Department of Gastroenterology, Kanto Rosai Hospital, Kawasaki, Japan.
Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Cancer Med. 2019 Oct;8(13):6139-6150. doi: 10.1002/cam4.2499. Epub 2019 Aug 12.
Little is known about the risk of developing various cancers according to occupation and occupational physical activity.
Using nationwide clinical inpatient data (1984-2017) in Japan, we undertook a multicentered, matched case-control study with regard to the risk of developing various cancers according to occupation and using patients admitted with fractures as controls. Using standardized national occupation and industrial classifications, we first identified the longest-held job for each patient. Using sales workers as the reference group, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by conditional logistic regression, adjusted for age, admission period, and the admitting hospital, with smoking, alcohol consumption, and lifestyle diseases as covariates. The risk of high and low occupational physical activity was also estimated.
Across all occupations, a reduced risk for all common cancers among males was observed among those occupations associated with high physical activities, such as agriculture. People in these occupations tended to show a lower risk for most cancers, including, for example, prostate cancer (OR 0.58, 95% CI 0.45-0.75) and lung cancer (OR 0.63, 95% CI 0.51-0.76). For females, the breast cancer risk was low in women engaged in agriculture (OR 0.58, 95% CI 0.45-0.75) and in those occupations with high levels of occupational physical activity (OR 0.58, 95% CI 0.52-0.66).
This study revealed differences in cancer risk among diverse occupations in Japan. Specifically, those occupations associated with high levels of physical activity may be associated with a decreased risk of cancer.
对于职业和职业体力活动与各种癌症发病风险的关系，人们知之甚少。
我们利用日本全国性临床住院数据（1984-2017 年），开展了一项多中心、病例对照研究，根据职业和以骨折住院患者为对照，研究了各种癌症的发病风险。我们首先使用标准化的国家职业和工业分类，确定每位患者的最长工作经历。以销售人员为参照组，通过条件逻辑回归，调整年龄、入院时期和入院医院，以吸烟、饮酒和生活方式疾病为协变量，估计了各职业的比值比（OR）及其 95%置信区间（CI）。还估计了高和低职业体力活动的风险。
在所有职业中，与高体力活动相关的职业（如农业）的男性所有常见癌症的发病风险均降低。从事这些职业的人往往表现出较低的大多数癌症风险，例如前列腺癌（OR 0.58，95%CI 0.45-0.75）和肺癌（OR 0.63，95%CI 0.51-0.76）。对于女性，从事农业（OR 0.58，95%CI 0.45-0.75）和高职业体力活动（OR 0.58，95%CI 0.52-0.66）的女性乳腺癌发病风险较低。
本研究揭示了日本不同职业之间癌症风险的差异。具体而言，与高水平体力活动相关的职业可能与癌症风险降低有关。
