Paolo Boffetta1, Rachel Zeig-Owens2, Sylvan Wallenstein3, Jiehui Li4, Robert Brackbill4, James Cone4, Mark Farfel4, William Holden1, Roberto Lucchini3, Mayris P Webber2, David Prezant2,5, Steven D Stellman4,6. 1. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York. 2. New York City Fire Department, New York, New York. 3. Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. 4. New York City Department of Health and Mental Hygiene, New York, New York. 5. Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York. 6. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
Abstract
BACKGROUND: Three longitudinal studies of cancer incidence in varied populations of World Trade Center responders have been conducted. METHODS: We compared the design and results of the three studies. RESULTS: Separate analyses of these cohorts revealed excess cancer incidence in responders for all cancers combined and for cancers of the thyroid and prostate. Methodological dissimilarities included recruitment strategies, source of cohort members, demographic characteristics, overlap between cohorts, assessment of WTC and other occupational exposures and confounders, methods and duration of follow-up, approaches for statistical analysis, and latency analyses. CONCLUSIONS: The presence of three cohorts strengthens the effort of identifying and quantifying the cancer risk; the heterogeneity in design might increase sensitivity to the identification of cancers potentially associated with exposure. The presence and magnitude of an increased cancer risk remains to be fully elucidated. Continued long-term follow up with minimal longitudinal dropout is crucial to achieve this goal.
BACKGROUND: Three longitudinal studies of cancer incidence in varied populations of World Trade Center responders have been conducted. METHODS: We compared the design and results of the three studies. RESULTS: Separate analyses of these cohorts revealed excess cancer incidence in responders for all cancers combined and for cancers of the thyroid and prostate. Methodological dissimilarities included recruitment strategies, source of cohort members, demographic characteristics, overlap between cohorts, assessment of WTC and other occupational exposures and confounders, methods and duration of follow-up, approaches for statistical analysis, and latency analyses. CONCLUSIONS: The presence of three cohorts strengthens the effort of identifying and quantifying the cancer risk; the heterogeneity in design might increase sensitivity to the identification of cancers potentially associated with exposure. The presence and magnitude of an increased cancer risk remains to be fully elucidated. Continued long-term follow up with minimal longitudinal dropout is crucial to achieve this goal.
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