Aidan P Noon1, Jan Ivar Martinsen2, James W F Catto3, Eero Pukkala4. 1. Academic Urology Unit and Academic Unit of Molecular Oncology, University of Sheffield, Sheffield, UK. 2. Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway. 3. Academic Urology Unit and Academic Unit of Molecular Oncology, University of Sheffield, Sheffield, UK. Electronic address: j.catto@sheffield.ac.uk. 4. Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland; School of Health Sciences, University of Tampere, Tampere, Finland.
Abstract
BACKGROUND: We examined a national data set to determine if workers employed in specific occupations develop distinct bladder cancer (BCa) phenotypes. OBJECTIVE: To compare the incidence and disease-specific mortality (DSM) of localized and advanced BCa in workers with different job titles. DESIGN, SETTING, AND PARTICIPANTS: BCa incidence, stage at diagnosis, and DSM in 1.7 million Finnish men (13 717 with BCa) and 1.7 million women (4282 with BCa) with annotated occupational descriptions. Follow-up was 37 and 43 million person-years, respectively. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The gender-specific incidence and BCa DSM within each occupational category was compared with the expected number of cases based on the entire Finnish population to generate standardized incidence ratios (SIRs) and standard mortality ratios (SMRs). RESULTS AND LIMITATIONS: Occupations were found that had significant differences in the incidence of localized (SIRloc) and advanced (SIRadv, SMRadv) BCa and DSM. Male chemical process workers (SIRloc/SIRadv: 5.19; 95% confidence interval [CI], 1.73-25.7), male military personnel (SIRloc/SIRadv: 6.4; 95% CI, 1.09-259.0), and male public safety workers (SIRloc/SIRadv: 1.77; 95% CI, 1.04-3.23) had significantly more localized than advanced tumors. In contrast, miscellaneous construction workers had more advanced than localized cancers for both genders (male SIRloc/SIRadv: 0.67; 95% CI, 0.53-0.86; female SIRloc/SIRadv: 0.12; 95% CI, 0.09-0.54). Male chemical process workers had fewer deaths from BCa than expected from advanced tumors (SMRadv: 0.32; 95% CI, 0.07-0.94), and miscellaneous constructions workers had more deaths from advanced tumors than expected (male SMRadv: 1.44; 95% CI, 1.10-1.85; female SMRadv: 3.35; 95% CI, 1.23-7.30). Limitations of this study are failure to control accurately for the effects of smoking and a lack of specific treatment information. CONCLUSIONS: Occupations exist that may differ in their risks for localized and advanced BCa and for DSM. PATIENT SUMMARY: Occupations have been identified that may have different patterns of bladder cancer than expected. These findings may be explained by confounding factors such as exposure to tobacco smoke; however, it could be that workers with these job titles are exposed to specific bladder carcinogens.
BACKGROUND: We examined a national data set to determine if workers employed in specific occupations develop distinct bladder cancer (BCa) phenotypes. OBJECTIVE: To compare the incidence and disease-specific mortality (DSM) of localized and advanced BCa in workers with different job titles. DESIGN, SETTING, AND PARTICIPANTS: BCa incidence, stage at diagnosis, and DSM in 1.7 million Finnish men (13 717 with BCa) and 1.7 million women (4282 with BCa) with annotated occupational descriptions. Follow-up was 37 and 43 million person-years, respectively. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The gender-specific incidence and BCa DSM within each occupational category was compared with the expected number of cases based on the entire Finnish population to generate standardized incidence ratios (SIRs) and standard mortality ratios (SMRs). RESULTS AND LIMITATIONS: Occupations were found that had significant differences in the incidence of localized (SIRloc) and advanced (SIRadv, SMRadv) BCa and DSM. Male chemical process workers (SIRloc/SIRadv: 5.19; 95% confidence interval [CI], 1.73-25.7), male military personnel (SIRloc/SIRadv: 6.4; 95% CI, 1.09-259.0), and male public safety workers (SIRloc/SIRadv: 1.77; 95% CI, 1.04-3.23) had significantly more localized than advanced tumors. In contrast, miscellaneous construction workers had more advanced than localized cancers for both genders (male SIRloc/SIRadv: 0.67; 95% CI, 0.53-0.86; female SIRloc/SIRadv: 0.12; 95% CI, 0.09-0.54). Male chemical process workers had fewer deaths from BCa than expected from advanced tumors (SMRadv: 0.32; 95% CI, 0.07-0.94), and miscellaneous constructions workers had more deaths from advanced tumors than expected (male SMRadv: 1.44; 95% CI, 1.10-1.85; female SMRadv: 3.35; 95% CI, 1.23-7.30). Limitations of this study are failure to control accurately for the effects of smoking and a lack of specific treatment information. CONCLUSIONS: Occupations exist that may differ in their risks for localized and advanced BCa and for DSM. PATIENT SUMMARY: Occupations have been identified that may have different patterns of bladder cancer than expected. These findings may be explained by confounding factors such as exposure to tobacco smoke; however, it could be that workers with these job titles are exposed to specific bladder carcinogens.
Authors: James W F Catto; Amy Downing; Samantha Mason; Penny Wright; Kate Absolom; Sarah Bottomley; Luke Hounsome; Syed Hussain; Mohini Varughese; Caroline Raw; Phil Kelly; Adam W Glaser Journal: Eur Urol Date: 2021-02-10 Impact factor: 20.096
Authors: Samantha J Mason; Amy Downing; Penny Wright; Luke Hounsome; Sarah E Bottomley; Jessica Corner; Mike Richards; James W Catto; Adam W Glaser Journal: Br J Cancer Date: 2018-05-14 Impact factor: 7.640
Authors: Florian Janisch; Hang Yu; Malte W Vetterlein; Roland Dahlem; Oliver Engel; Margit Fisch; Shahrokh F Shariat; Armin Soave; Michael Rink Journal: J Clin Med Date: 2019-09-13 Impact factor: 4.241
Authors: Oliver Reed; Ibrahim Jubber; Jon Griffin; Aidan P Noon; Louise Goodwin; Syed Hussain; Marcus G Cumberbatch; James W F Catto Journal: PLoS One Date: 2020-10-21 Impact factor: 3.240