Lymphohematopoietic Cancers Research Articles

Disparities in overall and site-specific cancer mortality among immigrant generations in Sweden: A nationwide follow-up study over three decades.

We examined the overall and site-specific cancer mortality disparities among first-generation - separately in adults (G1) and children (G1.5) at immigration - and second-generation (G2) immigrants and their countries of origin using population-based registries in Sweden, encompassing over 8.5 million individuals aged 20 and above residing in Sweden since 1990, with follow-up until December 31, 2023. Cox proportional hazard models were fitted, stratified by gender, to estimate hazard ratios and 95% confidence intervals compared to natives. Mortality rates for most cancers transitioned from lower in G1 towards the rate of natives in G2. However, elevated mortality rates were sustained across generations for liver cancer in males and stomach cancer in females. Among G2, mortality from lymphohematopoietic cancers in males, and lung and cervix uteri cancers in females were elevated - by 10%, 9%, and 17% respectively compared to natives. Country of origin analyses revealed substantial disparities. For instance, G2 females with Nordic parental origin had a 13% higher risk of death from lung cancer, while those with non-Western parental origin had a 54% lower risk as compared to natives. These findings suggest a generational and arrival-age dynamics of cancer mortality and highlight target groups for cancer prevention and control among immigrants.

Occupational exposure to benzene and mortality risk of lymphohaematopoietic cancers in the Swiss National Cohort.

Previous studies established a causal relationship between occupational benzene exposure and acute myeloid leukemia (AML). However, mixed results have been reported for associations between benzene exposure and other myeloid and lymphoid malignancies. Our work examined whether occupational benzene exposure is associated with increased mortality from overall lymphohaematopoietic (LH) cancer and major subtypes. Mortality records were linked to a Swiss census-based cohort from two national censuses in 1990 and 2000. Cases were defined as having any LH cancers registered in death certificates. We assessed occupational exposure by applying a quantitative benzene job-exposure matrix (BEN-JEM) to census-reported occupations. Exposure was calculated as the products of exposure proportions and levels (P × L). Cox proportional hazards models were used to calculate LH cancer death hazard ratios (HR) and 95% confidence intervals (CI) associated with benzene exposure, continuously and in ordinal categories. Our study included approximately 2.97 million persons and 13 415 LH cancer cases, including 3055 cases with benzene exposure. We observed increased mortality risks per unit (P × L) increase in continuous benzene exposure for AML (HR 1.03, 95% CI 1.00-1.06) and diffuse large B-cell lymphoma (HR 1.09, 95% CI 1.04-1.14). When exposure was assessed categorically, increasing trends in risks were observed with increasing benzene exposure for AML (P=0.04), diffuse large B-cell lymphoma (P=0.02), and follicular lymphoma (P=0.05). In a national cohort from Switzerland, we found that occupational exposure to benzene is associated with elevated mortality risks for AML, diffuse large B-cell lymphoma, and possibly follicular lymphoma.

Assessment of associations between inhaled formaldehyde and lymphohematopoietic cancer through the integration of epidemiological and toxicological evidence with biological plausibility.

Formaldehyde is recognized as carcinogenic for the portal of entry sites, though conclusions are mixed regarding lymphohematopoietic (LHP) cancers. This systematic review assesses the likelihood of a causal relationship between formaldehyde and LHP cancers by integrating components recommended by NASEM. Four experimental rodent bioassays and 16 observational studies in humans were included following the implementation of the a priori protocol. All studies were assessed for risk of bias (RoB), and meta-analyses were conducted on epidemiological studies, followed by a structured assessment of causation based on GRADE and Bradford Hill. RoB analysis identified systemic limitations precluding confidence in the epidemiological evidence due to inadequate characterization of formaldehyde exposure and a failure to adequately adjust for confounders or effect modifiers, thus suggesting that effect estimates are likely to be impacted by systemic bias. Mixed findings were reported in individual studies; meta-analyses did not identify significant associations between formaldehyde inhalation (when measured as ever/never exposure) and LHP outcomes, with meta-SMRs ranging from 0.50 to 1.51, depending on LHP subtype. No associations with LHP-related lesions were reported in reliable animal bioassays. No biologically plausible explanation linking the inhalation of FA and LHP was identified, supported primarily by the lack of systemic distribution and in vivo genotoxicity. In conclusion, the inconsistent associations reported in a subset of the evidence were not considered causal when integrated with the totality of the epidemiological evidence, toxicological data, and considerations of biological plausibility. The impact of systemic biases identified herein could be quantitatively assessed to better inform causality and use in risk assessment.

