Dietary omega-6/omega-3 fatty acids and risk of prostate cancer; Is there any potential interaction by organophosphate insecticides among the agricultural health study population |
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| Institution: | 1. Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA;2. Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA;3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA;1. Department of Internal Medicine, Jackson Memorial Hospital / University of Miami Health System, FL, USA;2. The Population Registry of Cancer of the Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Colombia;3. Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia;4. University of Miami Miller School of Medicine and Sylvester Comprehensive Cancer Center, FL, USA;1. Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA;2. Center for Integrative Oncology & Survivorship, Prisma Health, 900 W Faris Rd 1st Floor, Greenville, SC 29605, USA;3. Clemson Center for Geospatial Technologies, Clemson University Libraries, 116 Sigma Drive, Clemson, SC 29634, USA;1. Clinical Oncology Department, Faculty of Medicine, Assiut University, Assiut, Egypt;2. Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt;1. Faculty of Pharmacy, Universidade Federal de Minas Gerais, Brazil;2. Ezequiel Dias Foundation, Brazil;3. Hospital das Clínicas, Universidade Federal de Minas Gerais, Brazil;1. Department of Radiotherapy, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil;2. Department of Education and Research, Hospital de Câncer de Pernambuco, Recife, Pernambuco, Brazil;3. Department of Head and Neck Surgery, Hospital de Câncer de Pernambuco, Recife, Pernambuco, Brazil;4. Department of Oncology, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil;5. Department of Pneumology, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil;6. Clinical Research Division, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil;1. National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil;2. Health Technology Management Coordination, National Health Agency, Rio de Janeiro, Brazil;3. Department of Epidemiology and Quantitative Methods, National Public Health School, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil |
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| Abstract: | BackgroundIn the United States (US), the average annual increase in the incidence of prostate cancer (PCa) has been 0.5% between 2013 and 2017. Although some modifiable factors have been identified as the risk factors for PCa, the effect of lower ratio of omega-6 to omega-3 fatty acids intake (N-6/N-3) remains unknown. Previous studies of the Agricultural Health Study (AHS) reported a significant positive association between PCa and selected organophosphate pesticides (OPs) including terbufos and fonofos.ObjectiveThe aim of this study was to evaluate the association between N-6/N-3 and PCa and any interaction between N-6/N-3 and 2 selected OPs (i.e., terbufos and fonofos) exposure.Design and ParticipantsThis case-control study, nested within a prospective cohort study, was conducted on a subgroup of the AHS population (1193 PCa cases and 14,872 controls) who returned their dietary questionnaire between 1999 and 2003Main Outcome MeasuresPCa was coded based on the International Classification of Diseases of Oncology (ICD-O-3) definitions and obtained from the statewide cancer registries of Iowa (2003–2017) and North Carolina (2003–2014).Statistical AnalysisMultivariate logistic regression analysis was applied to obtain the odds ratios adjusted (aORs) for age at dietary assessment (years), race/ethnicity (white, African American, other), physical activity (hours/week), smoking (yes/no), terbufos (yes/no), fonofos (yes/no), diabetes, lycopene intake (milligrams/day), family history of PCa, and the interaction of N-6/N-3 with age, terbufos and fonofos. Pesticide exposure was assessed by self-administrated questionnaires collecting data on ever/never use of mentioned pesticides during lifetime as a yes/no variable. Assessing the P value for the interaction between pesticides and N-6/N-3, we used the continuous variable of “intensity adjusted cumulative exposure” to terbufos and fonofos. This exposure score was based on duration, intensity and frequency of exposure. We also conducted a stratified regression analysis by quartiles of age.ResultsRelative to the highest N-6/N-3 quartile, the lowest quartile was significantly associated with a decreased risk of PCa (aOR=0.61, 95% CI: 0.41–0.90), and quartile-specific aORs decreased toward the lowest quartile (Ptrend=<0.01). Based on the age-stratified analysis, the protective effect was only significant for the lowest quartile of N-6/N-3 among those aged between 48 and 55 years old (aORs=0.97, 95% CI, 0.45–0.55). Among those who were exposed to terbufos (ever exposure reported as yes in the self-report questionnaires), lower quartiles of N-6/N-3 were protective albeit nonsignificant (aORs: 0.86, 0.92, 0.91 in quartiles 1,2, and 3, respectively). No meaningful findings were observed for fonofos and N-6/N-3 interaction.ConclusionFindings showed that lower N-6/N-3 may decrease risk of PCa among farmers. However, no significant interaction was found between selected organophosphate pesticides and N-6/N-3. |
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| Keywords: | Prostate cancer Fatty acids Fat Diet Ratio of omega-6 to omega-3 fatty acids Pesticides Organophosphates Insecticides The agricultural health study |
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