Airborne exposures and risk of gastric cancer: A prospective cohort study

Sjödahl, Krister; Jansson, Catarina; Bergdahl, Ingvar A.; Adami, Johanna; Boffetta, Paolo; Lagergren, Jesper

doi:10.1002/ijc.22566

Cited by 47 publications

(32 citation statements)

References 54 publications

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“…However, workrelated exposure to airborne particles, especially cement-and silica dust, has repeatedly been associated with increased risk [63]. The increased SIRs in the present study for miners, chimney sweeps and construction workers fit with those findings.…”

Section: Stomach Cancersupporting

confidence: 85%

Occupation and cancer – follow-up of 15 million people in five Nordic countries

et al. 2009

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We present up to 45 years of cancer incidence data by occupational category for the Nordic populations. The study covers the 15 million people aged 30Á64 years in the 1960, 1970, 1980/1981 and/or 1990 censuses in Denmark, Finland, Iceland, Norway and Sweden, and the 2.8 million incident cancer cases diagnosed in these people in a follow-up until about 2005. The study was undertaken as a cohort study with linkage of individual records based on the personal identity codes used in all the Nordic countries.In the censuses, information on occupation for each person was provided through free text in self-administered questionnaires. The data were centrally coded and computerised in the statistical offices. For the present study, the original occupational codes were reclassified into 53 occupational categories and one group of economically inactive persons.All Nordic countries have a nation-wide registration of incident cancer cases during the entire study period. For the present study the incident cancer cases were classified into 49 primary diagnostic categories. Some categories have been further divided according to sub-site or morphological type. The observed number of cancer cases in each group of persons defined by country, sex, age, period and occupation was compared with the expected number calculated from the stratum specific person years and the incidence rates for the national population. The result was presented as a standardised incidence ratio, SIR, defined as the observed number of cases divided by the expected number. For all cancers combined (excluding non-melanoma skin cancer), the study showed a wide variation among men from an SIR of 0.79 (95% confidence interval 0.66Á0.95) in domestic assistants to 1.48 (1.43Á1.54) in waiters. The occupations with the highest SIRs also included workers producing beverage and tobacco, seamen and chimney sweeps. Among women, the SIRs varied from 0.58 (0.37Á0.87) in seafarers to 1.27 (1.19Á1.35) in tobacco workers. Low SIRs were found for farmers, gardeners and teachers.Our study was able to repeat most of the confirmed associations between occupations and cancers. It is known that almost all mesotheliomas are associated with asbestos exposure. Accordingly, plumbers, seamen and mechanics were the occupations with the highest risk in the present study. Mesothelioma was the cancer type showing the largest relative differences between the occupations. Outdoor workers such as fishermen, gardeners and farmers had the highest risk of lip cancer, while the lowest risk was found among indoor workers such as physicians and artistic workers.Studies of nasal cancer have shown increased risks associated with exposure to wood dust, both for those in furniture making and for those exposed exclusively to soft wood like the majority of Nordic woodworkers. We observed an SIR of 1.84 (1.66Á2.04) in male and 1.88 (0.90Á3.46) in female woodworkers. For nasal adenocarcinoma, the SIR in males was as high as 5.50 (4.60Á6.56).Male waiters and tobacco workers had the highest risk of ...

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Section: Stomach Cancersupporting

confidence: 85%

Occupation and cancer – follow-up of 15 million people in five Nordic countries

et al. 2009

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“…An industry-based study, however, did not observe an association with GNCA after either moderate or high asbestos exposure. 21 …”

Section: Gastric Cancermentioning

confidence: 99%

Occupational asbestos exposure and risk of esophageal, gastric and colorectal cancer in the prospective Netherlands Cohort Study

et al. 2014

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The evidence for an association between occupational asbestos exposure and esophageal, gastric and colorectal cancer is limited. We studied this association specifically addressing risk differences between relatively low and high exposure, risk associated with cancer subtypes, the influence of potential confounders and the interaction between asbestos and smoking in relation to cancer risk. Using the Netherlands Cohort Study (n 5 58,279 men, aged 55-69 years at baseline), asbestos exposure was estimated by linkage to a job-exposure matrix. After 17.3 years of follow-up, 187 esophageal, 486 gastric and 1,724 colorectal cancer cases were available for analysis. The models adjusted for age and family history of cancer showed that mainly (prolonged) exposure to high levels of asbestos was statistically significantly associated with risk of esophageal adenocarcinoma (EAC), total and distal colon cancer and rectal cancer. For overall gastric cancer and gastric non-cardia adenocarcinoma (GNCA), also exposure to lower levels of asbestos was associated. Additional adjustment for lifestyle confounders, especially smoking status, yielded non-significant associations with overall gastric cancer and GNCA in the multivariableadjusted model, except for the prolonged highly exposed subjects (tertile 3 vs. never: HR 2.67, 95% CI: 1.11-6.44 and HR 3.35, 95% CI: 1.33-8.44, respectively). No statistically significant additive or multiplicative interaction between asbestos and smoking was observed for any of the studied cancers. This prospective population-based study showed that (prolonged) high asbestos exposure was associated with overall gastric cancer, EAC, GNCA, total and distal colon cancer and rectal cancer.The International Agency for Research on Cancer evaluated the evidence for an association between asbestos exposure and gastric and colorectal cancer as limited, though for colorectal cancer they were evenly divided as to whether the evidence was strong enough to justify classification as sufficient. 1 For esophageal cancer, a relatively rare cancer, results of epidemiological studies on associations with asbestos are mixed and together with the fact that animal experiments do not support biological activity of asbestos at this site, the evidence was considered to be inadequate. 2 Therefore, the question remains whether asbestos entails an increased risk of developing gastrointestinal tumors, and if so, whether risk differs for relatively low and high exposure levels. As there are numerous other risk factors for gastrointestinal cancers, an additional question relates to the influence of potential confounders. Furthermore, cancer subtypes may have different etiologies and should be studied separately if possible. Finally, as for lung cancer, the question arises if interaction between asbestos and smoking is present in relation to gastrointestinal cancers. 1,2

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“…Moreover, they found an increase in risk of all malignant neoplasm (SMR = 1.3; 95% CI 1.0-1.5) and of urinary bladder cancer (SIR = 1.8; 95% CI 0.9-3.5) inside the entire cohort of cement workers. In addiction, there is an indication of association between cement dust and risk of gastric and colon cancer (Sjödahl et al 2007;Jakobsson et al 1993).…”

Section: Introductionmentioning

confidence: 99%