Use of CT, ED presentation and hospitalisations 12 months before and after a diagnosis of cancer in Western Australia: a population-based retrospective cohort study

ObjectiveTo examine the use of CT, emergency department (ED)-presentation and hospitalisation and in 12 months before and after a diagnosis of cancer.DesignPopulation-based retrospective cohort study.SettingWest Australian linked administrative records at...

Lymphohematopoietic cancer mortality among Korean semiconductor manufacturing workers

BackgroundWe aimed to examine the lymphohematopoietic cancer mortality in a cohort of workers at a semiconductor manufacturing company in South Korea according to their jobs.MethodsA retrospective cohort was constructed using the personnel records of semiconductor manufacturing workers who were employed in a semiconductor company in South Korea in 1998–2012. Data on their vital status and causes of death were obtained from the National Statistical Office of South Korea. The standardized mortality ratios (SMRs) of lymphohematopoietic cancer were calculated.ResultsA total of 288 deaths were reported, of which 22 were caused by lymphohematopoietic cancer, among 65,782 workers in 878,325 person-years. The SMRs for lymphohematopoietic cancer were 0.78 (95% confidence interval [CI] = 0.39–1.40; the number of observed cases [Obs] = 11) among male workers and 1.71 (95% CI = 0.85–3.06; Obs = 11) among female workers. Among female operators, excess deaths due to lymphohematopoietic cancer (SMR = 2.59, 95% CI = 1.24–4.76) and leukemia (SMR = 2.92, 95% CI = 1.26–5.76) were observed. However, they were not observed among office workers, facility managers, utility managers, or process managers.ConclusionFemale operators involved in the semiconductor wafer fabrication process had higher risk of mortality from lymphohematopoietic cancer.

Ethylene oxide emissions and incident breast cancer and non-Hodgkin lymphoma in a US cohort.

Ethylene oxide (EtO) is a carcinogenic gas used in chemical production and to sterilize medical equipment that has been linked to risk of breast and lymphohematopoietic cancers in a small number of occupational studies. We investigated the relationship between environmental EtO exposure and risk of these cancers. Using the US Environmental Protection Agency's Toxics Release Inventory, we estimated historical exposures for National Institutes of Health-AARP Diet and Health Study participants enrolled in 1995-1996. We constructed 2 metrics at 3, 5, and 10 km: 1) distance between residences and EtO-emitting facilities, weighted by the proportion of time the home was downwind of each facility, and 2) distance-weighted, wind direction-adjusted average airborne emissions index (AEI=∑[lbs EtO/km2]). We estimated risk (hazard ratio [HR], 95% confidence interval [CI]) of incident breast cancer (in situ and invasive) among postmenopausal women (n = 173 670) overall and by tumor estrogen receptor status and non-Hodgkin lymphoma in the full cohort (n = 451 945). We observed an increased risk of breast cancer associated with EtO-emitting facilities within 10 km (HR[≤10vs>10] = 1.05, 95% CI = 1.00 to 1.10) that appeared stronger for in situ (HR[≤10vs>10] = 1.13, 95% CI = 1.00 to 1.27) than invasive (HR[≤10vs>10] = 1.03, 95% CI = 0.97 to 1.09) disease. Risk of breast cancer in situ was also increased in the top AEI quartiles, and associations weakened with larger distances (HR[Q4vs0] = 1.60, 95% CI = 0.98 to 2.61; HR[Q4vs0] = 1.28, 95% CI = 0.92 to 1.79; HR[Q4vs0] = 1.25, 95% CI = 1.02 to 1.53 at 3, 5, and 10 km, respectively). No differences in breast cancer risk were observed by estrogen receptor status. We found no clear pattern of increased non-Hodgkin lymphoma risk. A novel potential association between EtO emissions and risk of in situ, but not invasive, breast cancer warrants additional evaluation.

