title: Coumaphos exposure and incident cancer among male participants in the Agricultural Health Study (AHS).
abstract: BACKGROUND
  Coumaphos is an organophosphate livestock insecticide. Previous research in the Agricultural Health Study (AHS) cohort observed a positive association between coumaphos and prostate cancer in men with a family history of prostate cancer.
  
  
  OBJECTIVE
  This study was performed to determine the association between coumaphos and other major cancer sites and to explore the consistency of the association with prostate cancer early (1993-1999) and later (2000-2005) in AHS follow-up.
  
  
  METHODS
  This study included 47,822 male licensed pesticide applicators. Incident cases were ascertained by linkage to state cancer registries, and exposure data were collected by enrollment questionnaire. Poisson regression was used to estimate rate ratio (RR) and 95% confidence interval (CI) of cancer for coumaphos exposure controlling for potentially confounding variables.
  
  
  RESULTS
  Approximately 8% of applicators reported use of coumaphos; 8.5% reported a family history of prostate cancer. Cumulative exposure to coumaphos was not associated with cancer risk overall or with any major cancer site including prostate. In men with a family history of prostate cancer, we observed a positive association between ever use of coumaphos and prostate cancer in both early (RR = 2.07; 95% CI, 1.19-3.62, p-interaction = 0.005) and later (RR = 1.46; 95% CI, 0.89-2.40; p-interaction = 0.11) periods of follow-up. Across all years, this association was statistically significant (RR = 1.65; 95% CI, 1.13-2.38; p-interaction = 0.004).
  
  
  CONCLUSIONS
  Coumaphos was not associated with any cancer evaluated here. In men with a family history of disease, there was evidence of an association between coumaphos and prostate cancer, possibly due to genetic susceptibility; however, other explanations, including chance, are plausible.
authors.affiliation: Toxicology and Epidemiology Branch, Health Effects Division, Office of Pesticide Programs, U.S. Environmental Protection Agency, Washington, DC, USA.
authors.forename: Carol H
authors.initials: CH
authors.lastname: Christensen
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Platz
authors.forename: Gabriella
authors.initials: G
authors.lastname: Andreotti
authors.forename: Aaron
authors.initials: A
authors.lastname: Blair
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.forename: Stella
authors.initials: S
authors.lastname: Koutros
authors.forename: Charles F
authors.initials: CF
authors.lastname: Lynch
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
authors.forename: Michael C R
authors.initials: MC
authors.lastname: Alavanja
mesh_terms: D000328:Adult; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000453:epidemiology* / Q000209:etiology*; D000822:Animal Husbandry; D015331:Cohort Studies; D003372:Coumaphos / Q000008:administration & dosage / Q000633:toxicity*; D020022:Genetic Predisposition to Disease; D006801:Humans; D007306:Insecticides / Q000008:administration & dosage / Q000633:toxicity*; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D009657:North Carolina / Q000453:epidemiology; D016273:Occupational Exposure; D016272:Occupational Health; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000235:genetics; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007306:Insecticides; D003372:Coumaphos