Abstract
Background Tobacco, alcohol consumption, and HPV infection are the most common risk factors for head and neck cancer (HNC). Despite of this, recent evidences are growing on the association between long-term exposure to pesticides and the risk of chronic diseases, including different types of cancer. The present review evaluated in current literature evidence of an association between exposure to pesticides and the occurrence of HNCs. Material and Methods A literature search of the case-control studies was conducted in the PubMed, Web of science and Cochrane databases. Methodological quality of each study was rated with the Scottish Intercollegiate Guidelines Network (SIGN 50) checklist. Results One thousand and thirty-five studies were identified and twelve met all criteria and, therefore, considered for quality assessment and data extraction. According to SIGN 50 criteria, six studies received an overall high-quality. All the studies considered of high quality found a positive association between exposure to pesticides and different HNC sites, including larynx, pharynx and nasal cavity. In addition, the increased risk was associated with the frequency of exposure. Conclusions Finally, improving pesticide users' awareness of their risks and proper handling, as well as adopting protective measures such as the use of personal protective equipment, appear to be effective in reducing human health damage. Key words:Case control studies, head and neck cancer, pesticides, review, risk factors.
Highlights
IntroductionThe insecticides trichlorophenol, tetrachlorvinphos and parathion showed sufficient evidence in animal carcinogenesis experiments, but the epidemiological data were considered inadequate
The present review evaluated in current literature evidence of an association between exposure to pesticides and the occurrence of head and neck cancer (HNC)
All the studies considered of high quality found a positive association between exposure to pesticides and different HNC sites, including larynx, pharynx and nasal cavity
Summary
The insecticides trichlorophenol, tetrachlorvinphos and parathion showed sufficient evidence in animal carcinogenesis experiments, but the epidemiological data were considered inadequate They were classified as possibly carcinogenic to humans (Group 2B) (13). Our group conducted a review evaluating the association between pesticide exposure and the risk of head and neck cancers, considering cohort studies, and observed that the number of publications is small. The aim of this review of case-control studies is to evaluate the possible association between exposure to pesticides and HNC. - Study Eligibility criteria Articles were included if they met all of the following criteria: 1) Case control study design published in the English language; 2) cases included at least one head and neck cancer sites, including oral cavity, lip, larynx, pharynx, nasal cavity, paranasal sinuses, thyroid, and salivary glands. - Data extraction Data were independently extracted from reports, by two members of the research team, according to sample characteristics (cases and controls, gender and age), study area, evaluation time, studied pesticides, risk assessment, HNC studied, considered confounders, and risk estimative
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