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Ahmed RO, Sewram V, Oyesegun AR, Ayele B, van Wyk A, Fernandez P. A comparison of clinicopathologic features of prostate cancer between Nigerian and South African black men. AFRICAN JOURNAL OF UROLOGY 2022; 28:6. [PMID: 35280496 PMCID: PMC8897758 DOI: 10.1186/s12301-022-00273-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/13/2022] [Indexed: 12/24/2022] Open
Abstract
Abstract
Background
Globally, prostate cancer (PCa) is the commonest non-cutaneous male malignancy. It is more aggressive among black men with little known reasons as to the cause and continued trend among black men. This disproportionate pattern of PCa especially among black men of African ancestry resident in Africa calls for a closer look. Nigeria and South Africa, combined, have the highest cumulative risk incidence of PCa in Africa. The present study investigated the clinicopathologic behaviour of PCa among Nigerian and South African black men and the relationship between the disease and socio-demographic characteristics alongside medical co-morbidities.
Methods
A retrospective cross-sectional study was undertaken in which de-identified records of 234 black men with pathologically confirmed PCa between 2007 and 2017 from two tertiary hospitals, in Nigeria (National Hospital, Abuja) and South Africa (Tygerberg Hospital, Cape Town), were reviewed.
Results
Median age at presentation from both countries was 66 years (interquartile range, IQR 61–73 years) while the median PSA at presentation was 46 ng/ml (IQR 16–336.5 ng/ml). Half of the men (117/234) presented with locally advanced disease while metastatic disease was observed in 65.9% (27/41) of Nigerian men and 34.1% (14/41) of South African men. Thirty-three per cent of the men presented with organ-confined disease. Overall, Nigerian men presented with less organ-confined disease and significantly higher stage of disease (p < 0.001). Risk stratification using PSA, Gleason scores and T-staging showed that 84.2% (n = 197) of all the men presented with high-risk PCa disease. There was a statistically significant difference between Nigerian and South African black men (p = 0.003) in terms of disease risk at presentation. Logistic regression analysis showed that age (Adjusted OR 1.053 (95% CI 1.003–1.106), p = 0.003) and country of residence (Adjusted OR 4.281 (95% CI 1.690–10.844), p = 0.002) had a statistically significant relationship with high risk of PCa while disease co-morbidities (like diabetes and hypertension) and rural/urban location in both countries did not.
Conclusions
Disparities exist between PCa presentation and clinicopathologic behaviour among Nigerian and South African black men. Nigerian men showed higher disease risk at presentation. Environmental-genetic interactions need further exploration in the aetio-pathogenesis of PCa in black men of African ancestry.
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Occupation and prostate Cancer risk: results from the epidemiological study of prostate cancer (EPICAP). J Occup Med Toxicol 2022; 17:5. [PMID: 35130905 PMCID: PMC8819870 DOI: 10.1186/s12995-022-00346-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background Although prostate cancer (PCa) is the most frequent male cancer in industrialized countries, little is known about its aetiology. The literature has suggested an influence of the environment, including occupational exposures, but results are inconsistent. In this context, we investigated PCa risk associated to employment among several occupations using data from EPICAP study. Methods EPICAP is a French population-based case-control study including 819 PCa incident cases and 879 controls frequency-matched on age. In-person interviews gathered data on potential risk factors and lifetime occupational histories for each job held at least 6 months. Then, occupations were coded using ISCO 68. Unconditional logistic regressions were performed to assess the association between occupations (ever occupied and by duration) and PCa risk, whether all and aggressive, after adjusting for potential confounders. Results For ≥10 years of employment, we found positive associations with PCa, whether overall and aggressive, among Medical, Dental and Veterinary workers (OR (odds ratios) =5.01 [95% confidence interval] [1.27; 19.77]), Members of the armed forces (OR = 5.14 [0.99; 26.71]) and Fishermen, hunters and related workers (OR = 4.58 [1.33; 15.78]); whether overall and non-aggressive PCa, among Legislative officials and Government administrators (OR = 3.30 [1.10; 9.84]) or Managers (OR = 1.68 [1.18; 2.41]); however a negative association, whether overall and non-aggressive PCa, among Material-Handling and Related Equipment Operators, Dockers and Freight Handlers (OR = 0.40 [0.17; 0.97]). Conclusion Excess PCa risks were observed in the EPICAP study mostly among white collar workers exposed to several factors in their work environment. These emerging associations can be used to lead future research investigating specific occupational exposures. Supplementary Information The online version contains supplementary material available at 10.1186/s12995-022-00346-2.