Low-Dose Radiation Risks of Lymphohematopoietic Cancer Mortality in U.S. Shipyard Workers.

The linear, non-threshold (LNT) hypothesis of cancer induction derived from studies of populations exposed to moderate-to-high acute radiation doses may not be indicative of cancer risks associated with lifetime radiation exposures less than 100 mSv. The objective of this study was to examine risks and dose-response patterns of lymphohematopoietic cancer (LHC) and its types associated with low radiation exposure while adjusting for possible confounding factors. A retrospective cohort of 437,937 U.S. nuclear shipyard workers (153,930 radiation and 284,007 non-radiation workers) was followed from 1957 to 2011, with 3,699 LHC deaths observed. The risk of LHC in radiation workers was initially compared to the risk in non-radiation workers. Time dependent accumulated radiation dose, lagged 2 years, was used in categorical and continuous dose analysis among radiation workers to examine the LHC risks and possible dose-response relationships based on Poisson regression models. These analyses controlled for sex, race, time dependent age, calendar time, socioeconomic status, solvent-related last job, and age at first hire. The median lifetime radiation dose for the radiation worker population was 0.82 mSv and the 95th percentile dose was 83.63 mSv. The study shows: 1. LHC mortality for radiation workers was significantly lower than non-radiation workers relative risk: 0.927; 95% confidence intervals (95% CI): 0.865, 0.992; P = 0.030]. Among LHC types, the risks for lymphoid leukemia and lymphomas in radiation workers were lower than the risk in non-radiation workers with statistical significance, while the risk for the rest of LHC types did not show any statistically significant difference. 2. In categorical dose analysis among radiation workers, sample size weighted linear trend of relative risk (RRs) for LHC and its types in five dose categories (>0-<25, 25-<50, 50-<100, 100-<200, and > = 200 mSv) vs. 0 mSv were not statistically significant, although there was an elevation of RR for chronic myeloid leukemia only in the 50-<100 mSv category (RR: 2.746; 95% CI: 1.002, 7.521; P = 0.049) vs. 0 mSv. 3. The Poisson regression analyses among radiation workers using the time dependent radiation dose as a continuous variable showed an excess relative risk (ERR) for LHC at 100 mSv of 0.094 (95% CI: -0.037, 0.225; P = 0.158) and leukemia less chronic lymphoid leukemia, of 0.178 (95% CI: -0.085, 0.440; P = 0.440) vs. 0 mSv. The ERRs and their linear trend for all other types were not statistically significant.

Rheumatoid arthritis and risk of site-specific cancers: Mendelian randomization study in European and East Asian populations

