Prostate cancer surveillance by occupation and industry: the Canadian Census Health and Environment Cohort (CanCHEC)

Abstract

As there are no well‐established modifiable risk factors for prostate cancer, further evidence is needed on possible factors such as occupation. Our study uses one of the largest Canadian worker cohorts to examine occupation, industry, and prostate cancer and to assess patterns of prostate cancer rates. The Canadian Census Health and Environment Cohort (CanCHEC) was established by linking the 1991 Canadian Census Cohort to the Canadian Cancer Database (1969–2010), Canadian Mortality Database (1991–2011), and Tax Summary Files (1981–2011). A total of 37,695 prostate cancer cases were identified in men aged 25–74 based on age at diagnosis. Cox proportional hazards models were used to estimate hazards ratios and 95% confidence intervals. In men aged 25–74 years, elevated risks were observed in the following occupations: senior management (HR = 1.12, 95% CI: 1.04–1.20); office and administration (HR = 1.19, 95% CI: 1.11–1.27); finance services (HR = 1.09, 95% CI: 1.04–1.14); education (HR = 1.05, 95% CI: 1.00–1.11); agriculture and farm management (HR = 1.12, 95% CI: 1.06–1.17); farm work (HR = 1.11, 95% CI: 1.01–1.21); construction managers (HR = 1.07, 95% CI: 1.01–1.14); firefighting (HR = 1.17, 95% CI: 1.01–1.36); and police work (HR = 1.22, 95% CI: 1.09–1.36). Decreased risks were observed across other construction and transportation occupations. Results by industry were consistent with occupation results. Associations were identified for white‐collar, agriculture, protective services, construction, and transportation occupations. These findings emphasize the need for further study of job‐related exposures and the potential influence of nonoccupational factors such as screening practices.

An examination of the association between lifetime history of prostate and pancreatic cancer diagnosis and occupation in a population sample of Canadians

“…Results we report here for Prostate Cancer closely mirror those of a recent study looking at occupation and title and its links with history of prostate cancer diagnosis by Sritharan et al [29]. Slight differences in the models we report here and Sritharan et al [29] include the narrower age range (our selected age range was 25-64 in keeping with the most accurate working aged population, compared to the 25-74 age range used previously), controlling for income level (proxy for social economic status) and therefore isolating factors that are specific to occupation (omitted in the Sritharan et al investigation), and looking at both 2-digit (broad occupation groups, omitted in the Sritharan et al investigation) and 4 digit occupation groups (surrogate for more homogeneous/specific exposure when we don't have an exposure metric). These differences may account for the slight variations in results between the two analyses.…”

“…Sritharan et al [29] reported an increase risk of history of prostate cancer diagnosis for senior and government management (HR = 1.12, 95% CI: 1.04-1.20), as well as for finance managers and financial services (HR = 1.09, 95% CI: 1.04-1.14) which mirror our results (HRs = 1.12 and 1.10, respectively). Senior and government management jobs are recognized as having few chemical exposures except for printed ink, air and water quality issues from exposure to older building infrastructure.…”

“…lead, cadmium, hexavalent chromium compounds and arsenic, are considered relevant prostate carcinogens by Doolan, Benke and Giles with their 2014 review stating, "there is sufficient evidence to implicate toxic metals, polychlorinated biphenyls and polycyclic aromatic hydrocarbons" [27] as well as other authors [21,25,28]. Several studies have also found associations with industries such as forestry, firefighting, police and rubber production, particularly with the last two occupations showing an increased risk of prostate cancer [25,28,29].…”

“…However, smaller, exposure specific studies have implicated a link between certain cancers or occupations [21,25,28,30,[39][40][41]. A recent study by Sritharan et al (2018) found elevated risks of PCa incidence in occupations related to administration and management, agriculture, and protective services and decreased risks in construction and transportation in a population-based sample of Canadian men aged 25-74 years. They also observed an elevated risk of PCa mortality among agriculture management workers.…”

Prostate cancer: an occupational hazard in Romania?

“…The most well-established non-modifiable risk factors are age, family history of prostate cancer, and ethnicity. Prostate cancer is more common in men over the age of 50, but in recent years, it has been diagnosed with increased frequency in younger men and professional active groups [4] leading to more years lived with disability caused by health status impairment. In Romania, the burden of the disease increased over the last ten years.…”