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Laroche E, L’Espérance S. Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2519. [PMID: 33802629 PMCID: PMC7967542 DOI: 10.3390/ijerph18052519] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 12/26/2022]
Abstract
Firefighters are exposed to carcinogens that may increase their risk of developing many types of occupational cancer. Many systematic reviews (SRs) have been produced with sometimes conflicting conclusions. In this overview of reviews, we aim to assess the conclusion consistency across the available systematic reviews on the cancer risk in firefighters. Literature searches were conducted in several indexed databases and grey literature to retrieve systematic reviews aiming to evaluate cancer incidence or cancer mortality in firefighters. Results from included SRs were analyzed according to the tumour site. Out of 1054 records identified by the search in the databases, a total of 11 SRs were ultimately included. The original studies (n = 104) analyzed in the SRs were published between 1959 and 2018. The results consistently reported a significant increase in the incidence of rectal, prostate, bladder and testicular cancers as well as mesothelioma and malignant melanoma in firefighters compared to the general population. The SRs also indicate that death rates from rectal cancer and non-Hodgkin's lymphoma are higher among firefighters. Consistent SR results suggest that several types of cancer may be more frequent in firefighters than in the general population.
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Affiliation(s)
- Elena Laroche
- School of Administration Sciences, Université TELUQ, Quebec, QC G1K 9H6, Canada;
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Singh S, McDonald JT, Ilie G, Adisesh A. An examination of the association between lifetime history of prostate and pancreatic cancer diagnosis and occupation in a population sample of Canadians. PLoS One 2020; 15:e0227622. [PMID: 32023280 PMCID: PMC7001921 DOI: 10.1371/journal.pone.0227622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 12/24/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Occupation was assessed as possible risk factors for prostate (PCa) and pancreatic cancer in a large Canadian worker cohort. METHODS The Canadian Census Health and Environment Cohort (CanCHEC) was derived from linking the 1991 Canadian Census Cohort to the Canadian Cancer Database (1969-2010), Canadian Mortality Database (1991-2011), and Tax Summary Files (1981-2011). From the total sample of 1,931,110 persons, we identified and derived two samples of 28,610 men and 3,220 men and women with a past history of PCa and pancreatic cancer diagnoses, respectively. Cox proportional hazards models were used to estimate hazards ratios and 95% confidence intervals for occupation. RESULTS In Canadian men aged 24-64 years, the highest elevated risks of PCa were observed for library clerks (HR = 2.36, 95% CI:1.12-4.97), medical radiation technologists (HR = 1.66, 95% CI:1.04-2.65), telecommunications and line cable workers (HR = 1.62, 95% CI: 1.22-3.16) and commissioned police officers (HR = 1.54, 95% CI: 1.10-2.16. The highest elevated risk for pancreatic cancer were observed for commissioned police officers (HR = 4.34, 95% CI: 1.85-10.21), photographic and film processors (HR = 3.97, 95% CI:1.69-9.34), railway and motor transport labourers (HR = 3.94, 95% CI: 1.67-9.29), and computer engineers (HR = 3.82, 95%CI: 1.52-9.61). CONCLUSION These findings emphasize the need for further study of job-related exposures and the potential influence of non-occupational factors such as screening practices.
