Peñalver-Piñol A, Benavente Y, Frias-Gomez J, Alguacil J, Santibañez M, Contreras-Llanes M, Peremiquel-Trillas P, … & Costas L. Occupational exposure to pesticides and endometrial cancer in the Screenwide case-control study. Environ Health. 2023 Nov 2;22(1):77. doi: 10.1186/s12940-023-01028-0.


What is known about the subject?

Pesticides are chemicals used mainly in agriculture to increase food production and reduce vector-borne diseases. Despite measures implemented by the European Union to regulate the use of these chemicals and to mitigate environmental and health risks, there still remains controversy about the safety of certain pesticides as a result of diverging assessments of its carcinogenicity.
Exposure to pesticides is associated with some mechanisms such as oxidative stress, disruption of methyltransferases activity and epigenetic alterations, which may contribute to the development of cancer and other chronic diseases. Furthermore, certain pesticides may interact with estrogenic and androgenic pathways, thus their consideration as endocrine disruptors.
Endometrial cancer is the most common gynaecological cancer in developed countries and the burden of this disease is expected to rise in the coming years. Previous studies exploring the potential relation between the exposure to pesticides and endometrial cancer, especially biomonitoring studies, have yielded no positive results.


What does this study add to the existing literature?

Our study evaluated the association between occupational exposure to pesticides and endometrial cancer using a job-exposure matrix. To assess the risk, we grouped the job positions potentially exposed to pesticides into three different scenarios: agricultural activities, cleaning staff, and manufacturing and lumber industries.
In epidemiological studies, job-exposure matrices can be used as a fast and systematic means of converting occupational data into a matrix of potential exposures to specific compounds, thus removing the need for evaluating the exposure of each individual in detail. Our study is the first to specifically assess the association between occupational exposure to pesticides and endometrial cancer using this method.
The assessment of occupational exposure to pesticides using an exposure matrix revealed a positive association with endometrial cancer, especially in female workers exposed to these chemicals in agricultural scenarios.


What are the implications of the findings?

Further studies with detailed exposure assessments combining exposure matrices and data obtained by biomonitoring methods are needed to confirm our results. The study of how pesticides contribute to the development of endometrial cancer should shed light to the etiology of this tumour and help implement public health policies aiming at reducing the burden associated with this disease.


Arnau Peñalver Piñol
Medical Resident of Preventive Medicine and Public Health
Preventive Medicine and Epidemiology Service
Hospital Universitari Vall d’Hebron de Barcelona