In Pennsylvania, a new study sheds light on the elevated melanoma rates among farmers, revealing potential links between agricultural practices and skin cancer. With generations of farming in his bloodline, Tommy Nagle, a Pennsylvania cattle and row crop farmer, finds himself concerned as melanoma appears frequently in his family. This isn’t an isolated case, as recent research highlights a broader pattern across central Pennsylvania.
Nagle, who also serves as vice president for the Pennsylvania Farm Bureau, explained, “My grandfather had it. My uncles have it. We’re exposed to the sun a lot more than average people, because our jobs are mainly outside. It is something that is prevalent in farmers due to increased sun exposure 365, 14 hours a day.”
The study conducted by Pennsylvania State University researchers identified a melanoma “hotspot” within 15 counties in central Pennsylvania. This area, closely associated with farmland, shows a significant increase in melanoma cases.
Central Pennsylvania’s Melanoma Concerns
Published in the journal JCO Clinical Cancer Informatics, the research analyzed data from the state’s cancer registry spanning 2017 to 2021. It highlighted that adults aged 50 and older in these counties are 57% more likely to develop melanoma compared to those residing outside this zone. However, the study did not pinpoint the exact cause of this increased risk, merely suggesting a correlation.
Dr. Eugene Joseph Lengerich, an emeritus professor at Penn State’s College of Medicine and one of the study’s authors, emphasized, “There was an association between this land cover as well as the agricultural chemical usage. That does not necessarily mean that it specifically comes from that. This is a correlation, not a causation study.”
Benjamin Marks, a student and co-author of the study, pointed out that counties forming the hotspot met specific criteria. “The county itself, plus its six surrounding neighbors … has to both be elevated and so that’s why, if you look at the map, some counties that have high incidence, such as Wyoming or like Lancaster, are not included in the clusters, because the surrounding counties do not meet that neighborhood requirement,” Marks said.
Even counties adjacent to the hotspot face heightened risks, as Marks noted, “There’s this 15-county hotspot, and even counties touching that hotspot are also at an increased risk.”
Dr. Charlene Lam, an associate professor of dermatology at Penn State and another co-author, observed a high incidence of melanoma among her farming patients. “In no way is this study blaming our agricultural workers at all, but I think it’s more of a demonstration of how we care and how this research can help us understand more about targeted prevention, as knowing that there might be high risk areas,” Lam said.
Adopting a ‘One Health’ Approach
This research is part of a broader ‘one health’ approach, which considers the interconnectedness of environmental, animal, and human health. Marks stated, “This study fits into the bigger picture that the growing popularity of a one health approach, which is really trying to integrate environmental, animal, human health, and so instead of looking at them in different silos, it’s saying, we’re all interconnected.”
Dr. Lengerich added, “We are very much supportive of a one health approach to preventive medicine to human health as well, recognizing that human health is a composite of what goes on in our environment, and we really need to be able to look at it in that perspective.”
Understanding the Wider Implications
One of the key insights from the study is the preventable nature of melanoma. Lengerich stated, “One of the first implications is that this is a preventable cancer. A second implication is that our study does find that there is some risk that may be coming from the agricultural industry. That risk, though, is not specific to farms or farmers. It is for the entire population of that county.”
Marks emphasized the importance of preventative measures without causing alarm. “The takeaway is not panic; it is that people in these counties, especially those who work in agriculture or outdoors, or who live in high-agricultural areas, should be more intentional about prevention, including sun protection and regular skin checks,” Marks said.
As a proactive measure, Nagle and his family have incorporated sun protection routines into their daily activities. “The older farmers were unaware of the risk of what sun caused. Younger farmers, I can speak for myself. I can speak for my children. They’re out helping on the farm. We sunblock every morning when we leave. Cab tractors have helped with that because we spent numerous hours in tractors,” Nagle shared.
The research team plans further investigations to better understand the causes by collaborating directly with farmers in central Pennsylvania. “One of the things that’s already underway is site investigations with farms and farmers in central Pennsylvania,” Lengerich noted.
