Solid waste and pancreatic cancer: an ecologic study in Florida, USA.

BACKGROUND Other than cigarette smoking, modifiable risk factors for pancreatic cancer have not been consistently identified. This study explored the ecologic relationship between pancreatic cancer incidence and measures of cigarette smoking, income, and solid waste collection for Florida's 67 counties. METHODS We used Florida's population-based cancer registry to compare county-specific incidence rates of pancreatic cancer among Whites to median household income, the per county prevalence of cigarette smoking, and to measures of per capita municipal solid waste collected. RESULTS County-specific incidence rates for pancreatic cancer ranged from 0 to 8.1 per 100,000 per year and were significantly correlated with income (r = 0.35), cigarette smoking (r = 0.39), and solid waste (r = 0.47). The correlation between pancreatic cancer and solid waste was largely attributable to one sub-component of solid waste, yard trash (grass clippings, and tree and shrub trimmings) (r = 0.42). Using a stepwise regression procedure, only cigarette smoking and yard trash remained significant in the model. CONCLUSIONS These data suggest that some factor associated with grass and tree trimmings, e.g. insecticides and herbicides, may increase the risk for pancreatic cancer. This hypothesis is consistent with several reports of pancreatic cancer and insecticide exposure in individuals and may suggest new avenues for research in pancreatic cancer.