Pesticide exposure and cancer: an integrative literature review

ABSTRACT We conducted an integrative literature review of published studies on pesticide and cancer exposure, focusing on farmers, rural population, pesticide applicators, and rural workers. The Medline/PubMed was used as searching database. After the retrieval, 74 articles were selected according to pre-established criteria, which design involved 39 case-controls, 32 cohorts, 2 ecological ones, and 1 cross-sectional. Among them, 64 studies showed associations between pesticides and cancer while 10 did not find any significant association. The studies found 53 different types of pesticides significantly associated with at least one type of cancer and 19 different types of cancers linked to at least one type of pesticide. Although few studies presented contradictory results, the sole fact of being a farmer or living near crops or high agricultural areas have also been used as a proxy for pesticide exposure and significantly associated with higher cancer risk. The literature well illustrates the case of prostate cancer, Non-Hodgkin lymphoma, leukemia, multiple myeloma, bladder and colon cancers. Studies are recommended to further investigate the relationship between pesticide and neoplasm of testis, breast, esophagus, kidney, thyroid, lip, head and neck, and bone.

摘要：本研究针对已发表的农药与癌症暴露相关研究开展整合性文献综述，聚焦群体涵盖农民、农村人口、农药施用者及农村劳动者。本研究以Medline/PubMed数据库作为检索平台。检索完成后，共筛选出74篇符合预先设定标准的文献，其研究设计包括39项病例对照研究（case-control study）、32项队列研究（cohort study）、2项生态学研究（ecological study）及1项横断面研究（cross-sectional study）。其中，64项研究证实农药与癌症之间存在关联，10项研究未发现二者存在显著相关性。本综述共发现53种不同类型的农药与至少一种癌症存在显著关联，同时也发现19种不同类型的癌症与至少一种农药存在关联。尽管仅有少量研究得出了矛盾结果，但将“农民身份”或“居住于农田周边及高农业活动区域”作为农药暴露的替代指标，也被证实与更高的癌症风险显著相关。现有文献充分验证了前列腺癌、非霍奇金淋巴瘤、白血病、多发性骨髓瘤、膀胱癌及结肠癌与农药暴露的关联。建议后续研究进一步探讨农药与睾丸癌、乳腺癌、食管癌、肾癌、甲状腺癌、唇癌以及头颈部和骨骼恶性肿瘤的关联。