Risk of early-onset prostate cancer associated with occupation in the Nordic countries |
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| Affiliation: | 1. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA;2. Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA;3. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA;4. Department of Research, Cancer Registry of Norway – Institute of Population-Based Cancer Research, Oslo, Norway;5. Danish Cancer Society Research Center, Copenhagen, Denmark;6. University of Copenhagen, Copenhagen, Denmark;7. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;8. Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland;9. Faculty of Medicine, University of Iceland, Reykjavik, Iceland;10. Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland;11. Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway;12. Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland;13. Faculty of Social Sciences, University of Tampere, Tampere, Finland;1. Department of Emergency Medicine, Jacobi Medical Center, Bronx, NY;2. Department of Surgery, Jacobi Medical Center, Bronx, NY;3. Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY;1. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;2. Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada;3. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada;4. Patient Education, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;5. Oncology Nursing, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;6. Division of Cancer Care and Epidemiology, QCRI, Kingston, Ontario, Canada;7. Department of Patient and Family Support, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;8. Department of Psychiatry, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada;1. Urology Research Group, Division of Surgery and Interventional Science, University College London, 132 Hampstead Road, NW1 2PS London, UK;2. Department of Urology, University College London Hospitals Trust, 235 Euston Road, NW1 2BU London, UK;3. Department of Academic Urology, Royal Marsden Hospital, 203 Fulham Road, London SW3 6JJ, UK |
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| Abstract: | BackgroundEarly-onset prostate cancer is often more aggressive and may have a different aetiology than later-onset prostate cancer, but has been relatively little studied to date. We evaluated occupation in relation to early- and later-onset prostate cancer in a large pooled study.MethodsWe used occupational information from census data in five Nordic countries from 1960 to 1990. We identified prostate cancer cases diagnosed from 1961 to 2005 by linkage of census information to national cancer registries and calculated standardised incidence ratios (SIRs) separately for men aged 30–49 and those aged 50 or older. We also conducted separate analyses by period of follow-up, 1961–1985 and 1986–2005, corresponding to pre- and post-prostate-specific antigen (PSA) screening.ResultsFor early-onset prostate cancer (n = 1521), we observed the highest SIRs for public safety workers (e.g. firefighters) (SIR = 1.71, 95% confidence interval [CI]: 1.23–2.31) and military personnel (SIR = 1.97, 95% CI: 1.31–2.85). These SIRs were significantly higher than the SIRs for later-onset disease (for public safety workers, SIR = 1.10, 95% CI: 1.07–1.14 and for military personnel, SIR = 1.09, 95% CI: 1.05–1.13; pheterogeneity = 0.005 and 0.002, respectively). Administrators and technical workers also demonstrated significantly increased risks for early-onset prostate cancer, but the SIRs did not differ from those of later-onset disease (pheterogeneity >0.05). While our early-onset finding for public safety workers was restricted to the post-PSA period, that for military personnel was restricted to the pre-PSA period.ConclusionOur results suggest that occupational exposures, particularly for military personnel, may be associated with early-onset prostate cancer. Further evaluation is needed to explain these findings. |
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| Keywords: | Age Early-onset prostate cancer Nordic Occupation Standardised incidence ratios |
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