Prostate cancer as an environmental disease: an ecological study in the French Caribbean islands, Martinique and Guadeloupe.

Using a transdisciplinary methodological approach we have conducted a multifactorial analysis in Martinique and Guadeloupe in order to elucidate the aetiology of prostate cancer. In 2002, world age standardized rates of prostate cancer were 152 new cases per 100,000 person-years in the two islands; one of the highest worldwide rates and much higher than those reported for other Caribbean islands and metropolitan France. Using a linear regression analysis, we found that the growth curves of incidence rates for Martinique and metropolitan France have been significantly diverging since 1983. That these curves are not parallel suggests that although a Caribbean genetic susceptibility factor may be involved in carcinogenesis, this factor cannot per se account for the observed growing incidence. On the basis of mapping analysis of soil pollution, we further showed that water contamination by pesticides originates from banana plantations. Moreover, we have established retrospectively that general population subjects investigated in 1972 in Martinique for the presence of organochlorinated pesticides in their adipose tissue had been contaminated by extremely high levels of DDT, DDE, alpha, beta and gammaHCH, aldrin and dieldrin. Our study leads to the conclusion that the growing incidence of prostate cancer cannot be related either to a modification of ethnographic factors nor to a change in lifestyle and therefore suggests that environmental factors such as the intensive and prolonged exposure to carcinogenic, mutagenic and reproductive toxin pesticides may cause prostate cancer.