TY - JOUR
T1 - Insecticide use and breast cancer risk among farmers’ wives in the agricultural health study
AU - Engel, Lawrence S.
AU - Werder, Emily
AU - Satagopan, Jaya
AU - Blair, Aaron
AU - Hoppin, Jane A.
AU - Koutros, Stella
AU - Lerro, Catherine C.
AU - Sandler, Dale P.
AU - Alavanja, Michael C.
AU - Beane Freeman, Laura E.
N1 - Funding Information:
We thank C. Sima (Memorial Sloan Kettering Cancer Center) for statistical assistance. This research was supported by National Institutes of Health (NIH) grant R03CA137824 and by the Intramural Research Program of the NIH [National Cancer Institute (NCI; Z01-CP010119) and the National Institute of Environmental Health Sciences/NIH(Z01-ES049030)].
Funding Information:
This research was supported by National Institutes of Health (NIH) grant R03CA137824 and by the Intramural Research Program of the NIH [National Cancer Institute (NCI; Z01-CP010119) and the National Institute of Environmental Health Sciences/NIH (Z01-ES049030)].
Publisher Copyright:
© 2017, Public Health Services, US Dept of Health and Human Services. All rights reserved.
PY - 2017/9
Y1 - 2017/9
N2 - BACKGROUND: Some epidemiologic and laboratory studies suggest that insecticides are related to increased breast cancer risk, but the evidence is inconsistent. Women engaged in agricultural work or who reside in agricultural areas may experience appreciable exposures to a wide range of insecticides. OBJECTIVE: We examined associations between insecticide use and breast cancer incidence among wives of pesticide applicators (farmers) in the prospective Agricultural Health Study. METHODS: Farmers and their wives provided information on insecticide use, demographics, and reproductive history at enrollment in 1993–1997 and in 5-y follow-up interviews. Cancer incidence was determined via cancer registries. Among 30,594 wives with no history of breast cancer before enrollment, we examined breast cancer risk in relation to the women’s and their husbands’ insecticide use using Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: During an average 14.7-y follow-up, 39% of the women reported ever using insecticides, and 1,081 were diagnosed with breast cancer. Although ever use of insecticides overall was not associated with breast cancer risk, risk was elevated among women who had ever used the organophosphates chlorpyrifos [HR = 1:4 (95% CI: 1.0, 2.0)] or terbufos [HR = 1:5 (95% CI: 1.0, 2.1)], with nonsignificantly increased risks for coumaphos [HR = 1:5 (95% CI: 0.9, 2.5)] and heptachlor [HR = 1:5 (95% CI: 0.7, 2.9)]. Risk in relation to the wives’ use was associated primarily with premenopausal breast cancer. We found little evidence of differential risk by tumor estrogen receptor status. Among women who did not apply pesticides, the husband’s use of fonofos was associated with elevated risk, although no exposure–response trend was observed. CONCLUSION: Use of several organophosphate insecticides was associated with elevated breast cancer risk. However, associations for the women’s and husbands’ use of these insecticides showed limited concordance. Ongoing cohort follow-up may help clarify the relationship, if any, between individual insecticide exposures and breast cancer risk.
AB - BACKGROUND: Some epidemiologic and laboratory studies suggest that insecticides are related to increased breast cancer risk, but the evidence is inconsistent. Women engaged in agricultural work or who reside in agricultural areas may experience appreciable exposures to a wide range of insecticides. OBJECTIVE: We examined associations between insecticide use and breast cancer incidence among wives of pesticide applicators (farmers) in the prospective Agricultural Health Study. METHODS: Farmers and their wives provided information on insecticide use, demographics, and reproductive history at enrollment in 1993–1997 and in 5-y follow-up interviews. Cancer incidence was determined via cancer registries. Among 30,594 wives with no history of breast cancer before enrollment, we examined breast cancer risk in relation to the women’s and their husbands’ insecticide use using Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: During an average 14.7-y follow-up, 39% of the women reported ever using insecticides, and 1,081 were diagnosed with breast cancer. Although ever use of insecticides overall was not associated with breast cancer risk, risk was elevated among women who had ever used the organophosphates chlorpyrifos [HR = 1:4 (95% CI: 1.0, 2.0)] or terbufos [HR = 1:5 (95% CI: 1.0, 2.1)], with nonsignificantly increased risks for coumaphos [HR = 1:5 (95% CI: 0.9, 2.5)] and heptachlor [HR = 1:5 (95% CI: 0.7, 2.9)]. Risk in relation to the wives’ use was associated primarily with premenopausal breast cancer. We found little evidence of differential risk by tumor estrogen receptor status. Among women who did not apply pesticides, the husband’s use of fonofos was associated with elevated risk, although no exposure–response trend was observed. CONCLUSION: Use of several organophosphate insecticides was associated with elevated breast cancer risk. However, associations for the women’s and husbands’ use of these insecticides showed limited concordance. Ongoing cohort follow-up may help clarify the relationship, if any, between individual insecticide exposures and breast cancer risk.
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U2 - 10.1289/EHP1295
DO - 10.1289/EHP1295
M3 - Article
C2 - 28934092
AN - SCOPUS:85031812442
VL - 125
JO - Environmental Health Perspectives
JF - Environmental Health Perspectives
SN - 0091-6765
IS - 9
M1 - 097002
ER -