Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

Cancer risks in a population-based study of 70,570 agricultural workers: results from the Canadian census health and Environment cohort (CanCHEC)

Authors: Linda Kachuri, M. Anne Harris, Jill S. MacLeod, Michael Tjepkema, Paul A. Peters, Paul A. Demers

Published in: BMC Cancer | Issue 1/2017

Login to get access

Abstract

Background

Agricultural workers may be exposed to potential carcinogens including pesticides, sensitizing agents and solar radiation. Previous studies indicate increased risks of hematopoietic cancers and decreased risks at other sites, possibly due to differences in lifestyle or risk behaviours. We present findings from CanCHEC (Canadian Census Health and Environment Cohort), the largest national population-based cohort of agricultural workers.

Methods

Statistics Canada created the cohort using deterministic and probabilistic linkage of the 1991 Canadian Long Form Census to National Cancer Registry records for 1992–2010. Self-reported occupations were coded using the Standard Occupational Classification (1991) system. Analyses were restricted to employed persons aged 25–74 years at baseline (N = 2,051,315), with follow-up until December 31, 2010. Hazard ratios (HR) and 95% confidence intervals (CI) were modeled using Cox proportional hazards for all workers in agricultural occupations (n = 70,570; 70.8% male), stratified by sex, and adjusted for age at cohort entry, province of residence, and highest level of education.

Results

A total of 9515 incident cancer cases (7295 in males) occurred in agricultural workers. Among men, increased risks were observed for non-Hodgkin lymphoma (HR = 1.10, 95% CI = 1.00–1.21), prostate (HR = 1.11, 95% CI = 1.06–1.16), melanoma (HR = 1.15, 95% CI = 1.02–1.31), and lip cancer (HR = 2.14, 95% CI = 1.70–2.70). Decreased risks in males were observed for lung, larynx, and liver cancers. Among female agricultural workers there was an increased risk of pancreatic cancer (HR = 1.36, 95% CI = 1.07–1.72). Increased risks of melanoma (HR = 1.79, 95% CI = 1.17–2.73), leukemia (HR = 2.01, 95% CI = 1.24–3.25) and multiple myeloma (HR = 2.25, 95% CI = 1.16–4.37) were observed in a subset of female crop farmers.

