Marine Renier, Juliette Hippert, Weiswald Louis-Bastien, Séverine Tual, Matthieu Meryet-Figuiere, Nicolas Vigneron, Elisabeth Marcotullio, Isabelle Baldi, Pierre Lebailly
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Female farmers were the reference group (for the principal analyses).</p><p><strong>Results: </strong>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. 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引用次数: 0
摘要
背景：卵巢癌是一种罕见的癌症，预后较差，且已确定的风险因素很少。激素和生殖因素对卵巢癌的发病有很大影响，这表明卵巢癌可能与内分泌干扰物有关：在 AGRICAN 队列中，有 59 391 名女性农民填写了有关终生农业接触和生育期的数据。采用以年龄为时间尺度的 Cox 模型（HR 和 95% CI）。考虑了作为潜在混杂因素的荷尔蒙因素的作用以及特定的暴露时间窗（童年、青春期和更年期）。女性农民为参照组（用于主要分析）：从入学（2005-2007 年）到随访结束（2017 年 12 月 31 日），共发现 262 例卵巢癌。观察发现，养猪（HR=2.12（95% CI 1.27 至 3.52））、青春期（HR=1.83（95% CI 1.13 至 2.94））、水果种植（HR=2.17（95% CI 1.09 至 4.30））和马铃薯种子处理（HR=2.81（95% CI 1.29 至 6.09））的女性患卵巢癌的风险增加。相反，出生在种植谷物（HR=0.64（95% CI 0.46 至 0.90））或养猪（HR=0.78（95% CI 0.55 至 1.12））农场的女性患卵巢癌的风险降低。接触三嗪类除草剂与卵巢癌无关。在考虑了避孕、胎次、青春期年龄、绝经年龄和体重指数的多变量模型中，农业暴露的影响保持不变：这项研究首次全面评估了特定农业暴露与卵巢癌之间的关系。观察到的一些正相关关系表明，接触某些杀虫剂（尤其是在青春期）可能在卵巢癌的发生中起作用。另一方面，正如在农民肺癌中观察到的那样，早年的农业接触可能具有保护作用。最后，我们没有证实之前推测的接触三嗪类除草剂的影响。
Agricultural exposure and risk of ovarian cancer in the AGRIculture and CANcer (AGRICAN) cohort.
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.
期刊介绍：
Occupational and Environmental Medicine is an international peer reviewed journal covering current developments in occupational and environmental health worldwide. Occupational and Environmental Medicine publishes high-quality research relating to the full range of chemical, physical, ergonomic, biological and psychosocial hazards in the workplace and to environmental contaminants and their health effects. The journal welcomes research aimed at improving the evidence-based practice of occupational and environmental research; including the development and application of novel biological and statistical techniques in addition to evaluation of interventions in controlling occupational and environmental risks.
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