Cancer risk among residents of Rhineland-Palatinate winegrowing communities: a cancer-registry based ecological study.
OBJECTIVE
To investigate the cancer risk among residents of Rhineland-Palatinate winegrowing communities in an ecological study.


METHODS
On the basis of the Rhineland-Palatinate cancer-registry, we calculated age-adjusted incidence rate ratios for communities with a medium area under wine cultivation (>5 to 20 percent) and a large area under wine cultivation (>20 percent) in comparison with communities with a small area under wine cultivation (>0 to 5 percent). In a side analysis, standardized cancer incidence ratios (SIR) were computed separately for winegrowing communities with small, medium and large area under wine cultivation using estimated German incidence rates as reference.


RESULTS
A statistically significant positive association with the extent of viniculture can be observed for non-melanoma skin cancer in both males and females, and additionally for prostate cancer, bladder cancer, and non-Hodgkin lymphoma in males, but not in females. Lung cancer risk is significantly reduced in communities with a large area under cultivation. In the side-analysis, elevated SIR for endocrine-related tumors of the breast, testis, prostate, and endometrium were observed.


CONCLUSIONS
This study points to a potentially increased risk of skin cancer, bladder cancer, and endocrine-mediated tumors in Rhineland-Palatinate winegrowing communities. However, due to the explorative ecologic study design and the problem of multiple testing, these findings are not conclusve for a causal relationship.
Seidler
Andreas
A
Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg-University Mainz, Germany. hammer@imbei.uni-mainz.de.
Hammer
Gaël Paul
GP
Husmann
Gabriele
G
König
Jochem
J
Krtschil
Anne
A
Schmidtmann
Irene
I
Blettner
Maria
M