Introduction The use of pesticides in Brazil has been high. It is important to assess the risks related to the use of these substances. Some studies have reported an association between agricultural work and stomach cancer. This study aimed to estimate the risk of death from stomach cancer among agricultural workers in an intensive pesticide-use area in Brazil, 1996–2005.

Methods Cases were men and women aged ≥20 years old that died of stomach cancer. For each case two age and sex matched controls were randomly selected, from all possible controls where the cause of death was not cancer or haematological disease. Crude and adjusted ORs were estimated to evaluate the magnitude of the risk.

Results Agricultural workers living in the Serrana Region of Rio de Janeiro State were at higher risk of death from stomach cancer (OR: 1.41 (95% CI 1.10 to 1.82)) compared to non-agricultural workers. Stratified analysis revealed that the risk was higher among younger (OR: 3.34 (1.58 to 7.08)) agricultural workers.

Conclusion These results suggest that agricultural workers living in the Serrana Region of the state of Rio de Janeiro were at statistically significant higher risk of death from stomach cancer compared to non-agricultural workers.