美国国立癌症研究所甲醛工人队列研究中鼻咽癌死亡风险的新见解。
New insights into the mortality risk from nasopharyngeal cancer in the national cancer institute formaldehyde worker cohort study.
作者信息
Möhner Matthias, Liu Yimeng, Marsh Gary M
机构信息
1Federal Institute for Occupational Safety and Health, Berlin, Germany.
2Center for Occupational Biostatistics and Epidemiology and Department of Biostatistics, 7120 Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261 USA.
出版信息
J Occup Med Toxicol. 2019 Feb 20;14:4. doi: 10.1186/s12995-019-0224-2. eCollection 2019.
BACKGROUND
Indications were found that a diagnostic bias could have contributed to the National Cancer Institute's (NCI) suggestion of a persistent increased mortality risk for nasopharyngeal cancer (NPC).
METHODS
NCI provided the cohort data updated through 2004. We computed local county rate-based standardized mortality ratios (SMRs) for NPC and all other entities of the pharynx for two time periods. Moreover, SMRs were calculated for pharyngeal cancer in relation to study site by cumulative exposure to formaldehyde (FA).
RESULTS
Overall, our results corroborate the indications of a diagnostic bias by strong but contrary temporal trends for NPC and pharynx, not specified. Moreover, it was shown that mortality risks were increased in the Wallingford cohort for all pharyngeal cancer combined and for pharyngeal cancer excluding NPC. In contrast, no increased risks for these categories were found in the nine other study sites combined.
CONCLUSIONS
Our re-analysis provided little or no evidence to support NCI's suggestion of a persistent association between FA exposure and mortality from NPC.
背景
有迹象表明，诊断偏差可能导致美国国立癌症研究所（NCI）提出鼻咽癌（NPC）死亡率持续上升的风险。
方法
NCI提供了截至2004年更新的队列数据。我们计算了两个时间段内基于当地县发病率的鼻咽癌及咽部所有其他实体的标准化死亡率（SMR）。此外，根据甲醛（FA）的累积暴露量，计算了与研究地点相关的咽癌SMR。
结果
总体而言，我们的结果通过鼻咽癌和未明确的咽部强烈但相反的时间趋势证实了诊断偏差的迹象。此外，研究表明，沃灵福德队列中所有咽癌合并病例以及排除鼻咽癌的咽癌病例的死亡风险均有所增加。相比之下，在其他九个研究地点的合并病例中未发现这些类别风险增加。
结论
我们的重新分析几乎没有或没有证据支持NCI提出的FA暴露与鼻咽癌死亡率之间存在持续关联的建议。
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