Kidney cancer and occupational agricultural exposures in the AGRIculture and CANcer cohort

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.