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Soft Tissue Sarcoma

• Comparison of questionnaire data and analyzed dioxin concentrations as a measure of exposure in soft-tissue sarcoma studies.
  Soft-tissue sarcoma is one of the few specific tumors thought to be caused by polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and specifically TCDD. Evidence is, however, based on questionnaire-based case-control studies, and on very few cancer cases in cohort studies at high occupational exposures to chlorophenols or chlorophenoxy acid herbicides with dioxin impurities. Recall bias has been suspected to influence the reporting of exposure, but this possibility has never been adequately put to test. In the present study 87 cancer patients and 308 controls answered a questionnaire asking their exposure to wood preservatives, fungicides and herbicides, and insecticides, and their PCDD/F concentrations were also measured. After matching for age and area 67-69 sarcoma patients and 153-156 controls were available for the study depending on the chemical group, 1-3 controls for each sarcoma patient. Sarcoma patients reported exposure to these chemicals significantly more often than controls did, odds ratios were 6.7 for wood preservatives (p=0.02), 16 for fungicides and herbicides (p=0.01), and 4.9 for insecticides (p=0.06). There was no association, when the analysis was based on measured PCDD/F concentrations (odds ratios close to 1). Although it is not possible to exclude the role of the main chemical as the cause with certainty, the results indicate that recall bias is very likely in previous studies. Thus the causality between contaminant PCDD/Fs and soft tissue sarcoma cannot be considered proven.
  [Tuomisto J, Airaksinen R, Pekkanen J, et al. 2017. Toxicol Lett. 270:8-11.]
• Wartime toxin exposure: recognising the silent killer
  Wartime toxin exposures have been implicated in the genesis of malignancy in war veterans. Agent Orange, one toxin among many, has been linked to malignancy and the subcomponent phenoxyacetic acid has been associated with soft tissue sarcomas (STSs). This case demonstrates the association between a wartime toxin exposure (Agent Orange) and subsequent cancer development. Ultimately, we aim to highlight the importance of simple, specific questions in the patient history to account for previous wartime toxin exposures.
  [Khan K, Wozniak SE, Coleman J, Didolkar MS. 2016. BMJ Case Rep. pii: bcr2016217438.]
• 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]
• Risk of childhood cancers associated with residence in agriculturally intense areas in the United States
  An ecological study analyzing incidence data from U.S. children ages 0-14 years diagnosed with cancer between 1995 and 2001 and residence in a county with agricultural activity finds an elevated risk for soft tissue sarcomas at high agricultural activity (greater than 60% of county acreage devoted to farming). When looking at sub-types, risk increased for rhabdomyosarcomas and category including germ cell, trophoblastic, and gonadal neoplasms. When looking at crop acreage, an increased risk if found for germ cell carcinomas and oat crops.
  [Carrozza, S.E., et al. 2008. Environ Health Perspect 116(4):559-565.]
• Home pesticide use and childhood cancer: A case-control study
  A 1995 case-control study of Denver children finds that yard pesticide applications are linked to a four-fold increase in risk to soft tissue sarcomas.
  [Leiss, J., et al. 1995. American Journal of Public Health 85:249-252]
• Soft tissue sarcoma and non-Hodgkin's lymphoma in workers exposed to phenoxy herbicides, chlorophenols, and dioxins: two nested case-control studies.
  A nested international occupational case-control study finds excess risk of soft tissue sarcoma with exposure to chlorophenoxy herbicides (OR 10.3) including 2,4-D.
  [Kogevinas, M, et al. 1995. Epidemiology 6(4):396-402]
• Risk factors for soft tissue sarcomas in childhood: a case-control study.
  A hospital-based case-control study on childhood soft tissue sarcomas in Italy finds a positive association with maternal employment as a farmer,=.
  [Magnani, C., et al. 1989. Tumori 75(4):396-400]