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Pancreatic Cancer

• Comprehensive assessment of pesticide use patterns and increased cancer risk
  Pesticides are an essential feature of modern-day agriculture that adds to the list of factors that increase cancer risk. Our study aims to comprehensively evaluate this relationship through a population-based approach that considers confounding variables such as county-specific rates of smoking, socioeconomic vulnerability, and agricultural land. We achieved our goal with the implementation of latent-class pesticide use patterns, which were further modeled among covariates to evaluate their associations with cancer risk. Our findings demonstrated an association between pesticide use and increased incidence of leukemia; non-Hodgkin's lymphoma; bladder, colon, lung, and pancreatic cancer; and all cancers combined that are comparable to smoking for some cancer types. Through our comprehensive analysis and unique approach, our study emphasizes the importance of a holistic assessment of the risks of pesticide use for communities, which may be used to impact future policies regarding pesticides.
  [Gerken, J. et al. (2024) Comprehensive assessment of pesticide use patterns and increased cancer risk, Frontiers. Available at: https://www.frontiersin.org/journals/cancer-control-and-society/articles/10.3389/fcacs.2024.1368086/full. ]
• Cancer risks in a population-based study of 70,570 agricultural workers: results from the Canadian census health and Environment cohort (CanCHEC).
  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. Study present findings from CanCHEC (Canadian Census Health and Environment Cohort), the largest national population-based cohort of agricultural workers. 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. 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. 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.
  [Kachuri L, Harris MA, MacLeod JS, et al. 2017. BMC Cancer. 17(1):343]
• Exposure to environmental chemicals and heavy metals, and risk of pancreatic cancer.
  Exposure to various chemicals and heavy metals has been associated with risk of different cancers; however, data on whether such exposures may increase the risk of pancreatic cancer (PC) are very limited and inconclusive. We examined PC risk with self-reported exposures to chemicals and heavy metals. The design was a clinic-based, case-control study of data collected from 2000 to 2014 at Mayo Clinic in Rochester, Minnesota, USA. Cases were rapidly ascertained patients diagnosed with pancreatic ductal adenocarcinoma (n = 2,092). Controls were cancer-free patients in primary care clinics (n = 2,353), frequency-matched to cases on age, race, sex, and state/region of residence. Cases and controls completed identical risk factor questionnaires, which included yes/no questions about regular exposure to pesticides, asbestos, benzene, chlorinated hydrocarbons, chromium, and nickel. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) comparing those who affirmed exposure to each of the chemicals/heavy metals to those who reported no regular exposure, adjusting for potential confounders. Self-reported regular exposure to pesticides was associated with increased odds of PC (OR 1.21, 95% CI 1.02-1.44). Regular exposure to asbestos (OR 1.54, 95% CI 1.23-1.92), benzene (OR 1.70, 95% CI 1.23-2.35), and chlorinated hydrocarbons (OR 1.63, 95% CI 1.32-2.02) also was associated with higher odds of PC. Chromium and nickel exposures were not significantly associated with PC. These findings add to the limited data suggesting that exposure to pesticides, asbestos, benzene, and chlorinated hydrocarbons may increase PC risk. They further support the importance of implementing strategies that reduce exposure to these substances.
  [Antwi SO, Eckert EC, Sabaque CV, Leof ER, et al. 2015. Cancer Causes Control. 26(11):1583-91.]
• Agricultural pesticide use and pancreatic cancer risk in the Agricultural Health Study Cohort.
  Pancreatic cancer is a rapidly fatal disease that has been linked with pesticide use. To further examine the potential associations between the use of a number of pesticides and pancreatic cancer, authors conducted a case-control analysis in the Agricultural Health Study, one of the largest prospective cohorts with over 89,000 participants including pesticide applicators and their spouses in Iowa and North Carolina. Among pesticide applicators, 2 herbicides (EPTC and pendimethalin) of the 13 pesticides examined for intensity-weighted lifetime use showed a statistically significant exposure-response association with pancreatic cancer. Applicators in the top half of lifetime pendimethalin use had a 3.0-fold risk compared with never users, and those in the top half of lifetime EPTC use had a 2.56-fold risk compared with never users. Organochlorines were not associated with an excess risk of pancreatic cancer in this study. These findings suggest that herbicides, particularly pendimethalin and EPTC, may be associated with pancreatic cancer.
