Oral Pathology Section, Department of Clinical and Preventive Dentistry, School of Dentistry, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Center, São Paulo, SP, Brazil.
J Oral Pathol Med. 2018 Aug;47(7):641-651. doi: 10.1111/jop.12701. Epub 2018 Mar 24.
Humans may be exposed to pesticides such as fungicides, herbicides, and insecticides, during occupational and non-occupational activities. Pesticides could be related to cancer development mainly because of their effects on the endocrine and immune systems and their cumulative effect. The present review evaluated in current literature evidence of an association between exposure to pesticides and the occurrence of head and neck cancer (HNC). A literature search for cohort studies was conducted in the PubMed, Web of science, and Cochrane databases. Methodological quality of each study was rated with the Scottish Intercollegiate Guidelines Network (SIGN) checklist. One thousand one hundred and thirty-two studies were identified. Thirty-two were included. Most of the studies found addressed occupational exposure to pesticides and were conducted in Europe and North America. Eleven high-quality studies were found. Most of them found no association between exposure to pesticides and increased risk of HNC. Two studies found some evidence of a positive association between pesticide (malathion and atrazine) exposure and thyroid cancer. The literature review does not support a clear evidence for association between pesticides exposure and HNC. Only limited evidence points to a positive association between exposure to some pesticides and thyroid cancer. Further standardized studies based on appropriate designs are required to clarify the effect of pesticides on the genesis of HNC, considering dose, length of exposure, and type of pesticide.
人类可能会在职业和非职业活动中接触到杀菌剂、除草剂和杀虫剂等农药。农药可能与癌症的发展有关，主要是因为它们对内分泌和免疫系统的影响及其累积效应。本综述评估了目前文献中关于接触农药与头颈部癌症（HNC）发生之间关联的证据。在 PubMed、Web of science 和 Cochrane 数据库中对队列研究进行了文献检索。使用苏格兰校际指南网络（SIGN）清单对每项研究的方法学质量进行了评分。确定了 1132 项研究，其中 32 项被纳入。大多数研究都涉及到职业性接触农药，并且是在欧洲和北美进行的。发现了 11 项高质量的研究。其中大多数研究发现，接触农药与 HNC 风险增加之间没有关联。有两项研究发现，接触某些农药（马拉硫磷和莠去津）与甲状腺癌之间存在一定的正相关证据。文献综述不支持接触农药与 HNC 之间存在明确关联的证据。只有有限的证据表明接触某些农药与甲状腺癌之间存在正相关关系。需要进一步开展基于适当设计的标准化研究，以阐明农药对头颈部癌症发生的影响，包括剂量、暴露时间和农药类型。
