Soerensen Simon John Christoph, Lim David S, Montez-Rath Maria E, Chertow Glenn M, Chung Benjamin I, Rehkopf David H, Leppert John T
Department of Urology, Stanford University School of Medicine, Stanford, California, USA.
Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA.
Cancer. 2025 Jan 1;131(1):e35572. doi: 10.1002/cncr.35572. Epub 2024 Nov 4.
Prostate cancer is the most common cancer among men in the United States, yet modifiable risk factors remain elusive. In this study, the authors investigated the potential role of agricultural pesticide exposure in prostate cancer incidence and mortality.
For this environment-wide association study (EWAS), linear regression was used to analyze county-level associations between the annual use of 295 distinct pesticides (measured in kg per county) and prostate cancer incidence and mortality rates in the contiguous United States. Data were analyzed in two cohorts: 1997-2001 pesticide use with 2011-2015 outcomes (discovery) and 2002-2006 use with 2016-2020 outcomes (replication). The reported effect sizes highlight how a 1-standard-deviation increase in log-transformed pesticide use (kg per county) corresponds to changes in incidence. Analyses were adjusted for county-level demographics, agricultural data, and multiple testing.
Twenty-two pesticides showed consistent, direct associations with prostate cancer incidence across both cohorts. Of these, four pesticides were also associated with prostate cancer mortality. In the replication cohort, each 1-standard-deviation increase in log-transformed pesticide use corresponded to incidence increases per 100,000 individuals (trifluralin, 6.56 [95% confidence interval (CI), 5.04-8.07]; cloransulam-methyl, 6.18 [95% CI, 4.06-8.31]; diflufenzopyr, 3.20 [95% CI, 1.09-5.31]; and thiamethoxam, 2.82 [95% CI, 1.14-4.50]). Limitations included ecological study design, potential unmeasured confounding, and lack of individual-level exposure data.
The results of this study suggest a potential link between certain pesticides and increased prostate cancer incidence and mortality. These findings warrant further investigation of these specific pesticides to confirm their role in prostate cancer risk and to develop potential public health interventions.
前列腺癌是美国男性中最常见的癌症，但可改变的风险因素仍然难以捉摸。在本研究中，作者调查了农业农药暴露在前列腺癌发病率和死亡率中的潜在作用。
对于这项全环境关联研究（EWAS），使用线性回归分析了美国本土295种不同农药的年使用量（以每县千克为单位衡量）与前列腺癌发病率和死亡率之间的县级关联。数据在两个队列中进行分析：1997 - 2001年农药使用情况与2011 - 2015年结果（发现队列）以及2002 - 2006年使用情况与2016 - 2020年结果（复制队列）。报告的效应大小突出了对数转换后的农药使用量（每县千克）增加1个标准差如何对应发病率的变化。分析针对县级人口统计学、农业数据和多重检验进行了调整。
22种农药在两个队列中均显示出与前列腺癌发病率一致的直接关联。其中，四种农药也与前列腺癌死亡率相关。在复制队列中，对数转换后的农药使用量每增加1个标准差，每10万人的发病率增加情况如下（氟乐灵，6.56 [95%置信区间（CI），5.04 - 8.07]；甲基磺草酮，6.18 [95% CI，4.06 - 8.31]；双氟磺草胺，3.20 [95% CI，1.09 - 5.31]；噻虫嗪，2.82 [95% CI，1.14 - 4.50]）。局限性包括生态研究设计、潜在的未测量混杂因素以及缺乏个体水平的暴露数据。
本研究结果表明某些农药与前列腺癌发病率和死亡率增加之间可能存在联系。这些发现值得对这些特定农药进行进一步研究，以确认它们在前列腺癌风险中的作用，并制定潜在的公共卫生干预措施。
