Cancer Risk Among Residents of Rhineland-Palatinate Winegrowing Communities - Recent Advances and Issues in Environmental Science - page 91

Chapter 7
Cancer Risk Among Residents of Rhineland-
Palatinate Winegrowing Communities
Andreas Seidler, Ga ë l Paul Hammer, Gabriele Husmann, Jochem K ö nig,
Anne Krtschil, Irene Schmidtmann, and Maria Blettner
INTRODUCTION
To investigate the cancer risk among residents of Rhineland-Palatinate winegrowing
communities in an ecological study.
On the basis of the Rhineland-Palatinate cancer-registry, we calculated age-
adjusted incidence rate ratios (RRs) for communities with a medium area under wine
cultivation (>5-20%) and a large area under wine cultivation (>20%) in comparison
with communities with a small area under wine cultivation (>0-5%). In a side analy-
sis, standardized cancer incidence ratios (SIRs) were computed separately for wine-
growing communities with small, medium and large area under wine cultivation using
estimated German incidence rates as reference.
A statistically signifi cant 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 (NHL) in males, but
not in females. Lung cancer risk is signifi cantly 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.
This study points to a potentially increased risk of skin cancer, bladder cancer, and
endocrine-mediated tumors in Rhineland-Palatinate winegrowing communities. How-
ever, due to the explorative ecologic study design and the problem of multiple testing,
these fi ndings are not conclusive for a causal relationship.
Some previous studies point to a potential association between pesticide exposure
respiratory farming or winegrowing and lymphoma [1-5] or multiple myeloma [6-11],
brain cancer [12-14], prostate cancer [15], or bladder cancer [16, 17]. However, the
mechanisms of the suspected carcinogenic effects of pesticides are widely unclear.
Among the hypothesis on potential carcinogenic mechanisms from pesticides, the
endocrine mediated effects have received much attention. Several pesticides interact
with endocrine receptors in vitro or have endocrine-mediated effects in laboratory
animals in vivo : The European Union has listed over 40 pesticides suspected to in-
terfere with the hormone system of humans and wildlife [18]. As endocrine-related
mechanisms play an etiologic role in several cancers in humans, the potential associa-
tion between exposure to pesticides with endocrine activity and cancer incidence has
been discussed in the last years. Many epidemiological studies have, for example,