BackgroundThe associations of rheumatoid arthritis (RA) with risk of site-specific cancers beyond lymphohematopoietic cancer have been scarcely explored. We conducted a Mendelian randomization investigation of the associations of RA with site-specific cancers in European and East Asian populations.MethodsIndependent genetic variants strongly associated with RA in European and East Asian populations were selected as instrumental variables from genome-wide association studies of 58,284 European individuals (14,361 cases and 43,923 controls) and 22,515 East Asian individuals (4873 cases and 17,642 controls), respectively. The associations of genetic variants with overall and 22 site-specific cancers were extracted from the UK Biobank study (n = 367,561), the FinnGen study (n = 260,405), Biobank Japan (n = 212,453), and international consortia. The associations for one outcome from different data sources were combined by meta-analysis.ResultsIn the European population, the combined odds ratios per 1-unit increase in log odds of genetic liability to RA were 1.06 (95% confidence interval [CI] 1.03–1.10) for head and neck cancer, 1.06 (95% CI 1.02–1.10) for cervical cancer, 0.92 (95% CI 0.87–0.96) for testicular cancer, and 0.94 (95% CI 0.90–0.98) for multiple myeloma. In the East Asian population, the corresponding odds ratios were 1.17 (95% CI 1.06–1.29) for pancreatic cancer, 0.91 (95% CI 0.88–0.94) for breast cancer, and 0.90 (95% CI 0.84–0.96) for ovarian cancer. There were suggestive associations for breast and ovarian cancer and overall cancer in the European population. No other associations were observed.ConclusionThis study suggests that RA may play a role in the development of several site-specific cancers.

An updated lymphohematopoietic and bladder cancers risk evaluation for occupational and environmental exposures to 1,3-butadiene

EPA designated 1,3-butadiene (BD) as a high priority chemical in December 2019 and is presently performing an evaluation under the Toxic Substances Control Act (TSCA). EPA's cancer dose-response assessment for BD was published in 2002 and was primarily based on a study on workers exposed to BD in the North American synthetic Styrene-Butadiene Rubber (SBR) Industry developed by the University of Alabama at Birmingham (UAB). EPA relied upon a Poisson regression of leukemia mortality data from this cohort (hereinafter referred to as the SBR study) to estimate the cancer potency of BD. At the time, the SBR cohort included more than 15,000 male workers that were followed up through 1991. The SBR cohort has undergone multiple updates over the past two decades. Most recently, Sathiakumar et al. (2021a, b) published an update, with 18 more years of follow up in addition to approximately 5,000 female workers and updated exposure concentration estimates. Recent EPA assessments (e.g., for ethylene oxide, USEPA 2016) based on epidemiological studies use Cox proportional hazards models because they offer better control of the effect of age in cancer development and are less restrictive than Poisson regression models. Here, we develop exposure-response models using standard Cox proportional hazards regression. We explore the relationship between six endpoints (all leukemia, lymphoid leukemia, myeloid leukemia, multiple myeloma, non-Hodgkin's lymphoma, and bladder cancer) and exposures to BD using the most recent exposure metrics and the most recent update of the SBR study. After adjusting for statistically significant covariates, an upper 95% confidence level on the cancer potency based on leukemia derived herein is 0.000086 per ppm, which is approximately 1,000-fold less than EPA's (2002) estimate of 0.08 per ppm and about 10-fold less than TCEQ's (2008) estimate of 0.0011 per ppm.

Erythroderma as a Paraneoplastic Cutaneous Disorder in Mantle Cell Lymphoma: A Case Report and Literature Review of Molecular Insights into Physiopathology

Mantle Cell Lymphoma (MCL) is a lymphohematopoietic cancer of follicular origin and diffuse growth. It is a rare small B-cell lymphoma, with an incidence of 7-10% of all non-Hodgkin lymphomas, affecting adults (55-60 years), of which 80% are typically male. According to the World Health Organization guidelines, the diagnosis of MCL should be established based on morphological examination and immunophenotyping with detection of cyclin D1 resulting from the chromosomal translocation t(11;14)(q13;q32) of the CCND1 gene or SOX11 protein overexpression. Herein we present an infrequent clinical case of a female patient with MCL who presented erythroderma as a paraneoplastic cutaneous disorder. Moreover, we delved into the molecular insights of immune B-cell lymphocytic affections in this communication.