Conclusions

Exposure to pesticides may have contributed to increased risks of hematopoietic cancers, while increased risks of lip cancer and melanoma may be attributed to sun exposure. The array of decreased risks suggests reduced smoking and alcohol consumption in this occupational group compared to the general population.
Appendix
Available only for authorised users
Literature
1.
Blair A, Malker H, Cantor KP, Burmeister L, Wiklund K. Cancer among farmers. A review. Scand J Work Environ Health. 1985;11(6):397–407.CrossRefPubMed
2.
Blair A, Zahm SH, Pearce NE, Heineman EF, Fraumeni JF Jr. Clues to cancer etiology from studies of farmers. Scand J Work Environ Health. 1992;18(4):209–15.CrossRefPubMed
3.
Acquavella J, Olsen G, Cole P, Ireland B, Kaneene J, Schuman S, Holden L. Cancer among farmers: a meta-analysis. Ann Epidemiol. 1998;8(1):64–74.CrossRefPubMed
4.
Pearce N, Reif JS. Epidemiologic studies of cancer in agricultural workers. Am J Ind Med. 1990;18(2):133–48.CrossRefPubMed
5.
Laakkonen A, Pukkala E. Cancer incidence among Finnish farmers, 1995-2005. Scand J Work Environ Health. 2008;34(1):73–9.CrossRefPubMed
6.
Blair A, Walrath J, Rogot E. Mortality patterns among U.S. veterans by occupation. I. Cancer. J Natl Cancer Inst. 1985;75(6):1039–47.PubMed
7.
Pukkala E, Martinsen JI, Lynge E, Gunnarsdottir HK, Sparen P, Tryggvadottir L, Weiderpass E, Kjaerheim K. Occupation and cancer - follow-up of 15 million people in five Nordic countries. Acta Oncol. 2009;48(5):646–790.CrossRefPubMed
8.
Neugut AI, Terry MB, Hocking G, Mosca L, Garbowski GC, Forde KA, Treat MR, Waye J. Leisure and occupational physical activity and risk of colorectal adenomatous polyps. Int J Cancer. 1996;68(6):744–8.CrossRefPubMed
9.
Pfeiffer S, Graham TE, Webb RD, Wilson BA, Rivington-Moss EG, Fisher-Ingram LM. Aspects of physical fitness and health in Ontario dairy farmers. Can J Public Health. 1984;75(3):204–11.PubMed
10.
Koutros S, Alavanja MC, Lubin JH, Sandler DP, Hoppin JA, Lynch CF, Knott C, Blair A, Freeman LE. An update of cancer incidence in the agricultural health study. J Occup Environ Med. 2010;52(11):1098–105.CrossRefPubMedPubMedCentral
11.
12.
13.
Leon ME, Beane Freeman LE, Douwes J, Hoppin JA, Kromhout H, Lebailly P, Nordby KC, Schenker M, Schuz J, Waring SC, et al. AGRICOH: a consortium of agricultural cohorts. Int J Environ Res Public Health. 2011;8(5):1341–57.CrossRefPubMedPubMedCentral
14.
Wilkins R, Tjepkema M, Mustard C, Choiniere R. The Canadian census mortality follow-up study, 1991 through 2001. Health Rep. 2008;19(3):25–43.PubMed
15.
Peters PA, Tjepkema M, Wilkins R, Fines P, Crouse DL, Chan PC, Burnett RT. Data resource profile: 1991 Canadian census cohort. Int J Epidemiol. 2013;42(5):1319–26.CrossRefPubMed
16.
Carpenter M, Fair ME, Poliquin C, Lalonde P. Canadian cancer Data Base, 1969 to 1991 history and development. In: Vol. report no. 16: health Statistics Division, Statistics Canada; 2008.
17.
International Agency for Research on Cancer. International rules for multiple primary cancers. Lyon: IARC, World Health Organization; 2004.
18.
Soskolne CL, Sieswerda LE. Cancer risk associated with pulp and paper mills: a review of occupational and community epidemiology. Chronic Dis Can. 2010;29(Suppl 2):86–100.PubMed
19.
Rostgaard K. Methods for stratification of person-time and events - a prerequisite for Poisson regression and SIR estimation. Epidemiol Perspect Innov. 2008;5:7.CrossRefPubMedPubMedCentral
20.
Dickman PW, Sloggett A, Hills M, Hakulinen T. Regression models for relative survival. Stat Med. 2004;23(1):51–64.CrossRefPubMed
21.
Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82(6):816–20.CrossRefPubMedPubMedCentral
22.
Sanmartin C, Fines P, Khan S, Peters P, Tjepkema M, Bernier J, Burnett R. Modelling risk factor information for linked census data: the case of smoking. Health Rep. 2013;24(6):9–15.PubMed
