Institut National de la Santé et de la Recherche Médicale (INSERM), Unité mixte de Recherche (UMR) 1086 ANTICIPE, Caen, France
Centre François Baclesse Centre de Lutte Contre le Cancer, Caen, France.
Occup Environ Med. 2024 Feb 2;81(2):75-83. doi: 10.1136/oemed-2023-109089.
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.
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).
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.
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.
卵巢癌罕见且预后不良，目前仅有少数已确定的危险因素。激素和生殖因素对其发病有显著影响，这表明其与内分泌干扰物之间可能存在关联。
在 AGRICAN 队列中，59391 名女性农民完成了终生农业暴露和生殖生活的数据调查。采用基于达到年龄的 Cox 模型（HR 和 95%CI）进行分析。同时考虑了激素因素作为潜在混杂因素，并考虑了暴露的特定时间窗（儿童期、青春期和绝经期）。女性农民为参考组（主要分析）。
在入组（2005-2007 年）和随访结束（2017 年 12 月 31 日）之间，共发现 262 例卵巢癌新发病例。结果显示，从事养猪（HR=2.12（95%CI 1.27-3.52））、水果种植（HR=2.17（95%CI 1.09-4.30））和土豆种子处理（HR=2.81（95%CI 1.29-6.09））的女性卵巢癌风险增加，尤其是在青春期（HR=1.83（95%CI 1.13-2.94））时风险更高。相反，出生于种植谷物（HR=0.64（95%CI 0.46-0.90））或养猪（HR=0.78（95%CI 0.55-1.12））农场的女性卵巢癌发病风险降低。三嗪类除草剂的暴露与卵巢癌无关联。在考虑了避孕措施、产次、青春期年龄、绝经期年龄和体重指数等因素的多变量模型中，农业暴露的影响仍然不变。
本研究首次全面评估了特定农业暴露与卵巢癌之间的关系。一些观察到的阳性关联表明，某些农药暴露（尤其是在青春期）可能在卵巢癌的发生中起作用。另一方面，儿童期的农业暴露可能具有保护作用，就像农民的肺癌一样。最后，我们没有证实先前关于三嗪类除草剂暴露的假定作用。