Rural labor associated with lymphohematopoietic cancers in a public reference hospital: a case-control study, Ceará, Brazil, 2019-2021

This is a paired case-control study that sought to verify the association between professions and lymphohematopoietic cancers in a public reference hospital in the State of Ceará, Brazil, during 2019-2021. Case group consisted of hematological patients with multiple myeloma, leukemias or non-Hodgkin lymphomas, monitored by the social service of a bone marrow transplant hospital unit (n = 114), whereas comparable individuals from a different hospital unit made up the control group (n = 114), forming 1:1 pairs. Diagnosis was performed by a medical team and the variables were measured by accessing hospital records. Group comparison was conducted using bivariate conditional logistic regression and adjusted by region of residence. Results show that multiple myeloma (43.9%), leukemias (43%) and non-Hodgkin lymphomas (13.2%) were the cancer with the highest prevalence in the case group. Proportions of jobs, area of residence, water supply and Regional Superintendence of Health showed statistically significant difference between the case and control groups. Rural workers were more likely to present the cancers studied (ORraw = 5.00, 95%CI: 1.91; 13.06 and ORadjusted = 3.38, 95%CI: 1.20; 9.54), whereas trade workers had lower odds (ORraw = 0.26, 95%CI: 0.10; 0.70 and ORadjusted = 0.30, 95%CI: 0.10; 0.88). The findings allow us to reflect on the process of illness among rural workers and illustrate the potential of health services to contribute to investigations on occupational exposures.

Quantitative NanoLC/NSI+-HRMS Method for 1,3-Butadiene Induced bis-N7-guanine DNA-DNA Cross-Links in Urine.

1,3-Butadiene (BD) is a common environmental and industrial chemical widely used in plastic and rubber manufacturing and also present in cigarette smoke and automobile exhaust. BD is classified as a known human carcinogen based on evidence of carcinogenicity in laboratory animals treated with BD by inhalation and epidemiological studies revealing an increased risk of leukemia and lymphohematopoietic cancers in workers occupationally exposed to BD. Upon exposure via inhalation, BD is bioactivated to several toxic epoxides including 3,4-epoxy-1-butene (EB), 3,4-epoxy-1,2-butanediol (EBD), and 1,2,3,4-diepoxybutane (DEB); these are conjugated with glutathione and excreted as 2-(N-acetyl-L-cystein-S-yl)-1-hydroxybut-3-ene/1-(N-acetyl-L-cystein-S-yl)-2-hydroxybut-3-ene (MHBMA), 4-(N-acetyl-L-cystein-S-yl)-1,2-dihydroxybutane (DHBMA), and 1,4-bis-(N-acetyl-L-cystein-S-yl)butane-2,3-diol (bis-BDMA). Exposure to DEB generates monoalkylated DNA adducts, DNA-DNA crosslinks, and DNA-protein crosslinks, which can cause base substitutions, genomic rearrangements, and large genomic deletions. In this study, we developed a quantitative nanoLC/NSI+-HRMS methodology for 1,4-bis-(gua-7-yl)-2,3-butanediol (bis-N7G-BD) adducts in urine (LOD: 0.1 fmol/mL urine, LOQ: 1.0 fmol/mL urine). This novel method was used to quantify bis-N7G-BD in urine of mice treated with 590 ± 150 ppm BD for 2 weeks (6 h/day, 5 days/week). Bis-N7G-BD was detected in urine of male and female BD-exposed mice (574.6 ± 206.0 and 571.1 ± 163.4 pg/mg of creatinine, respectively). In addition, major urinary metabolites of BD, bis-BDMA, MHBMA and DHBMA, were measured in the same samples. Urinary bis-N7G-BD adduct levels correlated with DEB-derived metabolite bis-BDMA (r = 0.80, Pearson correlation), but not with the EB-derived DNA adducts (EB-GII) or EB-derived metabolites MHBMA and DHBMA (r = 0.24, r = 0.14, r = 0.18, respectively, Pearson correlations). Urinary bis-N7G-BD could be employed as a novel non-invasive biomarker of exposure to BD and bioactivation to its most mutagenic metabolite, DEB. This method will be useful for future studies of 1,3-butadiene exposure and metabolism.

