Association between pesticide use and cancer incidence among farm workers: a systematic review protocol

OBJECTIVE: This systematic review will examine the association between pesticide use and cancer incidence among farm workers. INTRODUCTION: Farmers are the most essential part of many countries' agriculture-based economies. Several studies have identified acute and chronic hazards associated with pesticide use, including lymphoma, leukemia, brain tumors, and other cancers. However, no systematic reviews have comprehensively assessed the association between pesticide use and cancer incidence among farmers. ELIGIBILITY CRITERIA: Primary observational studies (case-control, cohort, and cross-sectional) that include participants who are farm workers (farmers, their spouses, and seasonal workers) in any geographic location and document exposure to pesticides associated with cancer incidence will be eligible for inclusion. METHODS: Academic databases (PubMed, Web of Science Core Collection, Ovid Embase, Cochrane CENTRAL, and ProQuest Health and Medical Collection), non-academic databases (Google Scholar up to 20 pages), and other gray literature (OAIster, Shodhganga, and medRxiv) will be searched. Two reviewers will independently screen titles/abstracts and full texts, with adjudication by a third reviewer. Critical appraisal of the included studies will be performed using JBI checklists. Quantitative outcomes on the association of pesticide exposure and cancer incidence will be pooled in statistical meta-analysis, where possible. Heterogeneity between studies will be assessed statistically using standard χ 2 and I2 tests. Where statistical pooling is not possible, the findings will be presented narratively. Certainty of the evidence regarding the carcinogenicity of pesticides will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. REVIEW REGISTRATION: PROSPERO CRD420251019979.