Tual Séverine, Lemarchand Clémentine, Boulanger Mathilde, Dalphin Jean-Charles, Rachet Bernard, Marcotullio Elisabeth, Velten Michel, Guizard Anne-Valérie, Clin Bénédicte, Baldi Isabelle, Lebailly Pierre
Am J Epidemiol. 2017 Aug 15;186(4):463-472. doi: 10.1093/aje/kwx125.
Epidemiologic studies have found lower risks of lung cancer in farmers. However, little is known about the types of agricultural activities concerned. In the Agriculture and Cancer cohort, we assessed the relationship between animal farming and lung cancer by investigating the types of animals, tasks, and timing of exposure. Analyses included 170,834 participants from the Agriculture and Cancer (AGRICAN) cohort in France. Incident lung cancers were identified through linkage with cancer registries from enrollment (2005-2007) to 2011. A Cox model, adjusting for pack-years of cigarette smoking, was used to calculate hazard ratios and 95% confidence intervals. Lung cancer risk was inversely related to duration of exposure to cattle (≥40 years: hazard ratio = 0.60, 95% confidence interval: 0.41, 0.89; P for trend < 0.01) and to horse farming (≥20 years: hazard ratio = 0.64, 95% confidence interval: 0.35, 1.17; P for trend = 0.09), especially for adenocarcinomas, but not with poultry or pig farming. More pronounced decreased risks were reported among individuals who had cared for animals, undertaken milking, and who had been exposed to cattle in infancy. Our study provides strong evidence of an inverse association between lung cancer and cattle and horse farming. Further research is warranted to identify the etiologic protective agents and biological mechanisms.
流行病学研究发现农民患肺癌的风险较低。然而,对于相关农业活动的类型却知之甚少。在农业与癌症队列研究中,我们通过调查所接触动物的类型、任务以及接触时间,评估了畜牧养殖与肺癌之间的关系。分析纳入了来自法国农业与癌症(AGRICAN)队列的170,834名参与者。通过与从入组(2005 - 2007年)至2011年的癌症登记处进行关联,确定新发肺癌病例。使用调整了吸烟包年数的Cox模型来计算风险比和95%置信区间。肺癌风险与接触牛的持续时间呈负相关(≥40年:风险比 = 0.60,95%置信区间:0.41,0.89;趋势P值 < 0.01)以及与养马(≥20年:风险比 = 0.64,95%置信区间:0.35,1.17;趋势P值 = 0.09),尤其是对于腺癌而言,但与家禽或养猪养殖无关。在照顾过动物、进行过挤奶以及在婴儿期接触过牛的个体中,报告的风险降低更为明显。我们的研究提供了肺癌与养牛和养马之间存在负相关的有力证据。有必要进一步开展研究以确定病因学保护因素和生物学机制。