  [Andreotti G, Freeman LE, Hou L, Coble J, Rusiecki J, et al. 2009. Int J Cancer. 124(10):2495-500.]
• Pesticide sales and adult male cancer mortality in Brazil.
  A study of pesticides sales in different parts of Brazil and cancer mortality rates a decade later finds a statistically significant correlation between pesticide sales with the mortality rates for leukemia and cancer of the lip, esophagus, pancreas, and prostate.
  [Chrisman, J.D., et al. 2009. Int J Hyg Environ Health ;212(3):310-21]
• Lifestyle, occupational, and reproductive factors in relation to pancreatic cancer risk
  This study examined the epidemiology of pancreatic cancer in Egypt. We obtained detailed information on smoking, occupational, medical, and reproductive histories from 194 pancreatic cancer cases and 194 controls. Compared with not smoking, smoking cigarettes alone or in conjunction with other smoking methods (eg, water pipe, cigar) was associated with an increased risk (odds ratio [OR], 4.5 and 7.8; 95% confidence interval [95% CI], 1.9-10.7 and 3.0-20.6, respectively). Passive smoking was also a significant risk factor (OR, 6.0; 95% CI, 2.4-14.8). The risk of pancreatic cancer was elevated among subjects exposed to pesticides (OR, 2.6; 95% CI, 0.97-7.2). A prior diagnosis of diabetes mellitus for a period of 10 years was associated with higher risk (OR, 5.4; 95% CI, 1.5-19.9). For women, having 7 or more live births and lactating for 144 months or longer were associated with a reduced risk (OR, 0.5 and 0.2; 95% CI, 0.2-1.3 and 0.1-0.9, respectively). No association was found between family history, allergy, or obesity and pancreatic cancer in Egypt. Multiple tobacco consumption methods, passive smoking, pesticide exposures, and diabetes are associated with an increased risk for pancreatic cancer. Prolonged lactation and increased parity are associated with a reduced risk for pancreatic cancer.
  [Lo, A.C., et al. 2007. Pancreas 35(2):120-129.]
• Occupational exposure to pesticides and pancreatic cancer
  Excess risk is found for occupational exposure to fungicides (OR 1.5) and herbicides (OR 1.6).
  [Ji, B.T., et al. 2001. Am J Ind Med 39(1):92-99.]
• Risk of pancreatic cancer and occupational exposures in Spain
  In a small study, occupational exposures to pesticides cause a three-fold increased risk for pancreatic cancer. For each type of pesticide group, moderately increased odds ratios were apparent in the high-intensity category, highest for arsenical pesticides (OR 3.4), and ‘other pesticides’ (OR 3.17).
  [Alguacil, J., et al. 2000. Ann Occup Hyg 44(5):391-403.]
• Mortality among aerial pesticide applicators and flight instructors: follow-up from 1965-1988
  A retrospective cohort mortality study of aerial pesticide applicator pilots finds a significantly elevated risk for pancreatic cancer (risk ratio 2.71).
  [Cantor, K.P. and Silberman, W. 1999. Am J Ind Medicine 36(2):239-47]
• Pancreatic cancer in industrial branches and occupations in Finland
  Finnish study finds a more than six-fold increased risk for male gardeners to pancreatic cancer.
  [Partanen, T., et al 1994. Am J Ind Med 25(6):851-866.]
• Cancer among farmers in central Italy
  A case-referent study of Italian farmers finds a significantly increased risk of pancreatic cancer, as well as other cancers, among licensed pesticides users with greater than 10 years’ experience.
  [Forastiere, F, et al. 1993. Scand J Work Environ Health 19(6):382-389.]
• Cancer mortality in the U.S. flour industry
  A study of U.S. flour mill workers finds an two-fold increased risk for pancreatic cancer (OR 2.2.) believed to be related to pesticide exposure.
  [Alavanja, M.C., et al. 1990. J Natl Cancer Inst 82(10):840-848]