Incidence and risk factors of cancer among men and women in Norwegian agriculture

OBJECTIVES: The objective of the study was to examine cancer incidence and identify risk factors among subjects born in 1925-1971 and engaged in agricultural activities in Norway. METHODS: A cohort was established through linkage between agricultural censuses in 1969-1989 and the Central Population Register, which identifies farm holders and their spouses. Available census information on the activity of the farm provided the exposure indicators. Incident cancer in 1969-1991 was identified in the Cancer Register. In an analysis for standardized incidence ratios (SIR), the cohort was compared with the total rural population of Norway. Associations with exposure indicators were investigated in a Poisson regression analysis. RESULTS: In the follow-up of 136,463 men for 1.5 million person-years and 109,641 women for 0.6 million person-years, 3333 and 2145 cancer cases were identified, respectively. The subset defined as farmers had an SIR of 77 95% confidence interval (95% CI) 73-81 for the men and 92 (95% CI 85-99) for the women, with particularly low SIR values for lung cancer and other sites linked to life-style. The several positive associations found confirmed the a priori hypothesis of an association between dairy farming and acute leukemia among men rate ratio 1.76, 95% CI 1.02-3.05. Multiple myeloma was associated with pesticide indicators for both genders, mainly for subjects cultivating potatoes. CONCLUSIONS: The results support the hypothesis of a relationship between acute leukemia and animal contact and between multiple myeloma and pesticides in potato cultivation. Other exposure associations, especially for cancer among women, warrant further investigation.