Nicole M Niehoff1, Marilie D Gammon2, Humberto Parada3, Steven D Stellman4, Alfred I Neugut5, Susan L Teitelbaum6. 1. Department of Epidemiology, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7435, USA. Electronic address: nicole.niehoff@nih.gov. 2. Department of Epidemiology, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599-7435, USA. 3. Division of Epidemiology & Biostatistics, School of Public Health, San Diego State University, 5500 Campanile Drive, Hardy Tower Room 168, San Diego, CA, 92182, USA. 4. Department of Epidemiology, Columbia University, 722 West 168th Street, New York, NY, 10032, USA. 5. Department of Epidemiology, Columbia University, 722 West 168th Street, New York, NY, 10032, USA; Department of Medicine, Columbia University, 722 West 168th Street, New York, NY, 10032, USA. 6. Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
Abstract
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, ptrend = 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 (pinteraction = 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.
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, ptrend = 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 (pinteraction = 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.
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