Cancer Res Treat.  2022 Jan;54(1):130-139. 10.4143/crt.2020.1106.

Occupational Exposure to Pesticides and Lung Cancer Risk: A Propensity Score Analyses

• Kim B
• Park EY
• Kim J
• Park E
• Oh JK
• Lim MK

• KMID: 2524594
• DOI: http://doi.org/10.4143/crt.2020.1106

Abstract

Purpose
Occupational exposure to pesticides is thought to be associated with lung cancer, but studies have yielded conflicting results. We performed a propensity score (PS) based analyses to evaluate the relationship between occupational exposure to pesticides and lung cancer risk in the Korea National Cancer Center community-based cohort study (KNCCCS).
Materials and Methods
During the follow-up period, 123 incidental lung cancer cases were identified, of the 7,471 subjects in the final statistical analysis. Information about occupational exposure to pesticides and other factors was collected at enrollment (2003-2010). Cox proportional hazards regression analyses were conducted. Four PS-based approaches (i.e., matching, stratification, inverse probability-of-treatment weighting, and the use of the PS as a covariate) were adopted, and the results were compared. PS was obtained from the logistic regression model. Absolute standardized differences according to occupational exposure to pesticides were provided to evaluate the balance in baseline characteristics.
Results
In the Cox proportional hazards regression model, the hazard ratio (HR) for lung cancer according to occupational exposure to pesticides was 1.82 (95% confidence interval [CI], 1.11 to 2.98). With all the propensity score matching (PSM) methods, the HRs for lung cancer based on exposure to pesticides ranged from 1.65 (95% CI, 1.04 to 2.64) (continuous term with PSM) to 2.84 (95% CI, 1.81 to 4.46) (stratification by 5 strata of the PS). The results varied slightly based on the method used, but the direction and statistical significance remained the same.
Conclusion
Our results strengthen the evidence for an association between occupational exposure to pesticides and the risk of lung cancer.

Keyword

Pesticide; Lung neoplasms; Propensity score methods

Figure

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  Fig. 1 Flow diagram of the selection of the study population.

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  Fig. 2 Comparison of the standardized mean differences by covariates with different propensity score-based methods according to occupational exposure to pesticides. Crude, whole dataset; Matched, 1:1 matched dataset; Strata5, dataset stratified into five strata; IPTW, inverse probability-of-treatment weighting dataset. This plot shows the standardized mean differences between study subjects who had been occupationally exposed to pesticides and those who had not; a value > 0.1 indicates the imbalance of a covariate.

Reference

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