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Affiliation(s)
- Smriti Singh
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Gabriela Ilie
- Department of Community Health and Epidemiology, Urology, and Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anil Adisesh
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Peters CE, Villeneuve PJ, Parent MÉ. Occupation as a predictor of prostate cancer screening behaviour in Canada. J Med Screen 2020; 27:215-222. [PMID: 32000565 DOI: 10.1177/0969141320902485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES If prostate cancer screening practices relate to occupation, this would have important implications when studying the aetiological role of workplace exposures on prostate cancer. We identified variations in screening by occupation among men in Montreal, Canada (2005-2012). METHODS Prostate specific antigen testing and digital rectal examination (ever-screened and frequency of screening, previous five years) were examined among population controls from the Prostate Cancer & Environment Study. Face-to-face interviews elicited lifestyle and occupational histories. Multivariable logistic regression was used to estimate the odds of ever-screening for the longest-held occupation, adjusting for potential confounders. Negative binomial models were used to examine relationships with screening frequency. RESULTS Among 1989 controls, 81% reported ever having had a prostate specific antigen test, and 77% a digital rectal examination. Approximately 40% of men reported having a prostate specific antigen test once a year, on average. Compared with those in management or administrative jobs, men in primary industry (odds ratio 0.26, 95% confidence interval 0.10-0.65), construction (0.44, 0.25-0.79), machining (0.45, 0.21-0.97), and teaching (0.37, 0.20-0.70) were less likely to have undergone prostate specific antigen screening. Results were similar when considering the most recent job. CONCLUSIONS Our findings highlight substantial variations in prostate cancer screening by occupation. Men in occupations where carcinogen exposures are more common are less likely to participate in prostate screening activities. This could be an important source of bias, and occupational studies of prostate cancer should account for screening practices.
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Affiliation(s)
- Cheryl E Peters
- Department of Health Sciences, Carleton University, Ottawa, Canada.,Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, Université du Québec, Laval, Canada.,Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada
| | - Paul J Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Canada
| | - Marie-Élise Parent
- Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, Université du Québec, Laval, Canada
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Sritharan J, MacLeod JS, McLeod CB, Peter A, Demers PA. Prostate cancer risk by occupation in the Occupational Disease Surveillance System (ODSS) in Ontario, Canada. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2019; 39:178-186. [PMID: 31091061 DOI: 10.24095/hpcdp.39.5.02] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Previous Canadian epidemiologic studies have identified associations between occupations and prostate cancer risk, though evidence is limited. However, there are no well-established preventable risk factors for prostate cancer, which warrants the need for further investigation into occupational factors to strengthen existing evidence. This study uses occupation and prostate cancer information from a large surveillance cohort in Ontario that linked workers' compensation claim data to administrative health databases. METHODS Occupations were examined using the Occupational Disease Surveillance System (ODSS). ODSS included 1 231 177 male workers for the 1983 to 2015 period, whose records were linked to the Ontario Cancer Registry (OCR) in order to identify and follow up on prostate cancer diagnoses. Cox proportional hazard models were used to calculate age-adjusted hazard ratios and 95% CI to estimate the risk of prostate cancer by occupation group. RESULTS A total of 34 997 prostate cancer cases were diagnosed among workers in ODSS. Overall, elevated prostate cancer risk was observed for men employed in management/ administration (HR 2.17, 95% CI = 1.98-2.38), teaching (HR 1.99, 95% CI = 1.79-2.21), transportation (HR 1.20, 95% CI = 1.16-1.24), construction (HR 1.09, 95% CI = 1.06-1.12), firefighting (HR 1.62, 95% CI = 1.47-1.78), and police work (HR 1.20, 95% CI = 1.10-1.32). Inconsistent findings were observed for clerical and farming occupations. CONCLUSION Associations observed in white collar, construction, transportation, and protective services occupations were consistent with previous Canadian studies. Findings emphasize the need to assess job-specific exposures, sedentary behaviour, psychological stress, and shift work. Understanding specific occupational risk factors can lead to better understanding of prostate cancer etiology and improve prevention strategies.
