Review: Prostate CancerPesticides and prostate cancer: a review of epidemiologic studies with specific agricultural exposure informationMink, Pamela J.a; Adami, Hans-Olovb e; Trichopoulos, Dimitriosb; Britton, Nicole L.c; Mandel, Jack S.d Author Information aExponent Health Sciences Group, Exponent, Inc., Washington, District of Columbia bDepartment of Epidemiology, Harvard School of Public Health, Boston, Massachusetts cExponent Health Sciences Group, Exponent, Inc., Alexandria, Virginia dDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA eDepartment of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden Correspondence to Dr Pamela J. Mink, PhD, MPH, Exponent, Inc., 1730 Rhode Island Ave., NW, Suite 1100, Washington, DC 20036, USA Tel: +1 202 772 4921; fax: +1 202 772 4979; e-mail: [email protected] Received 20 September 2006 Accepted 21 September 2006 European Journal of Cancer Prevention: April 2008 - Volume 17 - Issue 2 - p 97-110 doi: 10.1097/CEJ.0b013e3280145b4c Buy Metrics Abstract Prostate cancer is the most commonly diagnosed cancer in US men, and the second most commonly diagnosed cancer among men worldwide. Although pesticides have been implicated in studies of prostate cancer among farmers, meta-analyses have found heterogeneity across studies, and a number of exposures and lifestyle factors may be unique to farmers. The purpose of this paper is to review the epidemiologic literature to evaluate the hypothesis that agricultural exposure to pesticides is causally associated with prostate cancer risk. We analyzed the eight cohort studies and five case–control studies that quantified and/or evaluated agricultural exposure to particular pesticide classes or chemicals. Despite sporadic positive findings, these studies did not show consistently increased risks to support a causal association between agricultural pesticide use and prostate cancer. Studies using an ‘external’ comparison group must be interpreted in the context of confounding by differences in prostate-specific antigen screening intensity. Furthermore, most studies did not adjust for potential confounders other than age and time period. It is clearly not possible to exonerate any particular pesticide as a putative cause of prostate cancer – to do so would require an inverse empirical association with an upper confidence limit below the null value. Existing evidence does not point to any pesticide as satisfying widely used guidelines for establishing causation: a strong, exposure-dependent and demonstrably unconfounded, unbiased association, documented in several studies. © 2008 Lippincott Williams & Wilkins, Inc.