Prostate cancer (PCa) is one of the most commonly diagnosed cancers among men in developed countries; however, little is known about modifiable risk factors. Some studies have implicated organochlorine and organophosphate insecticides as risk factors (particularly the organodithioate class) and risk of clinically significant PCa subtypes. However, few studies have evaluated other pesticides. We used data from the Agricultural Health Study, a large prospective cohort of pesticide applicators in North Carolina and Iowa, to extend our previous work and evaluate 39 additional pesticides and aggressive PCa. We used Cox proportional hazards models, with age as the time scale, to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between ever use of individual pesticides and 883 cases of aggressive PCa (distant stage, poorly differentiated grade, Gleason score ≥ 7, or fatal prostate cancer) diagnosed between 1993 and 2015. All models adjusted for birth year, state, family history of PCa, race, and smoking status. We conducted exposure-response analyses for pesticides with reported lifetime years of use. There was an increased aggressive PCa risk among ever users of the organodithioate insecticide dimethoate (n = 54 exposed cases, HR = 1.37, 95% CI = 1.04, 1.80) compared to never users. We observed an inverse association between aggressive PCa and the herbicide triclopyr (n = 35 exposed cases, HR = 0.68, 95% CI = 0.48, 0.95), with the strongest inverse association for those reporting durations of use above the median (≥ 4 years; n = 13 exposed cases, HR=0.44, 95% CI=0.26, 0.77). Few additional pesticides were associated with prostate cancer risk after evaluation of extended data from this large cohort of private pesticide applicators.

中文翻译：

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私人农药施用者中的农药暴露和侵略性前列腺癌的风险。

前列腺癌（PCa）是发达国家男性中最常被诊断出的癌症之一；然而，关于可改变的危险因素知之甚少。一些研究认为有机氯和有机磷酸酯杀虫剂是危险因素（尤其是有机二硫酸盐类）和临床上重要的PCa亚型的危险因素。但是，很少有研究评估其他农药。我们使用了来自农业健康研究的数据，该研究是北卡罗来纳州和爱荷华州的一个大型前瞻性农药施用人群，用于扩展我们以前的工作并评估了39种其他农药和腐蚀性PCa。我们使用Cox比例危害模型（以年龄为时间标度）来计算危害比（HRs）和95％置信区间（CIs），以了解曾经使用过的每种农药与883例侵袭性PCa（远期，在1993年至2015年之间诊断出低分化等级，格里森评分≥7或致命的前列腺癌。所有模型均针对出生年，州，PCa家族史，种族和吸烟状况进行了调整。我们对报告使用年限的农药进行了暴露-响应分析。与从未使用过的有机二硫代杀虫剂乐果（n = 54暴露病例，HR = 1.37，95％CI = 1.04，1.80）的使用者相比，侵略性PCa风险增加。我们观察到攻击性PCa与除草剂三氯吡喃之间呈负相关（n = 35暴露病例，HR = 0.68，95％CI = 0.48，0.95），其中报告持续时间超过中位数（≥4年）的患者之间呈最强的负相关； n = 13例暴露病例，HR = 0.44，95％CI = 0.26，0.77）。