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Affiliation(s)
- Jeavana Sritharan
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Jill S MacLeod
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Christopher B McLeod
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Institute for Work & Health, Toronto, Ontario, Canada
| | - Alice Peter
- Population Health and Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Jalilian H, Ziaei M, Weiderpass E, Rueegg CS, Khosravi Y, Kjaerheim K. Cancer incidence and mortality among firefighters. Int J Cancer 2019; 145:2639-2646. [PMID: 30737784 DOI: 10.1002/ijc.32199] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/14/2019] [Accepted: 01/29/2019] [Indexed: 11/07/2022]
Abstract
Firefighters are exposed to both known and suspected carcinogens. This study aims to systematically review the literature on the association of firefighting occupation and cancer incidence and mortality, overall and for specific cancer sites. A systematic review using PubMed, Embase, and Web of Science was performed up to January 1, 2018. We extracted risk estimates of cancers and calculated summary incidence risk estimates (SIRE), summary mortality risk estimates (SMRE), and their 95% confidence intervals (CI). Publication bias and risk of bias in individual studies were assessed using Begg's and Egger's tests and the Newcastle-Ottawa scale (NOS), respectively. We included 50 papers in the review and 48 in the meta-analysis. We found significantly elevated SIREs for cancer of the colon (1.14; CI 1.06 to 1.21), rectum (1.09; CI 1.00 to 1.20), prostate (1.15; CI 1.05 to 1.27), testis (1.34; CI 1.08 to 1.68), bladder (1.12; CI 1.04 to 1.21), thyroid (1.22; CI 1.01 to 1.48), pleura (1.60; CI 1.09 to 2.34), and for malignant melanoma (1.21; CI 1.02 to 1.45). We found significant SMREs of 1.36 (1.18 to 1.57) and 1.42 (1.05 to 1.90) for rectal cancer and Non-Hodgkin's lymphoma, respectively. Considering the significantly elevated risk of some cancers in this occupational group, we suggest improving preventive measures and securing adequate and relevant medical attention for this group. Further studies with more accurate and in-depth exposure assessments are indicated.
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Affiliation(s)
- Hamed Jalilian
- Department of Occupational Health and Safety, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mansour Ziaei
- School of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Department of Research, Cancer Registry of Norway - Institute of Population-Based Cancer Research, Oslo, Norway.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Genetic Epidemiology Group, Folkhälsan Research Center, and Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Corina Silvia Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Yahya Khosravi
- Department of Occupational Health and Safety, Research Center for Health, Safety and Environment, Alborz University of Medical Sciences, Karaj, Iran
| | - Kristina Kjaerheim
- Department of Research, Cancer Registry of Norway - Institute of Population-Based Cancer Research, Oslo, Norway
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Aponte A, Penilla RP, Rodríguez AD, Ocampo CB. Mechanisms of pyrethroid resistance in Aedes (Stegomyia) aegypti from Colombia. Acta Trop 2019; 191:146-154. [PMID: 30552882 DOI: 10.1016/j.actatropica.2018.12.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/11/2018] [Accepted: 12/11/2018] [Indexed: 11/28/2022]
Abstract
In Colombia Aedes (Stegomyia) aegypti is the main vector of urban arboviruses such as dengue, chikungunya and Zika. This urban mosquito has a well-established capacity to develop insecticide resistance to different types of insecticides (pyrethroids, organochlorides, organophosphates), using multiple resistance mechanisms. An understanding of ongoing resistance mechanisms is critical to determining the activities of vector control programs. In order to identify the biochemical and molecular mechanisms associated with pyrethroid resistance in Colombia, three laboratory-selected strains resistant to DDT, Propoxur and lambdacyhalothrin, and 7 field-collected strains were evaluated. CDC bioassays were performed to measure the susceptibility status to pyrethroid type I (permethrin) and II (deltamethrin and lambdacyhalothrin), and potential cross-resistance to different types of insecticides; organochlorine (DDT), carbamates (propoxur) and organophosphates (malathion). The enzymatic activity of esterases, glutathione