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Lynge E, Kaerlev L, Olsen J, Sabroe S, Afonso N, Ahrens W, Eriksson M, Merletti F, Morales-Suarez-Varelas M, Stengrevics A, Guénel P. Rare cancers of unknown etiology: lessons learned from a European multi-center case-control study. Eur J Epidemiol 2020; 35:937-948. [PMID: 32681390 PMCID: PMC7524829 DOI: 10.1007/s10654-020-00663-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/10/2020] [Indexed: 11/05/2022]
Abstract
Rare cancers together constitute one fourth of cancers. As some rare cancers are caused by occupational exposures, a systematic search for further associations might contribute to future prevention. We undertook a European, multi-center case–control study of occupational risks for cancers of small intestine, bone sarcoma, uveal melanoma, mycosis fungoides, thymus, male biliary tract and breast. Incident cases aged 35–69 years and sex-and age-matched population/colon cancer controls were interviewed, including a complete list of jobs. Associations between occupational exposure and cancer were assessed with unconditional logistic regression controlled for sex, age, country, and known confounders, and reported as odds ratios (OR) with 95% confidence intervals (CI). Interviewed were 1053 cases, 2062 population, and 1084 colon cancer controls. Male biliary tract cancer was associated with exposure to oils with polychlorinated biphenyls; OR 2.8 (95% CI 1.3–5.9); male breast cancer with exposure to trichloroethylene; OR 1.9 (95% CI 1.1–3.3); bone sarcoma with job as a carpenter/joiner; OR 4.3 (95% CI 1.7–10.5); and uveal melanoma with job as a welder/sheet metal worker; OR 1.95 (95% CI 1.08–3.52); and cook; OR 2.4 (95% CI 1.4–4.3). A confirmatory study of printers enhanced suspicion of 1,2-dichloropropane as a risk for biliary tract cancer. Results contributed to evidence for classification of welding and 1,2-dichloropronane as human carcinogens. However, despite efforts across nine countries, for some cancer sites only about 100 cases were interviewed. The Rare Cancer Study illustrated both the strengths and limitations of explorative studies for identification of etiological leads.
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Affiliation(s)
- Elsebeth Lynge
- Nykøbing Falster Hospital, University of Copenhagen, Ejegodvej 63, 4800, Nykøbing Falster, Denmark.
| | - Linda Kaerlev
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Center for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, 5000, Odense C, Denmark
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Svend Sabroe
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Noemia Afonso
- Serviço de Oncologia, Centro Hospitalar E Universitário Do Porto, Largo Do Prof. Abel Salazar, 4099-001, Porto, Portugal
| | - Wolfgang Ahrens
- Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.,Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, E 28359, Bremen, Germany
| | - Mikael Eriksson
- Skane University Hospital and Lund University, Entrégatan 7, 222 42, Lund, Sweden
| | - Franco Merletti
- Cancer Epidemiology, Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Torino, Italy
| | - Maria Morales-Suarez-Varelas
- Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Legal Medicine, School of Pharmacy, University of Valencia, Avenida Vicente Andres Estellés s/n Burjassot, S46100, Valencia, Spain.,Biomedical Research Consortium in Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | | | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), Cancer and Environment team, Inserm U1018, Université Paris Sud, Université Paris Saclay, 16 avenue Paul Vaillant-Couturier, 94800, Villejuif, France
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