草甘膦使用与农业健康研究中的癌症发病率。
Glyphosate Use and Cancer Incidence in the Agricultural Health Study.
机构信息
Occupational and Environmental Epidemiology Branch.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC.
出版信息
J Natl Cancer Inst. 2018 May 1;110(5):509-516. doi: 10.1093/jnci/djx233.
BACKGROUND
Glyphosate is the most commonly used herbicide worldwide, with both residential and agricultural uses. In 2015, the International Agency for Research on Cancer classified glyphosate as "probably carcinogenic to humans," noting strong mechanistic evidence and positive associations for non-Hodgkin lymphoma (NHL) in some epidemiologic studies. A previous evaluation in the Agricultural Health Study (AHS) with follow-up through 2001 found no statistically significant associations with glyphosate use and cancer at any site.
METHODS
The AHS is a prospective cohort of licensed pesticide applicators from North Carolina and Iowa. Here, we updated the previous evaluation of glyphosate with cancer incidence from registry linkages through 2012 (North Carolina)/2013 (Iowa). Lifetime days and intensity-weighted lifetime days of glyphosate use were based on self-reported information from enrollment (1993-1997) and follow-up questionnaires (1999-2005). We estimated incidence rate ratios (RRs) and 95% confidence intervals (CIs) using Poisson regression, controlling for potential confounders, including use of other pesticides. All statistical tests were two-sided.
RESULTS
Among 54 251 applicators, 44 932 (82.8%) used glyphosate, including 5779 incident cancer cases (79.3% of all cases). In unlagged analyses, glyphosate was not statistically significantly associated with cancer at any site. However, among applicators in the highest exposure quartile, there was an increased risk of acute myeloid leukemia (AML) compared with never users (RR = 2.44, 95% CI = 0.94 to 6.32, Ptrend = .11), though this association was not statistically significant. Results for AML were similar with a five-year (RRQuartile 4 = 2.32, 95% CI = 0.98 to 5.51, Ptrend = .07) and 20-year exposure lag (RRTertile 3 = 2.04, 95% CI = 1.05 to 3.97, Ptrend = .04).
CONCLUSIONS
In this large, prospective cohort study, no association was apparent between glyphosate and any solid tumors or lymphoid malignancies overall, including NHL and its subtypes. There was some evidence of increased risk of AML among the highest exposed group that requires confirmation.
背景
草甘膦是世界上使用最广泛的除草剂，既有住宅用途，也有农业用途。2015 年，国际癌症研究机构将草甘膦归类为“对人类可能致癌”，指出在一些流行病学研究中，草甘膦具有强有力的机制证据和对非霍奇金淋巴瘤（NHL）的阳性关联。农业健康研究（AHS）中的先前评估显示，草甘膦的使用与任何部位的癌症均无统计学显著关联，随访至 2001 年。
方法
AHS 是北卡罗来纳州和爱荷华州持牌农药施用者的前瞻性队列研究。在这里，我们通过 2012 年（北卡罗来纳州）/2013 年（爱荷华州）的登记链接更新了以前对草甘膦与癌症发病率的评估。草甘膦的终生天数和加权终生天数基于入组时（1993-1997 年）和随访问卷（1999-2005 年）的自我报告信息。我们使用泊松回归估计发病率比（RR）和 95%置信区间（CI），控制了其他农药使用等潜在混杂因素。所有统计检验均为双侧。
结果
在 54251 名施药者中，有 44932 名（82.8%）使用了草甘膦，包括 5779 例癌症发病病例（所有病例的 79.3%）。在未滞后分析中，草甘膦与任何部位的癌症均无统计学显著关联。然而，在最高暴露四分位组中，与从不使用者相比，急性髓性白血病（AML）的风险增加（RR = 2.44，95%CI = 0.94 至 6.32，Ptrend =.11），尽管这一关联无统计学意义。AML 的结果与五年（RR 四分位 4 = 2.32，95%CI = 0.98 至 5.51，Ptrend =.07）和 20 年暴露滞后（RRTertile 3 = 2.04，95%CI = 1.05 至 3.97，Ptrend =.04）相似。
结论
在这项大型前瞻性队列研究中，草甘膦与总体任何实体瘤或淋巴恶性肿瘤均无明显关联，包括 NHL 及其亚型。在最高暴露组中，AML 的风险增加有一些证据，但需要进一步证实。
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