S-transferases (GST) and P450 monooxygenases were biochemically determined. Frequencies of kdr mutations Val1016Ile and Phe1534cys were determined through real-time PCR. The Rockefeller strain of Aedes (Stegomyia) aegypti was used as the susceptible control. The laboratory-selected strains "propoxur" and "lambdacyhalothrin" and one field population (Medellín (BF) F2 were resistant to all evaluated pyrethroids. Six of the seven field populations as well as the laboratory- selected "DDT" strain were resistant to permethrin. All the evaluated strains were resistant to DDT. Cross-resistance between lambdacyhalothrin and propoxur was observed in the laboratory-selected strains; however, all field-collected strains were susceptible to propoxur and no evidence of malathion resistance was found. The main biochemical mechanism for resistance observed in the field-collected strains was related to the enzyme GST. Further, the frequencies of kdr mutations alleles associated with insecticide resistance were high and ranged from 0.02 to 0.72 for Ile1016 and from 0.44 to 0.99 for Cys1534. Strains with high frequencies of both kdr mutations were resistant to both type I and II pyrethroids. These results suggest that Ae. aegypti from Colombia have developed multiple resistance mechanisms associated with pyrethroid resistance; therefore a resistance management strategy against these field populations of Ae. Aegypti, incorporating these findings is strongly recommended.
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Affiliation(s)
- Angélica Aponte
- Centro Internacional de Entrenamiento e Investigaciones Médicas CIDEIM, Carrera 125 N 19-225, Cali, Colombia.
| | - R Patricia Penilla
- Centro Regional de Investigación en Salud Pública- Instituto Nacional de Salud Pública de México, Avenida 4 Norte 19 calle poniente, CP 307000, Chiapas, Tapachula, Mexico.
| | - Américo D Rodríguez
- Centro Regional de Investigación en Salud Pública- Instituto Nacional de Salud Pública de México, Avenida 4 Norte 19 calle poniente, CP 307000, Chiapas, Tapachula, Mexico.
| | - Clara B Ocampo
- Centro Internacional de Entrenamiento e Investigaciones Médicas CIDEIM, Carrera 125 N 19-225, Cali, Colombia; Universidad ICESI, Calle 18 N 122-135, Cali, Colombia.
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Adler C, Friesen MC, Yeboah ED, Tettey Y, Biritwum RB, Adjei AA, Tay E, Okyne V, Mensah JE, Truelove A, Yang B, Kelly SP, Zhou CK, McCullough LE, Pardo L, Hoover RN, Hsing AW, Cook MB, Koutros S. Usual adult occupation and risk of prostate cancer in West African men: the Ghana Prostate Study. Occup Environ Med 2018; 76:71-77. [PMID: 30530485 DOI: 10.1136/oemed-2018-105391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/30/2018] [Accepted: 11/06/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Established prostate cancer (PCa) risk factors include age, family history of PCa and African ancestry. Studies, mostly among highly screened, predominantly European ancestral populations, suggest that employment in certain occupations (eg, farming, military) may also have an increased risk for PCa. Here, we evaluated the association between usual adult occupation and PCa risk in Ghanaian men, a population with historically low rates of PCa screening. METHODS The Ghana Prostate Study is a case-control study of PCa that was conducted from 2004 to 2012 in 749 cases and 964 controls. In-person interviews were conducted to collect information from participants, including longest held job. Industrial hygienists classified job titles into occupational categories. Unconditional logistic regression was used to calculate ORs and 95% CIs for the association between longest held job and PCa risk (overall, aggressive (Gleason≥7)), controlling for potential confounders. RESULTS Risk was increased among men in management (overall PCa OR=2.2, 95% CI 1.4 to 3.2; aggressive PCa OR=2.2, 95% CI 1.3 to 3.5) and military occupations (overall PCa OR=3.4, 95% CI 1.7 to 7.0; aggressive PCa OR=3.5, 95% CI 1.5 to 8.3). Risks were also elevated for management and military-specific jobs based on 3-digit level Standard Occupational Classification definitions. Sensitivity analyses accounting for access to medical care did not show significant differences. CONCLUSIONS Our study provides some evidence for increased risk of PCa among men in management and military occupations, which is consistent with the published literature. Additional research is needed to clarify the drivers of the associations between these occupations and PCa.
