世贸中心救援人员中的癌症：多个队列研究的结果及未来研究方向
Cancer in World Trade Center responders: Findings from multiple cohorts and options for future study.
作者信息
Boffetta Paolo, Zeig-Owens Rachel, Wallenstein Sylvan, Li Jiehui, Brackbill Robert, Cone James, Farfel Mark, Holden William, Lucchini Roberto, Webber Mayris P, Prezant David, Stellman Steven D
机构信息
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
New York City Fire Department, New York, New York.
出版信息
Am J Ind Med. 2016 Feb;59(2):96-105. doi: 10.1002/ajim.22555. Epub 2016 Jan 4.
BACKGROUND
Three longitudinal studies of cancer incidence in varied populations of World Trade Center responders have been conducted.
METHODS
We compared the design and results of the three studies.
RESULTS
Separate analyses of these cohorts revealed excess cancer incidence in responders for all cancers combined and for cancers of the thyroid and prostate. Methodological dissimilarities included recruitment strategies, source of cohort members, demographic characteristics, overlap between cohorts, assessment of WTC and other occupational exposures and confounders, methods and duration of follow-up, approaches for statistical analysis, and latency analyses.
CONCLUSIONS
The presence of three cohorts strengthens the effort of identifying and quantifying the cancer risk; the heterogeneity in design might increase sensitivity to the identification of cancers potentially associated with exposure. The presence and magnitude of an increased cancer risk remains to be fully elucidated. Continued long-term follow up with minimal longitudinal dropout is crucial to achieve this goal.
背景
已对世贸中心不同人群的癌症发病率进行了三项纵向研究。
方法
我们比较了这三项研究的设计和结果。
结果
对这些队列的单独分析显示，所有癌症合并以及甲状腺癌和前列腺癌的应答者中癌症发病率过高。方法学差异包括招募策略、队列成员来源、人口统计学特征、队列之间的重叠、世贸中心和其他职业暴露及混杂因素的评估、随访方法和持续时间、统计分析方法以及潜伏期分析。
结论
三个队列的存在加强了识别和量化癌症风险的工作；设计上的异质性可能会提高对识别潜在与暴露相关癌症的敏感性。癌症风险增加的存在和程度仍有待充分阐明。为实现这一目标，持续进行长期随访且纵向失访最少至关重要。
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