Sormunen Jorma, Talibov Madar, Sparén Pär, Martinsen Jan Ivar, Weiderpass Elisabete, Pukkala Eero
Faculty of Social Sciences, University of Tampere, Tampere, Finland.
Tampere University Hospital, Department of Oncology, Tampere, Finland. Email:
Asian Pac J Cancer Prev. 2018 Aug 24;19(8):2331-2335. doi: 10.22034/APJCP.2018.19.8.2331.
The evidence that prostate cancer is associated to physical inactivity is inconsistent. We studied the association of perceived physical workload (PPWL) at work and incidence of prostate cancer in a case-control setting. We used data from the Nordic Occupational Cancer study from Finland and Sweden. Five population controls were selected for each prostate cancer patient, matched on age and country. We had 239,835 cases and 1,199,175 controls in our study. For each case and control we estimated cumulative PPWL based on probability, level and duration of PPWL using the NOCCA Job Exposure Matrix. We then stratified individuals as having no exposure (reference category), low physical activity (below 50th percentile of the exposed), moderate exposure (50th-90th percentile) and high exposure (90th percentile and higher). The hazard ratios for prostate cancer from the lowest to highest cumulative PPWL levels were 0.90 (95% confidence interval 0.89-0.91), 0.88 (0.87-0.89) and 0.93 (0.92-0.95). There was no statistically significant dose response effect of PPWL on prostate cancer incidence. Inclusion of socioeconomic status in the model did not substantially change the result. The results were similar before Prostate Specific Antigen (PSA) testing and during the years of PSA testing in these countries. In summary, individuals with physical strain at work had a lower risk of invasive prostate cancer as compared to individuals without physical strain at work.
前列腺癌与身体活动不足相关的证据并不一致。我们在病例对照研究中探讨了工作中感知到的身体工作量(PPWL)与前列腺癌发病率之间的关联。我们使用了来自芬兰和瑞典的北欧职业癌症研究数据。为每位前列腺癌患者选取了5名人群对照,按照年龄和国家进行匹配。我们的研究中有239,835例病例和1,199,175名对照。对于每例病例和对照,我们使用NOCCA工作暴露矩阵,根据PPWL的概率、水平和持续时间来估算累积PPWL。然后,我们将个体分为无暴露(参照类别)、低身体活动(暴露人群中低于第50百分位数)、中度暴露(第50 - 90百分位数)和高暴露(第90百分位数及以上)。从最低到最高累积PPWL水平,前列腺癌的风险比分别为0.90(95%置信区间0.89 - 0.91)、0.88(0.87 - 0.89)和0.93(0.92 - 0.95)。PPWL对前列腺癌发病率没有统计学上显著的剂量反应效应。在模型中纳入社会经济地位并没有实质性改变结果。在这些国家,前列腺特异性抗原(PSA)检测之前和PSA检测期间的结果相似。总之,与工作中无身体劳损的个体相比,工作中有身体劳损的个体患浸润性前列腺癌的风险较低。