Usual adult occupation and risk of prostate cancer in West African men: the Ghana Prostate Study

Abstract

ObjectivesEstablished prostate cancer (PCa) risk factors include age, family history of PCa and African ancestry. Studies, mostly among highly screened, predominantly European ancestral populations, suggest that employment in certain occupations (eg, farming, military) may also have an increased risk for PCa. Here, we evaluated the association between usual adult occupation and PCa risk in Ghanaian men, a population with historically low rates of PCa screening.MethodsThe Ghana Prostate Study is a case-control study of PCa that was conducted from 2004 to 2012 in 749 cases and 964 controls. In-person interviews were conducted to collect information from participants, including longest held job. Industrial hygienists classified job titles into occupational categories. Unconditional logistic regression was used to calculate ORs and 95% CIs for the association between longest held job and PCa risk (overall, aggressive (Gleason≥7)), controlling for potential confounders.ResultsRisk was increased among men in management (overall PCa OR=2.2, 95% CI 1.4 to 3.2; aggressive PCa OR=2.2, 95% CI 1.3 to 3.5) and military occupations (overall PCa OR=3.4, 95% CI 1.7 to 7.0; aggressive PCa OR=3.5, 95% CI 1.5 to 8.3). Risks were also elevated for management and military-specific jobs based on 3-digit level Standard Occupational Classification definitions. Sensitivity analyses accounting for access to medical care did not show significant differences.ConclusionsOur study provides some evidence for increased risk of PCa among men in management and military occupations, which is consistent with the published literature. Additional research is needed to clarify the drivers of the associations between these occupations and PCa.

Putative Risk Factors of Prostate Cancer in Unscreened Ghanaian Men

“…Men within the informal working group were more in the study than men with the formal occupation. The nding contradicts the study of the Ghana prostate study, which found a high association of prostate cancer amongst men in formal occupation [48]. The study agrees to studies that have associated informal work such as farming, construction as posing a high risk to prostate cancer [49,50].…”

Prostate cancer: an occupational hazard in Romania?

“…Other case-control study [27] reported significant negative association between cancer of the prostate and employment in the construction industry (OR = 0.76, 95% CI = 0.65-0.89). Similar, a recent casecontrol study conducted on a low screened population found a similar lower risk of prostate cancer in construction trades [16]. Several factors could explain these observations.…”

“…However, our study was designed for hospitalized subjects with equal access to hospital facilities suggesting that medical care is less probable to alter the relationship observed. There is also other data indicating that enhanced access to health may not drive the observed risk [16].…”

“…These studies have mostly been conducted in Western Europe and North America, in countries with high prevalence of PSA screening, resulting in detection biases and also greater proportion of indolent cases with benign prognosis [16]. Screening in Romania is not a usual practice and published data are scarce.…”

Occupation as a predictor of prostate cancer screening behaviour in Canada

“…5 Several studies have documented elevated risks in occupational groups such as firefighters, farmers, white collar, and military workers. [6][7][8][9][10] Additionally, specific occupational agents have been identified, including toxic metals, polychlorinated biphenyls, and polycyclic aromatic hydrocarbons, that may increase prostate cancer risk. 11 Methodological issues have hampered progress in understanding the potential occupational causes of prostate cancer, including the inability to account for the role of screening in observed associations.…”