Residential proximity to animal feeding operations and risk of lymphohematopoietic cancers in the Iowa Women’s Health Study

BACKGROUND AND AIM: Animal feeding operations (AFOs) are important sources of hazardous emissions into the surrounding environment. Residential proximity to farm animals has been linked to the risk of lymphohematopoietic malignancies in farming populations; we evaluated this relationship for the first time in the general population residing in agricultural areas. METHODS: We linked enrollment (1986) addresses of 28,196 participants in the Iowa Women’s Health Study, a population-based cohort of postmenopausal women, to a statewide database of permitted AFOs that included animal counts standardized by animal size and manure production (animal units [AUs]). We computed inverse distance-weighted total and animal type-specific AUs within 5km of residences, weighted by the time over a 10-year period (1986-1996) the participant resided downwind from each AFO. We estimated the risk of incident lympho- and hematopoietic malignancies and non-Hodgkin lymphoma (NHL) subtypes (hazard ratio [HR]; 95% confidence interval [CI]) for AU quartiles compared to those with no AUs within 5km, adjusting for demographic and lifestyle factors. RESULTS:Through 2014, there were 663 and 262 cases of NHL and leukemia, respectively. We observed increased risk of NHL and some subtypes; however, associations were inconsistently positive and lacked monotonic trend. NHL risk was increased for the second quartile of total AUs within 5km (HRQ2.vs0=1.25; CI:1.00-1.56) but not for the other quartiles (HRQ1.vs0=1.06; HRQ3.vs0=1.00; HRQ4.vs0=1.02; ptrend=0.71). This association appeared to be driven by cattle AUs (HRQ2.vs0=1.29; CI:1.01-1.65, ptrend=0.71). We also found positive and significant associations with specific quartiles of cattle exposures for follicular lymphoma (HRQ2.vs.0=1.95; CI:1.04-3.66; ptrend=0.59) and diffuse large B-cell lymphoma (HRQ1.vs.0=1.66; CI:1.04-2.66; ptrend=0.76). There were no associations for other animal types, other NHL subtypes, or leukemia. CONCLUSIONS:In this first investigation in a population-based cohort, our findings of modest increases in NHL risk associated with animal agriculture near the home are consistent with limited prior studies in farming populations. KEYWORDS: Cancer and cancer precursors, Environmental Epidemiology, Female

Exposure to pesticides and digestive system cancers: systematic review and meta-analysis

Pesticides are substances often described as carcinogenic initiators for some neoplasms, such as lympho-hematopoietic and breast cancer. As for cancer of the digestive system, this relationship is still poorly explored and requires more evidence. A systematic review with meta-analysis was conducted on the association between pesticides and cancer of the digestive system in the PUBMED database. Of the 567 papers found, 32 were approved for qualitative analysis and seven for meta-analysis. Hexachlorobenzene and DDT were significantly associated with colorectal cancer (MD: 15.92; CI: 6.45; 25.40) in the analysis of continuous data and showed a borderline association in the analysis of binary data (OR: 1.17; CI: 0.93; 1.47). The cyclodienes family showed similar results in both analyzes. Polychlorinated biphenyls with low dosages were also associated with colorectal cancer (MD: 38.95; CI: 12.78; 65.11). Organophosphates (OR: 0.54; 95% CI: 0.29; 0.98), carbamates (OR: 0.96; CI: 0.77; 1.21) and triazines (OR: 0.91; 95% CI: 0.74; 1.13) showed inconclusive results. This review presents positive evidence for the association of pesticides with colorectal cancer. However, more evidence is required to determine the role of pesticides in the development of other cancers of the digestive system.

1,3-Butadiene, styrene and lymphohaematopoietic cancers among North American synthetic rubber polymer workers: exposure–response analyses

ObjectiveTo evaluate exposure–response between 1,3-butadiene, styrene and lymphohaematopoietic cancers in an updated cohort of workers at six North American plants that made synthetic rubber polymers.MethodsEmployees were followed from 1943 through...

