Identification of occupational cancer risks using a population-based cancer registry

Patterns and trends with cancer incidence and mortality rates reported by the China National Cancer Registry

National cancer registration reports provide a huge potential for identifying patterns and trends of important policy, research, prevention and treatment significance. As summary reports written on an annual basis, the China Cancer Registry Annual Reports (CCRARs) fall short from fully addressing their potential. This paper attempts to explore part of the patterns and trends hidden behind published CCRARs. It extracted data for cancer incidence rates (IRs) and mortality rates (MRs) for 2004, 2006 and 2009 from relevant CCRARs and portrayed 4 kinds of indicators in line graphs. The study showed that: a) all of the line graphs of age-specific IRs and MRs characterized typical "growth curves or histogram"; b) graphs of IRs and MRs for males and urban areas had higher peaks than that for females and rural regions; c) most of the line graphs of IR/MR ratios comprised a starting peak, a secondary peak and a decreasing tail and the secondary peaks for females and urban areas were higher than those for males and rural areas; d) most of the urban versus rural IR ratios valued above one, but most the urban versus rural MR ratios, below one; e) the accumulative IRs and MRs showed a stable increasing trend from 2004 to 2009 for urban areas, but mixed for rural regions.

Specific histone modifications were associated with the PAH-induced DNA damage response in coke oven workers

To investigate whether polycyclic aromatic hydrocarbon (PAH) exposure is associated with specific histone modifications and whether DNA damage triggers epigenetic alterations, we recruited 190 male workers with occupational exposure to PAHs and 100 male control workers from Benxi Steel Plant, Liaoning province, China. Urinary 1-hydroxypyrene (1-OHP), DNA damage, specific histone modification levels and the expression of selected DNA damage response (DDR) genes were measured in peripheral blood lymphocytes (PBLCs) of the subjects. The results showed that trimethylated Lys 27 of histone H3 (H3K27me3) and trimethylated Lys 36 of histone H3 (H3K36me3) were elevated in the PAH-exposed group (both P < 0.001), while trimethylated Lys H3 of histone H3 (H3K4me3) was decreased compared to the unexposed group (P < 0.001). Notably, H3K36me3 was positively associated with the level of internal exposure marker 1-OHP (β = 0.197; P < 0.001) and the degree of DNA damage (β = 0.175; P < 0.001) in all subjects, indicating that the PAH-induced DNA damage response might be mediated by H3K36me3 and/or H3K4me3 modifications. Particularly, the ChIP-qPCR assay revealed that the modifications of H3K36me3 were enriched in the gene body of DDR genes, MGMT and MLH1. The up-regulation of MGMT and MLH1 was correlated with the elevated H3K36me3 in the PAH-exposed workers (P < 0.001). Collectively, we revealed that H3K36me3 could be an indicator of PAH exposure and might be involved in the transcriptional regulation of DNA repair genes in response to DNA damage.

Lung cancer in never smokers: molecular profiles and therapeutic implications

The majority of lung cancers are caused by long term exposure to the several classes of carcinogens present in tobacco smoke. Although a significant fraction of lung cancers in never smokers may also be attributable to tobacco, many such cancers arise in the absence of detectable tobacco exposure, and may follow a very different cellular and molecular pathway of malignant transformation. Recent studies summarized here suggest that lung cancers arising in never smokers have a distinct natural history, profile of oncogenic mutations, and response to targeted therapy. The majority of molecular analyses of lung cancer have focused on genetic profiling of pathways responsible for metabolism of primary tobacco carcinogens. Limited research has been conducted evaluating familial aggregation and genetic linkage of lung cancer, particularly among never smokers in whom such associations might be expected to be strongest. Data emerging over the past several years show that lung cancers in never smokers are much more likely to carry activating mutations of the epidermal growth factor receptor (EGFR), a key oncogenic factor and direct therapeutic target of several newer anticancer drugs. EGFR mutant lung cancers may represent a distinct class of lung cancers, enriched in the never-smoking population, and less clearly linked to direct tobacco carcinogenesis. These insights followed initial testing and demonstration of efficacy of EGFR-targeted drugs. Focused analysis of molecular carcinogenesis in lung cancers in never smokers is needed, and may provide additional biologic insight with therapeutic implications for lung cancers in both ever smokers and never smokers.

