Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan.
Research Support Center, Shizuoka General Hospital, Shizuoka, Japan.
Cancer Sci. 2020 Dec;111(12):4581-4593. doi: 10.1111/cas.14663. Epub 2020 Oct 28.
We aimed to examine whether the number of types of hazardous operations at work experienced through a lifetime is associated with cancer incidence, and additionally examined the combined effects with lifestyle-related factors. Using a nationwide, multicenter, hospital inpatient dataset (2005-2015), we conducted a matched case-control study with 1 149 296 study subjects. We classified the participants into those with none, 1, or 2 or more types of hazardous operation experience, based on information of special medical examinations taken, mandatory in Japan for workers engaged in hazardous operations. Using those with no experience as the reference group, we estimated the odds ratios for cancer incidence (all sites, lung, stomach, colon and rectum, liver, pancreas, bile duct, and bladder) by conditional logistic regression with multiple imputations. We also examined the effects of the combination with hazardous operations and lifestyle-related factors. We observed increased risks for cancer of all sites, and lung, pancreas, and bladder cancer associated with the experience of hazardous operations. Multivariable-adjusted ORs (95% CIs) of cancer incidence of all sites were 1 (reference), 1.16 (1.12, 1.21), and 1.17 (1.08, 1.27) for none, 1, and 2 or more types of hazardous operation experience, respectively (P for trend <.001). Potential combined associations of hazardous operations with smoking were observed for lung, pancreas, and bladder cancer, and with diabetes for pancreas cancer. Engaging in hazardous operations at work and in combination with lifestyle-related factors may increase the risk of cancer. We highlight the potential for those engaged in hazardous work to avoid preventable cancers.
我们旨在研究一生中经历的危险作业类型数量是否与癌症发病率有关，并进一步研究与生活方式相关因素的综合影响。我们使用全国性的多中心医院住院数据集（2005-2015 年），进行了一项匹配病例对照研究，共有 1149296 名研究对象。根据在日本从事危险作业的工人必须进行的特殊体检信息，我们将参与者分为无、1 种或 2 种及以上类型的危险作业经历。以无经历者为参照组，我们通过条件逻辑回归和多重插补估计了癌症发病率（所有部位、肺癌、胃癌、结肠癌和直肠癌、肝癌、胰腺癌、胆管癌和膀胱癌）的比值比。我们还研究了与危险作业和生活方式相关因素相结合的影响。我们观察到与危险作业经历相关的所有部位、肺癌、胰腺癌和膀胱癌的癌症发病风险增加。多变量调整后的所有部位癌症发病比值比（95%CI）分别为 1（参照）、1.16（1.12，1.21）和 1.17（1.08，1.27）（趋势 P<.001）。危险作业与吸烟之间可能存在潜在的联合关联，与肺癌、胰腺癌和膀胱癌有关，与糖尿病有关，与胰腺癌有关。在工作中从事危险作业并与生活方式相关因素相结合可能会增加癌症风险。我们强调了从事危险工作的人避免可预防癌症的潜力。
