Agricultural land usage and bone cancer: Is there a link? Small-area analyses of osteosarcoma and Ewing sarcoma diagnosed in 0-49 year olds in Great Britain, 1985-2009


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Karen Blakey1, Richard Feltbower2, Roger Parslow2, Peter James1, Charles Stiller3, Paul Norman4, David Garthwaite5, Jacqueline Hughes6, Craig Gerrand7, Richard McNally1
1Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK, 2Paediatric Epidemiology Group, University of Leeds, Leeds, UK, 3Childhood Cancer Research Group, Department of Paediatrics, University of Oxford, Oxford, UK, 4School of Geography, University of Leeds, Leeds, UK, 5Food and Environment Research Agency, York, UK, 6Science and Advice for Scottish Agriculture, Edinburgh, UK, (NICR) Northern Institute for Cancer Research

Background

This study builds on previous research which found higher incidence of Ewing sarcoma in areas with low population density and high levels of car ownership. Since these factors are characteristic of rural environments the objective was to analyse associations between Ewing sarcoma and osteosarcoma incidence and agricultural land usage.

Method

All osteosarcoma and Ewing sarcoma cases aged 0-49 years diagnosed in GB during 1985-2009 were included in the study. Pesticide data were a proxy for agricultural land usage and population density an urban/rural indicator. Negative binomial regression was used to examine small area relationships between incidence rates and pesticide levels. The models adjusted for gender, age and deprivation and logarithm of the ‘at risk' population as an offset.

Results

There were 2562 osteosarcoma cases aged 0-49; 820 aged 0-14; 1262 aged 15-29 and 480 aged 30-49 years. Overall age-standardised incidence rate was 2.84 per million persons per year (95% confidence interval [CI] 2.73 to 2.95). For Ewing sarcoma there were 1711 cases aged 0-49; 670 aged 0-14; 822 aged 15-29 and 219 aged 30-49 years. Overall age-standardised incidence rate was 1.97 per million persons per year (95% CI 1.88 to 2.07).
After adjustment for gender, age and deprivation, pesticide usage was not found to have any significant effect on the incidence of osteosarcoma or Ewing sarcoma. For osteosarcoma, the relative risk (RR) for one kilogram per hectare increase in pesticide level = 0.987 (95% CI 0.954 to 1.022) and for Ewing sarcoma RR = 1.011 (95% CI 0.967 to 1.057).

Conclusion

Pesticide usage data and population density were used as proxies for land usage and no association with Ewing sarcoma or osteosarcoma was found. Some other agricultural related factors could explain the higher incidence found in predominantly farmland areas. Further research should investigate other activities such as livestock farming.