Pesticides and prostate cancer: a review of epidemiologic studies with specific agricultural exposure information.
ABSTRACT Prostate cancer is the most commonly diagnosed cancer in US men, and the second most commonly diagnosed cancer among men worldwide. Although pesticides have been implicated in studies of prostate cancer among farmers, meta-analyses have found heterogeneity across studies, and a number of exposures and lifestyle factors may be unique to farmers. The purpose of this paper is to review the epidemiologic literature to evaluate the hypothesis that agricultural exposure to pesticides is causally associated with prostate cancer risk. We analyzed the eight cohort studies and five case-control studies that quantified and/or evaluated agricultural exposure to particular pesticide classes or chemicals. Despite sporadic positive findings, these studies did not show consistently increased risks to support a causal association between agricultural pesticide use and prostate cancer. Studies using an 'external' comparison group must be interpreted in the context of confounding by differences in prostate-specific antigen screening intensity. Furthermore, most studies did not adjust for potential confounders other than age and time period. It is clearly not possible to exonerate any particular pesticide as a putative cause of prostate cancer - to do so would require an inverse empirical association with an upper confidence limit below the null value. Existing evidence does not point to any pesticide as satisfying widely used guidelines for establishing causation: a strong, exposure-dependent and demonstrably unconfounded, unbiased association, documented in several studies.
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ABSTRACT: To review the recent literature on the incidence and mortality of prostate cancer in farmers compared to non-farmers.Cancer Epidemiology 10/2014; · 2.56 Impact Factor
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ABSTRACT: To inform risk assessment and regulatory decision-making, the relationship between 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and prostate cancer requires clarification. This article systematically and critically reviews the epidemiologic evidence on the association between exposure to TCDD or Agent Orange, a TCDD-contaminated herbicide used during the Vietnam War, and prostate cancer risk. Articles evaluated include 11 studies of three cohorts, four case-control or cross-sectional studies, and three case-only studies of military veterans with information on estimated Agent Orange or TCDD exposure; 13 studies of seven cohorts, one case-control study, and eight proportionate morbidity or mortality studies of Vietnam veterans without information on Agent Orange exposure; 11 cohort studies of workers with occupational exposure to TCDD; and two studies of one community cohort with environmental exposure to TCDD. The most informative studies, including those of Vietnam veterans involved in Agent Orange spraying or other handling, herbicide manufacturing or spraying workers with occupational TCDD exposure, and community members exposed to TCDD through an industrial accident, consistently reported no significant increase in prostate cancer incidence or mortality. Only some potentially confounded studies of Vietnam veterans compared with the general population, studies with unreliable estimates of Agent Orange exposure, and analyses of selected subgroups of Vietnam veterans reported positive associations. Overall, epidemiologic research offers no consistent or convincing evidence of a causal relationship between exposure to Agent Orange or TCDD and prostate cancer. More accurate exposure assessment is needed in large epidemiologic studies to rule out a causal association more conclusively.European Journal of Epidemiology 07/2014; · 5.15 Impact Factor
- Current Neuropharmacology 01/2013; 11(3):315-335. · 2.35 Impact Factor