Kidney cancer and occupational agricultural exposures in the AGRIculture and CANcer cohort
Résumé
Abstract Introduction The relationship between kidney cancer and occupational exposures, especially agricultural, has been understudied. This study aimed to assess the risk of kidney cancer with a wide range of agricultural activities and tasks. Methods Participants from the French AGRIculture and CANcer cohort (≈180 000) were included. Incident kidney cancers (n = 654) were identified through cancer registries from 2005–2007 until 31 December 2017. Occupational exposures and potential confounders were identified by using enrollment questionnaires covering 5 livestock types, 13 crops, and related tasks. Cox models with age as the timescale were applied separately for men and women, using non-exposed farmers as the reference to account for genetic and agricultural exposure differences, along with exposure–response and sensitivity analyses. Results In men, positive associations were found between kidney cancer risk and working with rapeseed [hazard ratio (HR) = 1.26 (0.95–1.68)] and sunflowers [HR = 1.23 (0.89–1.68)], and tasks related to other crops such as corn, wheat/barley, beet, and tobacco. In women, an increased risk was noted for winegrowers [HR = 1.56 (1.12–2.18)]. Pesticide use (on fields and/or seeds) was associated, for both sexes, with these crops, showing exposure–response relationships with crop area and work duration. Conversely, some inverse associations were observed for livestock breeding, notably cattle in men and poultry in women. Conclusion We reported positive associations between kidney cancer risk and specific field crops, tobacco, and vineyards, with gender differences in pesticide-related tasks. Further studies are needed to understand these differences and identify substances linked to kidney cancer.