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Affiliation(s)
- Colin Adler
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Melissa C Friesen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | | | - Yao Tettey
- University of Ghana Medical School, Accra, Ghana
| | | | | | - Evelyn Tay
- University of Ghana Medical School, Accra, Ghana
| | | | | | | | - Baiyu Yang
- Stanford Cancer Institute, Stanford School of Medicine, Palo Alto, California, USA
| | - Scott P Kelly
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Cindy Ke Zhou
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | | | - Larissa Pardo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Ann W Hsing
- Stanford Cancer Institute, Stanford School of Medicine, Palo Alto, California, USA.,Stanford Prevention Research Center, Stanford School of Medicine, Palo Alto, California, USA
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
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Sritharan J, MacLeod J, Harris S, Cole DC, Harris A, Tjepkema M, Peters PA, Demers PA. Prostate cancer surveillance by occupation and industry: the Canadian Census Health and Environment Cohort (CanCHEC). Cancer Med 2018; 7:1468-1478. [PMID: 29493883 PMCID: PMC5911573 DOI: 10.1002/cam4.1358] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/28/2017] [Accepted: 01/02/2018] [Indexed: 01/23/2023] Open
Abstract
As there are no well-established modifiable risk factors for prostate cancer, further evidence is needed on possible factors such as occupation. Our study uses one of the largest Canadian worker cohorts to examine occupation, industry, and prostate cancer and to assess patterns of prostate cancer rates. The Canadian Census Health and Environment Cohort (CanCHEC) was established by linking the 1991 Canadian Census Cohort to the Canadian Cancer Database (1969-2010), Canadian Mortality Database (1991-2011), and Tax Summary Files (1981-2011). A total of 37,695 prostate cancer cases were identified in men aged 25-74 based on age at diagnosis. Cox proportional hazards models were used to estimate hazards ratios and 95% confidence intervals. In men aged 25-74 years, elevated risks were observed in the following occupations: senior management (HR = 1.12, 95% CI: 1.04-1.20); office and administration (HR = 1.19, 95% CI: 1.11-1.27); finance services (HR = 1.09, 95% CI: 1.04-1.14); education (HR = 1.05, 95% CI: 1.00-1.11); agriculture and farm management (HR = 1.12, 95% CI: 1.06-1.17); farm work (HR = 1.11, 95% CI: 1.01-1.21); construction managers (HR = 1.07, 95% CI: 1.01-1.14); firefighting (HR = 1.17, 95% CI: 1.01-1.36); and police work (HR = 1.22, 95% CI: 1.09-1.36). Decreased risks were observed across other construction and transportation occupations. Results by industry were consistent with occupation results. Associations were identified for white-collar, agriculture, protective services, construction, and transportation occupations. These findings emphasize the need for further study of job-related exposures and the potential influence of nonoccupational factors such as screening practices.
