Introduction

Previous investigations found elevated mortality after breast cancer in association with biomarkers of persistent organochlorine pesticides in non-occupationally exposed women. We hypothesized that lifetime residential pesticide use, which includes persistent and non-persistent pesticides, would also be associated with increased mortality after breast cancer.

Methods

A population-based cohort of 1505 women with invasive or in situ breast cancer was interviewed in 1996–1997, shortly after diagnosis, about pre-diagnostic lifetime residential pesticide use. Participants were followed for mortality through 2014 (595 deaths from any cause and 236 from breast cancer, after 17.6 years of follow-up). Pesticides were examined as 15 individual categories; a group of seven used for lawn and garden purposes; a group of eight used for nuisance-pest purposes; and all combined. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and breast cancer-specific mortality. Modification by estrogen receptor (ER) status, body mass index, and long-term residence was examined.

Results

Ever use (HR = 0.77, 95%CI = 0.63–0.95) and higher lifetime applications (4th quartile: HR = 0.62, 95%CI = 0.47–0.81, p_trend = 0.3) of the lawn and garden group of pesticides were inversely associated with all-cause mortality, compared to never use. The inverse association for lawn and garden pesticide use was limited to ER positive (vs. negative) tumors (p_interaction = 0.05). Nuisance-pest pesticides, and all groups combined, were not associated with all-cause or breast cancer-specific mortality.

Conclusions

Contrary to our hypothesis, lifetime residential use of lawn and garden pesticides, but not all combined or nuisance-pest pesticides, was inversely associated with all-cause mortality after breast cancer.

中文翻译：

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自我报告的住宅杀虫剂使用情况和乳腺癌后的生存情况。

介绍

先前的调查发现，非职业接触有机氯农药的女性乳腺癌后死亡率升高与持久性有机氯农药的生物标志物有关。我们假设终生住宅使用农药（包括持久性和非持久性农药）也与乳腺癌后死亡率增加有关。

方法

1996 年至 1997 年，在诊断后不久，对 1505 名患有浸润性或原位乳腺癌的女性进行了访谈，了解诊断前终生住宅杀虫剂的使用情况。2014 年对参与者的死亡率进行了随访（经过 17.6 年的随访，其中 595 例死于任何原因，236 例死于乳腺癌）。农药按 15 个单独类别进行审查；七人一组，用于草坪和花园；八人一组，用于防治害虫；并全部结合起来。Cox 回归用于估计全因死亡率和乳腺癌特异性死亡率的危险比 (HR) 和 95% 置信区间 (CI)。检查了雌激素受体（ER）状态、体重指数和长期居住的变化。

结果

草坪和花园组杀虫剂的使用次数（HR = 0.77，95%CI = 0.63–0.95）和较高寿命应用（第四个四分位数：HR = 0.62，95%CI = 0.47–0.81，p 趋势 = 0.3 _） 成反比与从不使用相比，与全因死亡率相关。草坪和花园杀虫剂使用的负相关仅限于 ER 阳性（与阴性）肿瘤（p_相互作用 = 0.05）。有害害虫杀虫剂以及所有组的总和与全因死亡率或乳腺癌特异性死亡率无关。

结论

与我们的假设相反，终生使用草坪和花园杀虫剂（但并非所有组合杀虫剂或有害害虫杀虫剂）与乳腺癌后的全因死亡率呈负相关。