Cytogenetic damage in workers from a coal-fired power plant

The aim of this study was to investigate the genotoxic risk to workers occupationally exposed to coal combustion products in Afsin-Elbistan A power plant, located in south-eastern Turkey. We analysed chromosomal aberrations (CAs), polyploidy, sister-chromatid exchanges (SCEs), and micronuclei (MN) in 48 male workers without a history of smoking, tobacco chewing, or alcohol consumption. The results were compared with a control group of 30 healthy male individuals without exposure to any known genotoxic agents. The mean frequencies of CA, polyploidy, SCEs (P<0.01), and MN (P<0.05) were significantly higher in workers than in the control group, by the Mann-Whitney U-test. Spearman's rho correlation analysis revealed a significant increase in the frequency of CA and MN with increasing years of exposure (P<0.05). However, there was no significant effect of age on the cytogenetic markers analysed in both groups (P>0.05). The data obtained from this study clearly showed chromosomal hazard in the peripheral lymphocytes of workers exposed to coal combustion products in Afsin-Elbistan A power plant for several years. This cytogenetic damage might be attributed to the cumulative effects of several substances due to chemical complexity of the coal ash and gaseous emissions rather than a specific substance.

TP53 mutations in workers exposed to occupational carcinogens

In some cases, evidence exists that exogenous carcinogenic exposures contribute to the mutation spectrum of the TP53 gene (p53) in human cancers. Although the clearest examples come from dietary and environmental sources, only a restricted number of papers have concentrated specifically on TP53 mutations in tumors from workers exposed to occupational carcinogens. In populations exposed to dietary aflatoxin B1 with liver cancer (AFB1) and ultraviolet (UV)-radiation with skin cancer, a single specific-looking TP53 mutation has been described in some of the tumors. Whether these fingerprints in the TP53 gene can be used to reveal an occupational etiology remains to be shown. In other cases, although differences in the TP53 mutation spectrum exist, they are more diffuse and difficult to interpret at this point. For instance, cigarette smoking seems to induce long-lasting molecular footprints in TP53. However, their use to rule out other occupational exposures as etiological factors in occupational cancers is still very questionable, especially due to the putative synergistic effects of cigarette smoke with other carcinogens. Although interesting implications of possible typical mutation spectra among cancers with other occupational etiologies exist, the data are scanty and await further development of TP53 mutation databases.

An epidemiologic study of employees at seven pulp and paper mills

The cohort consisted of 11,178 Mead Corporation employees (9,358 males and 1,820 females) who had worked for at least one year between January 1, 1975 and December 31, 1992 at seven pulp and/or paper mills in the United States. The vital status of the cohort was determined through a variety of sources over an observation period of 17 years (1976-1992). Mortality data were analyzed in terms of cause-specific standardized mortality ratios (SMRs), with expected deaths based on U.S. national mortality rates. Job categories with similar exposures were created based on an historical exposure assessment. Mortality analyses were performed separately for total female and male employees. Among female employees, overall mortality was less than expected, and no significant cause-specific mortality excesses were observed. The small number of deaths among female employees did not permit further detailed analyses. Among male employees, statistically significant deficits from overall mortality (SMR = 69.0) and from all cancers (SMR = 71.3) were reported. In addition, low mortality risks for many specific causes were also observed, including many specific cancer sites, various types of cardiovascular diseases, and different forms of nonmalignant respiratory diseases. In particular, there was no mortality excess from lung cancer (SMR = 77.5), digestive cancer (SMR = 69.4), stomach cancer (SMR = 46.7), laryngeal cancer (no observed death), rectal cancer (SMR = 82.8). Hodgkin's lymphoma (no observed death), non-Hodgkin's lymphoma (SMR = 103.6), leukemia (SMR = 72.2), diabetes mellitus (SMR = 110.4), ischemic heart disease (SMR = 80.0), and nonmalignant respiratory diseases (SMR = 36.7). Furthermore, detailed analyses by length of employment, interval since hire (latency), and job category demonstrated no occupationally related mortality increases from any of the diseases examined. Specifically, based on internal comparisons, no upward trends in cause-specific mortality risk were observed by duration of employment. In conclusion, the results of this epidemiologic investigation demonstrated a favorable mortality experience for employees at the seven pulp and/or paper mills.