Werder Emily J, Engel Lawrence S, Satagopan Jaya, Blair Aaron, Koutros Stella, Lerro Catherine C, Alavanja Michael C, Sandler Dale P, Beane Freeman Laura E
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina.
Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
Environ Epidemiol. 2020 May 27;4(3):e097. doi: 10.1097/EE9.0000000000000097. eCollection 2020 Jun.
Evidence from epidemiologic and laboratory studies relating pesticides to breast cancer risk is inconsistent. Women engaging in agricultural work or living in agricultural areas may experience appreciable exposures to a wide range of pesticides, including herbicides, fumigants, and fungicides.
We examined exposure to herbicides, fumigants, and fungicides in relation to breast cancer risk among farmers' wives with no prior history of breast cancer in the Agricultural Health Study. Women provided information on pesticide use, demographics, and reproductive history at enrollment (1993-1997) and at a 5-year follow-up interview. We used Cox proportional hazards regression to estimate associations (hazard ratios [HRs] and 95% confidence intervals [CIs]) between the women's and their husbands' self-reported use of individual pesticides and incident breast cancer risk.
Out of 30,594 women, 38% reported using herbicides, fumigants, or fungicides and 1,081 were diagnosed with breast cancer during a median 15.3 years of follow-up. We found elevated risk in relation to women's ever use of the fungicide benomyl (HR = 1.6; 95% CI = 0.9, 2.7) and the herbicide 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) (HR = 1.6; 95% CI = 0.8, 3.1) and to their husbands' use of the herbicide 2-(2,4,5-trichlorophenoxy) propionic acid (2,4,5-TP) (HR = 1.5; 95% CI = 0.9, 2.7). We observed few other chemical associations and little evidence of differential risk by tumor estrogen receptor status or linear exposure-response relationships.
We did not observe clear excesses between use of specific pesticides and breast cancer risk across exposure metrics, although we did observe elevated risk associated with women's use of benomyl and 2,4,5-T and husbands' use of 2,4,5-TP.
流行病学和实验室研究中关于农药与乳腺癌风险之间关系的证据并不一致。从事农业工作或居住在农业地区的女性可能会接触到大量的各类农药，包括除草剂、熏蒸剂和杀菌剂。
在农业健康研究中，我们调查了无乳腺癌病史的农民妻子接触除草剂、熏蒸剂和杀菌剂与患乳腺癌风险之间的关系。女性在入组时（1993 - 1997年）以及5年随访访谈时提供了农药使用情况、人口统计学信息和生殖史信息。我们使用Cox比例风险回归来估计女性及其丈夫自我报告的个体农药使用情况与乳腺癌发病风险之间的关联（风险比[HRs]和95%置信区间[CIs]）。
在30594名女性中，38%报告使用过除草剂、熏蒸剂或杀菌剂，在中位随访15.3年期间，1081名女性被诊断患有乳腺癌。我们发现，女性曾经使用杀菌剂苯菌灵（HR = 1.6；95% CI = 0.9，2.7）和除草剂2,4,5 - 三氯苯氧乙酸（2,4,5 - T）（HR = 1.6；95% CI = 0.8，3.1）以及其丈夫使用除草剂2 - (2,4,5 - 三氯苯氧基)丙酸（2,4,5 - TP）（HR = 1.5；95% CI = 0.9，2.7）与患癌风险升高有关。我们观察到的其他化学物质关联较少，且几乎没有证据表明肿瘤雌激素受体状态或线性暴露 - 反应关系存在差异风险。
尽管我们观察到女性使用苯菌灵和2,4,5 - T以及丈夫使用2,4,5 - TP与患癌风险升高有关，但在不同暴露指标下，我们并未观察到特定农药使用与乳腺癌风险之间存在明显的过量风险。