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Affiliation(s)
- Jeavana Sritharan
- Occupational Cancer Research CentreCancer Care OntarioTorontoOntarioCanada
- Institute of Medical ScienceUniversity of TorontoTorontoOntarioCanada
| | - Jill MacLeod
- Occupational Cancer Research CentreCancer Care OntarioTorontoOntarioCanada
| | - Shelley Harris
- Occupational Cancer Research CentreCancer Care OntarioTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Donald C. Cole
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Anne Harris
- Occupational Cancer Research CentreCancer Care OntarioTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- School of Occupational and Public HealthRyerson UniversityTorontoOntarioCanada
| | | | - Paul A. Peters
- Department of SociologyUniversity of New BrunswickFrederictonNew BrunswickCanada
| | - Paul A. Demers
- Occupational Cancer Research CentreCancer Care OntarioTorontoOntarioCanada
- Institute of Medical ScienceUniversity of TorontoTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
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Sritharan J, Pahwa M, Demers PA, Harris SA, Cole DC, Parent ME. Prostate cancer in firefighting and police work: a systematic review and meta-analysis of epidemiologic studies. Environ Health 2017; 16:124. [PMID: 29149887 PMCID: PMC5693511 DOI: 10.1186/s12940-017-0336-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/27/2017] [Indexed: 05/06/2023]
Abstract
OBJECTIVES We conducted a systematic review and meta-analysis to evaluate potential associations between firefighting and police occupations, and prostate cancer incidence and mortality. METHODS Original epidemiological studies published from 1980 to 2017 were identified through PubMed and Web of Science. Studies were included if they contained specific job titles for ever/never firefighting and police work and associated prostate cancer risk estimates with 95% confidence intervals (CI). Study quality was assessed using a 20-point checklist. Prostate cancer meta-risk estimates (mRE) and corresponding 95% CIs were calculated for firefighting and police work separately and by various study characteristics using random effects models. Between-study heterogeneity was evaluated using the I2 score. Publication bias was assessed using Begg's and Egger's tests. RESULTS A total of 26 firefighter and 12 police studies were included in the meta-analysis, with quality assessment scores ranging from 7 to 19 points. For firefighter studies, the prostate cancer incidence mRE was 1.17 (95% CI = 1.08-1.28, I2 = 72%) and the mortality mRE was 1.12 (95% CI = 0.92-1.36, I2 = 50%). The mRE for police incidence studies was 1.14 (95% CI = 1.02-1.28; I2 = 33%); for mortality studies, the mRE was 1.08 (95% CI = 0.80-1.45; I2 = 0%). By study design, mREs for both firefighter and police studies were similar to estimates of incidence and mortality. CONCLUSION Small excess risks of prostate cancer were observed from firefighter studies with moderate to substantial heterogeneity and a relatively small number of police studies, respectively. There is a need for further studies to examine police occupations and to assess unique and shared exposures in firefighting and police work.
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Affiliation(s)
- Jeavana Sritharan
- Occupational Cancer Research Centre, Cancer Care Ontario, 525 University Avenue, Toronto, ON M5G 2L3 Canada
- Institute of Medical Science, University of Toronto, 525 University Avenue, Toronto, ON M5G 2L3 Canada
| | - Manisha Pahwa
- Occupational Cancer Research Centre, Cancer Care Ontario, 525 University Avenue, Toronto, ON M5G 2L3 Canada
| | - Paul A. Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, 525 University Avenue, Toronto, ON M5G 2L3 Canada
- Institute of Medical Science, University of Toronto, 525 University Avenue, Toronto, ON M5G 2L3 Canada
- CAREX Canada, Simon Fraser University, Burnaby, Canada
- Dalla Lana School of Public Health, University of Toronto, 525 University Avenue, Toronto, ON M5G 2L3 Canada
| | - Shelley A. Harris
- Occupational Cancer Research Centre, Cancer Care Ontario, 525 University Avenue, Toronto, ON M5G 2L3 Canada
- Dalla Lana School of Public Health, University of Toronto, 525 University Avenue, Toronto, ON M5G 2L3 Canada
- Population Health and Prevention, Cancer Care Ontario, 525 University Avenue, Toronto, ON M5G 2L3 Canada
| | - Donald C. Cole
- Dalla Lana School of Public Health, University of Toronto, 525 University Avenue, Toronto, ON M5G 2L3 Canada
| | - Marie-Elise Parent
- INRS-Institut Armand-Frappier, University of Quebec, 531 Boulevard des Prairies, Laval, Quebec, H7V 1B7 Canada
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