23.
International Agency for Research on Cancer. Occupational exposures in insecticide application, and some pesticides. In: IARC monographs on the evaluation of carcinogenic risks to humans, vol. 53. Lyon: World Health Organization; 1991.
24.
International Agency for Research on Cancer. Some organophosphate insecticides and herbicides: Diazinon, Glyphosate, Malathion, parathion, and Tetrachlorvinphos. In: IARC monographs on the evaluation of carcinogenic risks to humans, vol. 112. Lyon: World Health Organization; 2015.
25.
National Toxicology Program. Report on carcinogens, thirteenth edition. Research Triangle Park: Department of Health and Human Services; 2014.
26.
Brouwer M, Schinasi L, Beane Freeman LE, Baldi I, Lebailly P, Ferro G, Nordby KC, Schuz J, Leon ME, Kromhout H. Assessment of occupational exposure to pesticides in a pooled analysis of agricultural cohorts within the AGRICOH consortium. Occup Environ Med. 2016;73(6):359–67.CrossRefPubMed
27.
Merhi M, Raynal H, Cahuzac E, Vinson F, Cravedi JP, Gamet-Payrastre L. Occupational exposure to pesticides and risk of hematopoietic cancers: meta-analysis of case-control studies. Cancer Causes Control. 2007;18(10):1209–26.CrossRefPubMed
28.
McDuffie HH, Pahwa P, McLaughlin JR, Spinelli JJ, Fincham S, Dosman JA, Robson D, Skinnider LF, Choi NW. Non-Hodgkin's lymphoma and specific pesticide exposures in men: cross-Canada study of pesticides and health. Cancer Epidemiol Biomark Prev. 2001;10(11):1155–63.
29.
Kachuri L, Demers PA, Blair A, Spinelli JJ, Pahwa M, McLaughlin JR, Pahwa P, Dosman JA, Harris SA. Multiple pesticide exposures and the risk of multiple myeloma in Canadian men. Int J Cancer. 2013;133(8):1846–58.CrossRefPubMed
30.
Hohenadel K, Harris SA, McLaughlin JR, Spinelli JJ, Pahwa P, Dosman JA, Demers PA, Blair A. Exposure to multiple pesticides and risk of non-Hodgkin lymphoma in men from six Canadian provinces. Int J Environ Res Public Health. 2011;8(6):2320–30.CrossRefPubMedPubMedCentral
31.
Brown LM, Blair A, Gibson R, Everett GD, Cantor KP, Schuman LM, Burmeister LF, Van Lier SF, Dick F. Pesticide exposures and other agricultural risk factors for leukemia among men in Iowa and Minnesota. Cancer Res. 1990;50(20):6585–91.PubMed
32.
Cantor KP, Blair A, Everett G, Gibson R, Burmeister LF, Brown LM, Schuman L, Dick FR. Pesticides and other agricultural risk factors for non-Hodgkin's lymphoma among men in Iowa and Minnesota. Cancer Res. 1992;52(9):2447–55.PubMed
33.
Brown LM, Burmeister LF, Everett GD, Blair A. Pesticide exposures and multiple myeloma in Iowa men. Cancer Causes Control. 1993;4(2):153–6.CrossRefPubMed
34.
Jones RR, Yu CL, Nuckols JR, Cerhan JR, Airola M, Ross JA, Robien K, Ward MH. Farm residence and lymphohematopoietic cancers in the Iowa Women's health study. Environ Res. 2014;133:353–61.CrossRefPubMedPubMedCentral
35.
Schinasi LH, De Roos AJ, Ray RM, Edlefsen KL, Parks CG, Howard BV, Meliker JR, Bonner MR, Wallace RB, LaCroix AZ. Insecticide exposure and farm history in relation to risk of lymphomas and leukemias in the Women's Health Initiative observational study cohort. Ann Epidemiol. 2015;25(11):803–10.CrossRefPubMed
36.
Alguacil J, Porta M, Benavides FG, Malats N, Kogevinas M, Fernandez E, Carrato A, Rifa J, Guarner L. Occupation and pancreatic cancer in Spain: a case-control study based on job titles. PANKRAS II study group. Int J Epidemiol. 2000;29(6):1004–13.CrossRefPubMed
37.
Santibanez M, Vioque J, Alguacil J, de la Hera MG, Moreno-Osset E, Carrato A, Porta M, Kauppinen T. Occupational exposures and risk of pancreatic cancer. Eur J Epidemiol. 2010;25(10):721–30.CrossRefPubMed
38.
Ojajarvi IA, Partanen TJ, Ahlbom A, Boffetta P, Hakulinen T, Jourenkova N, Kauppinen TP, Kogevinas M, Porta M, Vainio HU, et al. Occupational exposures and pancreatic cancer: a meta-analysis. Occup Environ Med. 2000;57(5):316–24.CrossRefPubMedPubMedCentral
