Mueller Alexandra K, Vaeth Brandon, Todd Andrew C, Dasaro Christopher R, Li Jiehui, Qiao Baozhen, Boffetta Paolo, Prezant David J, Hall Charles B, Goldfarb David G, Zeig-Owens Rachel
Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA.
Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.
Sci Rep. 2025 Jan 2;15(1):270. doi: 10.1038/s41598-024-82555-9.
Elevated cancer incidence has been reported among World Trade Center (WTC)-exposed responders, with some incidence rate ratios (IRRs) varying over time. This study describes the influence that different reference populations have on relative cancer incidence and temporal trends. Participants from the WTC Combined Rescue/Recovery Cohort (n = 65,691) were observed between 1/1/2002 and 12/31/2015 using data obtained from 13 state cancer registries. Poisson regression was used to estimate IRRs controlling for age, race/ethnicity, and calendar year. IRRs and change-points were estimated using three reference populations (New York City (NYC), New York State (NYS), and a US population). IRRs for each cancer site varied in magnitude. Prostate and thyroid cancer IRRs were significantly greater in WTC-exposed responders, while colon and lung cancer IRRs were significantly lower compared with NYC, NYS, and US population reference groups. The range of IRRs varied by reference population. Mixed findings were observed for other cancers, as results were dependent on the reference group used. A significant change-point was found only for prostate cancer, and only when compared to a US population. Our findings suggest that reference population selection will influence the IRR, timing, and statistical significance of change-point estimation, varying with follow-up length.
据报道，世界贸易中心（WTC）暴露人群中的癌症发病率有所上升，一些发病率比（IRR）随时间变化。本研究描述了不同参考人群对相对癌症发病率和时间趋势的影响。利用从13个州癌症登记处获得的数据，对世界贸易中心联合救援/恢复队列（n = 65,691）的参与者在2002年1月1日至2015年12月31日期间进行了观察。使用泊松回归来估计控制年龄、种族/民族和日历年的IRR。使用三个参考人群（纽约市（NYC）、纽约州（NYS）和美国人群）估计IRR和变化点。每个癌症部位的IRR在幅度上有所不同。与纽约市、纽约州和美国人群参考组相比，WTC暴露人群中前列腺癌和甲状腺癌的IRR显著更高，而结肠癌和肺癌的IRR显著更低。IRR的范围因参考人群而异。对于其他癌症，观察到混合结果，因为结果取决于所使用的参考组。仅在前列腺癌中发现了一个显著的变化点，并且仅在与美国人群进行比较时发现。我们的研究结果表明，参考人群的选择将影响IRR、变化点估计的时间和统计显著性，且随随访时间长度而变化。
