Genome-wide association studies have identified 8q24 region variants as risk factors for
prostate cancer. In the Agricultural Health Study, a prospective study of licensed
pesticide applicators, we observed increased
prostate cancer risk with specific
pesticide use among those with a family history of
prostate cancer. Thus, we evaluated the interaction among
pesticide use, 8q24 variants, and
prostate cancer risk. The authors estimated odds ratios (OR) and 95% confidence intervals (95% CI) for interactions among 211 8q24 variants, 49 pesticides, and
prostate cancer risk in 776 cases and 1,444 controls. The
ORs for a previously identified variant, rs4242382, and
prostate cancer increased significantly (P<0.05) with exposure to the
organophosphate insecticide fonofos, after correction for multiple testing, with per allele ORnonexposed of 1.17 (95% CI, 0.93-1.48), per allele OR(low) of 1.30 (95% CI, 0.75-2.27), and per allele ORhigh of 4.46 (95% CI, 2.17-9.17; P-interaction=0.002, adjusted P-interaction=0.02). A similar effect modification was observed for three other
organophosphate insecticides (
coumaphos,
terbufos, and
phorate) and one
pyrethroid insecticide (
permethrin). Among ever users of
fonofos, subjects with three or four risk alleles at rs7837328 and rs4242382 had approximately three times the risk of
prostate cancer (OR, 3.14; 95% CI, 1.41-7.00) compared with subjects who had zero risk alleles and never used
fonofos. We observed a significant interaction among variants on chromosome 8q24,
pesticide use, and risk of
prostate cancer.
Insecticides, particularly
organophosphates, were the strongest modifiers of risk, although the
biological mechanism is unclear. This is the first report of effect modification between 8q24 and an environmental exposure on
prostate cancer risk.