Mortality among individuals exposed to atomic bomb radiation in utero: 1950\u20132012

We examined the mortality risks among 2463 individuals who were exposed in utero to atomic bomb radiation in Hiroshima or Nagasaki in August 1945 and were followed from October 1950 through 2012. Individual estimates of mother’s weighted absorbed uterine dose (DS02R1) were used. Poisson regression method was used to estimate the radiation-associated excess relative risk per Gy (ERR/Gy) and 95% confidence intervals (CI) for cause-specific mortality. Head size, birth weight, and parents’ survival status were evaluated as potential mediators of radiation effect. There were 339 deaths (216 males and 123 females) including deaths from solid cancer (n = 137), lymphohematopoietic cancer (n = 8), noncancer disease (n = 134), external cause (n = 56), and unknown cause (n = 4). Among males, the unadjusted ERR/Gy (95% CI) was increased for noncancer disease mortality (1.22, 0.10–3.14), but not for solid cancer mortality (− 0.18, < − 0.77–0.95); the unadjusted ERR/Gy for external cause mortality was not statistically significant (0.28, < − 0.60–2.36). Among females, the unadjusted ERRs/Gy were increased for solid cancer (2.24, 0.44–5.58), noncancer (2.86, 0.56–7.64), and external cause mortality (2.57, 0.20–9.19). The ERRs/Gy adjusted for potential mediators did not change appreciably for solid cancer mortality, but decreased notably for noncancer mortality (0.39, < − 0.43–1.91 for males; 1.48, − 0.046–4.55 for females) and external cause mortality (0.10, < − 0.57–1.96 for males; 1.38, < − 0.46–5.95 for females). In conclusion, antenatal radiation exposure is a consistent risk factor for increased solid cancer mortality among females, but not among males. The effect of exposure to atomic bomb radiation on noncancer disease and external cause mortality among individuals exposed in utero was mediated through small head size, low birth weight, and parental loss.

A tiered approach to prioritizing registered pesticides for potential cancer hazard evaluations: Implications for decision making

Background: The U.S. Environmental Protection Agency (EPA) conducts cancer hazard evaluations of pesticides during the registration process when often only limited pre-market animal data is available. Due to the prolonged nature of the re-registration process, new population-based observational studies on the carcinogenicity of pesticides may not be readily incorporated into updated assessments. We aim to identify new cancer epidemiology studies that could inform future hazard evaluations for pesticides currently used in high volumes and considered potentially carcinogenic by EPA. Methods: We used a two-step systematic, tiered review approach to scope the literature for epidemiologic studies of pesticide exposure and carcinogenicity. First, we identified pesticides in EPA databases that are currently registered for use, considered potentially carcinogenic (classified by EPA as “possible”, “suggestive”, or “likely” carcinogenic), and used in high volumes. We excluded carcinogens listed by National Toxicology Program’s Report on Carcinogens or the International Agency for Research on Cancer. Second, using PubMed we identified studies published after EPA’s last publicly-available cancer hazard evaluation, then used Health Assessment Workplace Collaborative and Tableau to map evidence by cancer type, pesticide type, and number of studies. Results: We identified 17 potentially carcinogenic high-volume pesticides of which over half were evaluated initially 20-35 years ago; epidemiology data were available for 15 pesticides. Most pesticides were primarily applied as herbicides and insecticides, or in household or agricultural settings. The most frequent reported cancer types include lymphohematopoietic cancers (i.e., adult leukemia, non-Hodgkin lymphoma, multiple myeloma), childhood leukemia, childhood cancers, and prostate cancer. There were ≥5 studies for one or more cancer sites for seven pesticides: carbaryl, chlorothalonil, dimethoate, mancozeb, metolachlor, permethrin and trifluralin. Conclusions: These results highlight the potential need for updated hazard evaluations. Our multi-step approach and utilization of evidence mapping can be used to inform future decision-making to update cancer hazard evaluations.

