grant No. InCA 8422), the Association pour la Recherche sur le Cancer (Grant No. ARC 02-010), the Institut National de Médecine Agricole, the Centre François Baclesse, Ministère de l’Enseignement Supérieur et de la Recherche.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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