Prospective association between dietary pesticide exposure profiles and postmenopausal breast-cancer risk in the NutriNet-Santé cohort

Int J Epidemiol. 2021 Aug 30;50(4):1184-1198. doi: 10.1093/ije/dyab015.


Background: Some pesticides, used in large quantities in current agricultural practices all over Europe, are suspected of adverse effects on human reproductive health (breast and prostate cancers), through mechanisms of endocrine disruption and possible carcinogenic properties, as observed in agricultural settings. However, evidence on dietary pesticide exposure and breast cancer (BC) is lacking for the general population. We aimed to assess the associations between dietary exposure to pesticides and BC risk among postmenopausal women of the NutriNet-Santé cohort.

Methods: In 2014, participants completed a self-administered semi-quantitative food-frequency questionnaire distinguishing conventional and organic foods. Exposures to 25 active substances used in EU plant-protection products were estimated using a pesticide-residue database accounting for farming practices, from Chemisches und Veterinäruntersuchungsamt Stuttgart, Germany. Non-negative matrix factorization (NMF), adapted for data with excess zeros, was used to establish exposure profiles. The four extracted NMF components' quintiles were introduced into Cox models estimating hazard ratio (HR) and 95% confidence interval (95% CI), adjusted for known confounding factors.

Results: A total of 13 149 postmenopausal women were included in the analysis (169 BC cases, median follow-up = 4.83 years). Negative associations between Component 3, reflecting low exposure to synthetic pesticides, and postmenopausal BC risk were found [HRQ5 = 0.57; 95% CI (0.34; 0.93), p-trend = 0.006]. Positive association between Component 1 score (highly correlated to chlorpyrifos, imazalil, malathion, thiabendazole) and postmenopausal BC risk was found specifically among overweight and obese women [HRQ5 = 4.13; 95% CI (1.50; 11.44), p-trend = 0.006]. No associations were detected for the other components.

Conclusion: These associations suggest a potential role of dietary pesticide exposure on BC risk. Further research is needed to investigate the mechanisms and confirm these results in other populations.

Keywords: Dietary exposure; breast cancer; environmental health; epidemiology; organic farming; pesticides.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms* / chemically induced
  • Breast Neoplasms* / epidemiology
  • Dietary Exposure
  • Female
  • Humans
  • Male
  • Pesticides* / adverse effects
  • Postmenopause
  • Prospective Studies
  • Risk Factors


  • Pesticides