Is there an association between pesticides and oral cancer in rural workers? A literature review

Abstract

Oral and pharyngeal cancer represents an important global public health problem and is associated with risk factors such as tobacco use, alcohol consumption, and infection by the human papillomavirus (HPV). In addition to these factors, occupational exposure to pesticides has been investigated as a possible contributor to the development of neoplasms among rural populations. This study aimed to review the scientific literature regarding the possible association between pesticide exposure and the development of oral cancer. A narrative literature review was conducted using the PubMed database between April and May 2025, employing the descriptors “Farmers”, “Oral Cancer”, “Pesticides”, and “Agrochemicals”, combined with the Boolean operators AND and OR. Initially, 20 studies were identified, of which 8 met the inclusion criteria after title and abstract screening and full-text analysis. The findings suggest that occupational exposure to pesticides may be associated with relevant biological alterations, including dysbiosis of the oral microbiota, genetic and epigenetic damage, and increased susceptibility to chronic inflammatory processes, mechanisms potentially related to carcinogenesis. However, epidemiological evidence remains heterogeneous, with some studies indicating increased risk for specific neoplasms, while others report lower overall cancer incidence among farmers. Therefore, although current evidence suggests possible pathways of association, a direct causal relationship between pesticide exposure and oral cancer cannot yet be established. Further studies with improved methodological control and more accurate exposure assessment are needed to better clarify this relationship.