Agricultural exposure and risk of soft tissue sarcomas and gastrointestinal stromal sarcoma in the AGRIculture and CANcer (AGRICAN) cohort
Menée entre 2005 et 2015 par questionnaire auprès de 181 842 agriculteurs actifs ou retraités (56 % d'hommes ; âge médian : 67 ans), cette étude analyse l'association entre des expositions professionnelles et le risque de sarcome (188 cas), en fonction de l'activité exercée (élevage, production de fruits et légumes...)
Background: Sarcomas are a heterogeneous group of tumors whose incidence is nearly 5 per 100 000 inhabitants in Europe. Their causes are poorly understood, although occupational exposures (especially farming and pesticides) are suspected. Methods: The AGRICAN cohort is a prospective study of 181,842 individuals enrolled in 2005-2007 who completed an enrolment questionnaire with data on lifelong agricultural exposure. Associations between agricultural exposure and sarcoma overall, GIST (gastro-intestinal stromal tumors) and myomatous and fibrous sarcoma together, were analyzed with a Cox model. Results: Until 2015, 188 incident cases of sarcoma were identified. Increased risks were observed (1) among cattle farmers working < 10 years (HR<10years=2.45, 95%CI 1.36-4.43) and breeding ≥ 50 livestock (HR≥50 animals =3.84, 95%CI 1.60-9.22), especially if involved in animal care and building disinfection, (2) in greenhouse production (HR=1.82, 95%CI 1.01-3.30), and (3) in field-grown vegetable production (HR=1.49, 95%CI 0.96-2.32). Concerning histological subtypes, GIST were positively associated with pesticide use in vineyards (HR=2.24, 95%CI 0.95-5.30). For myomatous and fibrous sarcoma, the only increase was seen in field-grown vegetable production (HR=2.37, 95%CI 1.16-4.85). Conclusion: In AGRICAN, the risk of sarcomas was increased in several farming activities with differences according to histological subtype.