39.
Koutros S, Beane Freeman LE, Lubin JH, Heltshe SL, Andreotti G, Barry KH, DellaValle CT, Hoppin JA, Sandler DP, Lynch CF, et al. Risk of total and aggressive prostate cancer and pesticide use in the agricultural health study. Am J Epidemiol. 2013;177(1):59–74.CrossRefPubMed
40.
Van Maele-Fabry G, Libotte V, Willems J, Lison D. Review and meta-analysis of risk estimates for prostate cancer in pesticide manufacturing workers. Cancer Causes Control. 2006;17(4):353–73.CrossRefPubMed
41.
Depczynski J, Lower T. A review of prostate cancer incidence and mortality studies of farmers and non-farmers, 2002-2013. Cancer Epidemiol. 2014;38(6):654–62.CrossRefPubMed
42.
43.
Hanchette CL, Schwartz GG. Geographic patterns of prostate cancer mortality. Evidence for a protective effect of ultraviolet radiation. Cancer. 1992;70(12):2861–9.CrossRefPubMed
44.
Li H, Stampfer MJ, Hollis JB, Mucci LA, Gaziano JM, Hunter D, Giovannucci EL, Ma J. A prospective study of plasma vitamin D metabolites, vitamin D receptor polymorphisms, and prostate cancer. PLoS Med. 2007;4(3):e103.CrossRefPubMedPubMedCentral
45.
Gandini S, Boniol M, Haukka J, Byrnes G, Cox B, Sneyd MJ, Mullie P, Autier P. Meta-analysis of observational studies of serum 25-hydroxyvitamin D levels and colorectal, breast and prostate cancer and colorectal adenoma. Int J Cancer. 2011;128(6):1414–24.CrossRefPubMed
46.
Gilbert R, Martin RM, Beynon R, Harris R, Savovic J, Zuccolo L, Bekkering GE, Fraser WD, Sterne JA, Metcalfe C. Associations of circulating and dietary vitamin D with prostate cancer risk: a systematic review and dose-response meta-analysis. Cancer Causes Control. 2011;22(3):319–40.CrossRefPubMed
47.
Feldman D, Krishnan AV, Swami S, Giovannucci E, Feldman BJ. The role of vitamin D in reducing cancer risk and progression. Nat Rev Cancer. 2014;14(5):342–57.CrossRefPubMed
48.
Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, Keadle SK, Arem H, Berrington de Gonzalez A, Hartge P, et al. Association of Leisure-Time Physical Activity with Risk of 26 types of cancer in 1.44 million adults. JAMA Intern Med. 2016;176(6):816–25.CrossRefPubMed
49.
Brenner DR. Cancer incidence due to excess body weight and leisure-time physical inactivity in Canada: implications for prevention. Prev Med. 2014;66:131–9.CrossRefPubMed
50.
Zeegers MP, Kellen E, Buntinx F, van den Brandt PA. The association between smoking, beverage consumption, diet and bladder cancer: a systematic literature review. World J Urol. 2004;21(6):392–401.CrossRefPubMed
51.
Zeegers MP, Swaen GM, Kant I, Goldbohm RA, van den Brandt PA. Occupational risk factors for male bladder cancer: results from a population based case cohort study in the Netherlands. Occup Environ Med. 2001;58(9):590–6.CrossRefPubMedPubMedCentral
52.
Latifovic L, Villeneuve PJ, Parent ME, Johnson KC, Kachuri L, Canadian cancer registries epidemiology G, Harris SA. Bladder cancer and occupational exposure to diesel and gasoline engine emissions among Canadian men. Cancer Med. 2015;4(12):1948–62.CrossRefPubMedPubMedCentral
53.
Letasiova S, Medve'ova A, Sovcikova A, Dusinska M, Volkovova K, Mosoiu C, Bartonova A. Bladder cancer, a review of the environmental risk factors. Environ Health. 2012;11(Suppl 1):S11.CrossRefPubMedPubMedCentral
54.
Liebers V, Bruning T, Raulf-Heimsoth M. Occupational endotoxin-exposure and possible health effects on humans. Am J Ind Med. 2006;49(6):474–91.CrossRefPubMed
55.
Reisser D, Pance A, Jeannin JF. Mechanisms of the antitumoral effect of lipid a. BioEssays. 2002;24(3):284–9.CrossRefPubMed
56.
Pance A, Reisser D, Jeannin JF. Antitumoral effects of lipid a: preclinical and clinical studies. J Investig Med. 2002;50(3):173–8.CrossRefPubMed
57.
Chicoine MR, Won EK, Zahner MC. Intratumoral injection of lipopolysaccharide causes regression of subcutaneously implanted mouse glioblastoma multiforme. Neurosurgery. 2001;48(3):607–14. discussion 614-605CrossRefPubMed
