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Cancer incidence in the Agricultural Health Study after 20 years of follow-up

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Abstract

Purpose

To evaluate cancer incidence in the Agricultural Health Study (AHS), a cohort of private pesticide applicators, their spouses, and commercial applicators, based on 12,420 cancers, adding 5,989 cancers, and 9 years of follow-up since last evaluation.

Methods

We calculated age, year, sex, and race-adjusted standardized incidence ratios (SIR) and 95% confidence intervals (CI) for cancer sites in the AHS relative to the general population.

Results

Overall AHS cancer incidence was lower than the general population (SIRprivate = 0.91, CI 0.89–0.93; SIRspouse = 0.89, CI 0.86–0.92; SIRcommercial = 0.83, CI 0.76–0.92), with notable deficits across applicators and spouses for oral cavity, pancreas, and lung cancers. Cancer excesses included prostate cancer, lip cancer, certain B-cell lymphomas (e.g., multiple myeloma), acute myeloid leukemia (AML), thyroid cancer, testicular cancer, and peritoneal cancer. The lung cancer deficit was strongest among applicators reporting potential exposure to endotoxin at study enrollment (tasks such as raising animals and handling stored grain).

Conclusions

Although an overall deficit in cancer was observed, there were notable exceptions, including newly observed excesses for AML, thyroid, testicular, and peritoneal cancers. Furthermore, endotoxin exposure may, in part, account for observed lung cancer incidence deficits. Cancer incidence patterns in the AHS suggest farm exposures’ relevance to cancer etiology.

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Fig. 1

1Private Applicators: raise farm animals or exposed to grain dust. Spouses: direct contact with farm animals at least once/year or occupationally exposed to grain dust 2Wald test comparing endotoxin exposed and unexposed within categories of smoking

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Acknowledgments

This work was supported by the Intramural Research Program of the National Institutes of Health, the National Cancer Institute at the National Institutes of Health (Z01-CP010119), and the National Institute of Environmental Health Sciences at the National Institutes of Health (Z01-ES049030). Data in this analysis are based on Agricultural Health Study releases P1REL201701 and AHSREL201706.

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Correspondence to Catherine C. Lerro.

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Lerro, C.C., Koutros, S., Andreotti, G. et al. Cancer incidence in the Agricultural Health Study after 20 years of follow-up. Cancer Causes Control 30, 311–322 (2019). https://doi.org/10.1007/s10552-019-01140-y

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