Residential Proximity to Intensive Animal Agriculture and Risk of Lymphohematopoietic Cancers in the Agricultural Health Study.

Although occupational exposure to animals has been associated with lymphohematopoietic malignancies, to our knowledge no studies have evaluated adult cancer risks associated with living near intensive animal agriculture. We linked participants in the prospective Agricultural Health Study to permitted animal feeding operations in Iowa. We created metrics reflecting the intensity of animal exposures within 2 and 5 km of participants' residences, enumerating both total and inverse distance-weighted animal units (AUs), standardized by animal size and manure production. We estimated risk of lymphohematopoietic malignancies and subtypes [hazard ratio (HR), 95% confidence interval (95% CI)], adjusting for demographic and farming-related factors, including occupational pesticide exposure. We stratified associations by animal type and animal-related work activities. We observed 519 cases (1993-2015) among 32,635 pesticide applicators and 211 cases among 19,743 spouses. Among applicators, no associations were evident within 2 km, but risk of any lymphohematopoietic cancer was elevated across quintiles of weighted AUs within 5 km. Risk of non-Hodgkin lymphoma (NHL) was elevated for the second (HR = 1.5; 95% CI, 1.1, 2.1), third (HR = 1.6; 95% CI, 1.1, 2.2), and fourth (HR = 1.7; 95% CI, 1.3, 2.4) highest quintiles of weighted AUs within 5 km (Ptrend = 0.52) and increased with dairy cattle AUs (Ptrend = 0.04). We found positive trends for leukemia and some NHL subtypes with increasing numbers of both beef and dairy cattle. Risks did not vary by animal-related work (Pinteraction = 0.61). Associations were similar using the total exposure metric and inconsistent among spouses. Residential proximity to intensive animal agriculture was positively associated with risk of NHL and leukemia, even after consideration of occupational animal and pesticide exposures.

Perfil clínico-hematológico y epidemiológico en los pacientes pediátricos con cáncer linfohematopoyético en un hospital de Piura-Perú, 2014-2018

Objetivo: determinar el perfil clínico-hematológico y epidemiológico en los pacientes pediátricos con cáncer linfohematopoyético del Servicio de Pediatría en el Hospital III ESSALUD José Cayetano Heredia – Piura, Perú en el 2014 al 2018. Materiales y métodos: se realizó un estudio descriptivo, retrospectivo y transversal en el periodo de 2014- 2018 en el Hospital III ESSALUD José Cayetano Heredia-Piura. Resultados: en el periodo de estudio, se seleccionaron 25 pacientes con diagnóstico de cáncer linfohematopoyético, 15 correspondieron a Leucemia Linfoblástica Aguda, 1 con Leucemia Mieloide Aguda y 9 con Linfoma No Hodgkin. De ellos el 56% fueron del sexo femenino. El grupo etáreo más afectado fueron los escolares y la edad promedio de los casos fue 6 años. Entre las formas clínicas sobresalieron el síndrome anémico, el síndrome adénico y el síndrome febril. De las características hematológicas más frecuentes en la Leucemia Linfoblástica Aguda fueron la leucocitosis, anemia severa y trombocitopenia severa mientras que los pacientes con Linfoma No Hodgkin se presentan con mayor frecuencia con leucopenia, anemia leve o sin anemia y recuento de plaquetas normal. Conclusiones: las formas clínicas de presentación más frecuente fueron el síndrome anémico, el síndrome adénico y el síndrome febril. El tipo de anemia más frecuente fue normocítica, normocrómica. En promedio el 50% de los pacientes presentaron dos síndromes clínicos al momento del diagnóstico y dos series hematopoyéticas afectadas.

Overall and cause-specific mortality in a cohort of farmers and their spouses

ObjectivesLower mortality rates compared with the general population have been reported for Agricultural Health Study (AHS) participants (enrolled 1993–1997) followed through 2007. We extended analysis of mortality among AHS participants...