58.
Lenters V, Basinas I, Beane-Freeman L, Boffetta P, Checkoway H, Coggon D, Portengen L, Sim M, Wouters IM, Heederik D, et al. Endotoxin exposure and lung cancer risk: a systematic review and meta-analysis of the published literature on agriculture and cotton textile workers. Cancer Causes Control. 2010;21(4):523–55.CrossRefPubMed
59.
Rigel DS. Cutaneous ultraviolet exposure and its relationship to the development of skin cancer. J Am Acad Dermatol. 2008;58(5 Suppl 2):S129–32.CrossRefPubMed
60.
Alfonso JH, Martinsen JI, Pukkala E, Weiderpass E, Tryggvadottir L, Nordby KC, Kjaerheim K. Occupation and relative risk of cutaneous squamous cell carcinoma (cSCC): a 45-year follow-up study in 4 Nordic countries. J Am Acad Dermatol. 2016;75(3):548–55.CrossRefPubMed
61.
Dennis LK, Lynch CF, Sandler DP, Alavanja MC. Pesticide use and cutaneous melanoma in pesticide applicators in the agricultural heath study. Environ Health Perspect. 2010;118(6):812–7.CrossRefPubMedPubMedCentral
62.
Fortes C, Mastroeni S, Melchi F, Pilla MA, Alotto M, Antonelli G, Camaione D, Bolli S, Luchetti E, Pasquini P. The association between residential pesticide use and cutaneous melanoma. Eur J Cancer. 2007;43(6):1066–75.CrossRefPubMed
63.
Curado MP, Hashibe M. Recent changes in the epidemiology of head and neck cancer. Curr Opin Oncol. 2009;21(3):194–200.CrossRefPubMed
64.
Gillison ML, Chaturvedi AK, Anderson WF, Fakhry C. Epidemiology of human Papillomavirus-positive head and neck Squamous cell carcinoma. J Clin Oncol. 2015;33(29):3235–42.CrossRefPubMedPubMedCentral
65.
Freeman LE, Rusiecki JA, Hoppin JA, Lubin JH, Koutros S, Andreotti G, Zahm SH, Hines CJ, Coble JB, Barone-Adesi F, et al. Atrazine and cancer incidence among pesticide applicators in the agricultural health study (1994-2007). Environ Health Perspect. 2011;119(9):1253–9.CrossRefPubMedPubMedCentral
66.
Pearce N, Checkoway H, Kriebel D. Bias in occupational epidemiology studies. Occup Environ Med. 2007;64(8):562–8.CrossRefPubMed
67.
Jeon SH. The long term effects of cancer on employment and earnings. Health Econ. 2017;26(5):671–84.
68.
Nelson DE, Emont SL, Brackbill RM, Cameron LL, Peddicord J, Fiore MC. Cigarette smoking prevalence by occupation in the United States. A comparison between 1978 to 1980 and 1987 to. J Occup Med. 1990;36(5):516–25.
69.
Mandell W, Eaton WW, Anthony JC, Garrison R. Alcoholism and occupations: a review and analysis of 104 occupations. Alcohol Clin Exp Res. 1992;16(4):734–46.CrossRefPubMed
Metadata
Title
Cancer risks in a population-based study of 70,570 agricultural workers: results from the Canadian census health and Environment cohort (CanCHEC)
Authors
Linda Kachuri
M. Anne Harris
Jill S. MacLeod
Michael Tjepkema
Paul A. Peters
Paul A. Demers
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3346-x

Other articles of this Issue 1/2017

BMC Cancer 1/2017 Go to the issue

Research article

Linking hypoxia, DNA damage and proliferation in multicellular tumor spheroids

Research article

Addition of rituximab to CHOP-like chemotherapy in first line treatment of primary mediastinal B-cell lymphoma

Research article

Assessing the adequacy of lymph node yield for different tumor stages of colon cancer by nodal staging scores

Research article

Comparison of immunohistochemistry with PCR for assessment of ER, PR, and Ki-67 and prediction of pathological complete response in breast cancer

Research article

YBX1 gene silencing inhibits migratory and invasive potential via CORO1C in breast cancer in vitro

Research article

The optimal extent of gastrectomy for middle-third gastric cancer: distal subtotal gastrectomy is superior to total gastrectomy in short-term effect without sacrificing long-term survival
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits