Intake of fruits and vegetables by pesticide residue status in relation to cancer risk

Environ Int. 2021 Nov:156:106744. doi: 10.1016/j.envint.2021.106744. Epub 2021 Jul 10.


Background: Conventionally grown fruits and vegetables (FVs) are the main source of general population exposure to pesticide residues.

Objective: To evaluate the relation of intake of high- and low-pesticide-residue FVs with cancer risk.

Methods: We followed 150,830 women (Nurses' Health Study, 1998-2016, and Nurses' Health Study II, 1999-2017) and 29,486 men (Health Professionals Follow-up Study, 1998-2016) without a history of cancer. We ascertained FV intake via validated food frequency questionnaires and categorized FVs as having high or low pesticide residue levels based on USDA surveillance data. We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) of total and site-specific cancer related to quintiles of high- and low-pesticide-residue FV intake.

Results: We documented 23,678 incident cancer cases during 2,862,118 person-years of follow-up. In the pooled multivariable analysis, neither high- nor low-pesticide-residue FV intake was associated with cancer. The HRs (95% CI) per 1 serving/day increase in intake were 0.99 (0.97-1.01) for high- and 1.01 (0.99-1.02) for low-pesticide-residue FVs. Additionally, we found no association between high-pesticide-residue FV intake and risk of specific sites, including malignancies previously linked to occupational pesticide exposure ([HR, 95% CI comparing extreme quintiles of intake] lung [1.17 (0.95-1.43)], non-Hodgkin lymphoma [0.89 (0.72-1.09)], prostate [1.31 (0.88-1.93)]) or inversely related to intake of organic foods (breasts [1.03 (0.94-1.31)]).

Conclusions: These findings suggest that overall exposure to pesticides through FV intake is not related to cancer risk, although they do not rule out associations with specific chemicals or sub-types of specific cancers.

Keywords: Cancer; Fruits and vegetables; Pesticide residues.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Diet
  • Follow-Up Studies
  • Fruit / chemistry
  • Humans
  • Neoplasms* / epidemiology
  • Pesticide Residues* / analysis
  • Pesticides*
  • Proportional Hazards Models
  • Risk Factors
  • Vegetables


  • Pesticide Residues
  • Pesticides