Weiderpass E, Pukkala E, Vasama-Neuvonen K, Kauppinen T, Vainio H, Paakkulainen H, Boffetta P, Partanen T
Department of Epidemiology and Biostatistics, Finnish Institute of Occupational Health, Helsinki, Finland.
Am J Ind Med. 2001 Jun;39(6):572-80. doi: 10.1002/ajim.1056.
Endometrial cancer incidence rates are low in Asia and Africa and high in North America and Northern Europe. Cervical cancer is often the most common female cancer in developing countries, and infection with human papillomavirus (HPV) is its main risk factor. However, other factors, such as occupational exposures may modify the HPV-related risk. We conducted an exploratory register-linkage study in Finland to assess the role of occupational exposures on incidence rates of cancers of the endometrium and cervix uteri.
Occupational risk factors for endometrial and cervical cancers were explored in a 25-year follow-up of female workers born 1906-1945 (N = 413,877) identified through the Population Census of Finland of 1970. Job titles in census records were converted to exposures of 31 occupational agents through a job-exposure matrix. Poisson regression models estimated relative risks (RR) for each agent, standardized for birth cohort, follow-up period, and socio-economic status. For each agent, the product of level and probability of exposure was calculated and subdivided in three categories: zero, low, and medium/high. Adjustment at the job title level was done for the turnover rate (endometrial and cervical cancers), mean parity, and age at first birth (endometrial cancer).
Endometrial cancer (2,833 cases) was associated with exposure to animal dust (RR 1.2, low level, 174 cases) and sedentary work (RR 1.3, high level, 145 cases). Cervical cancer (1,101 cases) was associated with exposure to aliphatic and alicyclic (RR 1.3, low level, 91 cases), aromatic (RR 1.2, low level, 318 cases; RR 1.4, high level, 41 cases), and chlorinated hydrocarbon solvents (RR 1.3, low level, 50 cases), silica dust (RR 1.2, low level, 251 cases), and wood dust (RR 1.2, low level, 249 cases).
This study suggests that occupational exposures may be associated with increased risk of endometrial and cervical cancers.
子宫内膜癌发病率在亚洲和非洲较低，在北美和北欧较高。宫颈癌在发展中国家通常是最常见的女性癌症，人乳头瘤病毒（HPV）感染是其主要危险因素。然而，其他因素，如职业暴露，可能会改变与HPV相关的风险。我们在芬兰进行了一项探索性的登记关联研究，以评估职业暴露对子宫内膜癌和子宫颈癌发病率的作用。
对1906年至1945年出生的女性工人（N = 413,877）进行了25年的随访，通过芬兰1970年人口普查确定了她们患子宫内膜癌和宫颈癌的职业危险因素。通过工作暴露矩阵将普查记录中的职位名称转换为31种职业因素的暴露情况。泊松回归模型估计了每种因素的相对风险（RR），并根据出生队列、随访期和社会经济地位进行了标准化。对于每种因素，计算暴露水平和暴露概率的乘积，并将其细分为三类：零、低和中/高。在职位级别上对周转率（子宫内膜癌和宫颈癌）、平均产次和初产年龄（子宫内膜癌）进行了调整。
子宫内膜癌（2833例）与接触动物粉尘（RR 1.2，低水平，174例）和久坐工作（RR 1.3，高水平，145例）有关。宫颈癌（1101例）与接触脂肪族和脂环族（RR 1.3，低水平，91例）、芳香族（RR 1.2，低水平，318例；RR 1.4，高水平，41例）以及氯代烃溶剂（RR 1.3，低水平，50例）、矽尘（RR 1.2，低水平，251例）和木尘（RR 1.2，低水平，249例）有关。
本研究表明职业暴露可能与子宫内膜癌和宫颈癌风险增加有关。
