Godono Alessandro, Quattrocolo Andrea, Caradonna Roberta, Picciaiola Maria Vittoria, Boffetta Paolo, Seyyedsalehi Monireh Sadat
Department of Public Health and Pediatrics, University of Torino, Turin, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Am J Ind Med. 2025 Aug;68(8):666-678. doi: 10.1002/ajim.23740. Epub 2025 May 27.
Benzene is an established Group 1 carcinogen due to its leukemogenic properties. Recent studies suggest that occupational benzene exposure may be associated with solid cancers. However, little is known about its association with male genital cancers. We aimed to summarize the scientific evidence on occupational benzene exposure and the risk of male genital cancers.
We searched for relevant articles in three electronic databases. Methodological quality and the certainty of evidence were evaluated using a modified version of the Newcastle-Ottawa Scale (NOS) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment tool. We performed pooled and stratified meta-analyses, as well as meta-regressions to explore potential sources of heterogeneity.
Thirty-one publications were included. Pooled results of incidence and mortality for prostate and testis cancer did not indicate a significant association with occupational benzene exposure. A borderline association was found for the incidence of prostate cancer (standardized incidence ratio (SIR): 1.07, 95% CI 0.97-1.19). Subgroup analyses stratified by study design and study quality revealed significant heterogeneity, with case-control (relative risk (RR): 1.19, 95% CI 1.04-1.36) and high-quality studies (RR: 1.22, 95% CI 1.14-1.31) showing an increased risk. Both NOS and GRADE assessments yielded mostly low to very low-quality results.
This review provides no clear evidence of an association between occupational exposure to benzene and the risk of male genital cancers. Subgroup analysis suggests an increased risk of prostate cancer in high-quality studies. Nevertheless, it is important to acknowledge the methodological limitations of the available studies. Further analyses including methodologically sound studies are needed to corroborate these findings.
苯因其致白血病特性，是已确定的第1类致癌物。近期研究表明，职业性苯暴露可能与实体癌有关。然而，关于其与男性生殖系统癌症的关联知之甚少。我们旨在总结职业性苯暴露与男性生殖系统癌症风险的科学证据。
我们在三个电子数据库中检索相关文章。使用纽卡斯尔-渥太华量表（NOS）的修改版和推荐分级评估、制定与评价（GRADE）评估工具评估方法学质量和证据的确定性。我们进行了汇总和分层荟萃分析，以及荟萃回归以探索异质性的潜在来源。
纳入31篇出版物。前列腺癌和睾丸癌发病率及死亡率的汇总结果未表明与职业性苯暴露有显著关联。前列腺癌发病率存在临界关联（标准化发病率比（SIR）：1.07，95%置信区间0.97 - 1.19）。按研究设计和研究质量分层的亚组分析显示出显著异质性，病例对照研究（相对风险（RR）：1.19，95%置信区间1.04 - 1.36）和高质量研究（RR：1.22，95%置信区间1.14 - 1.31）显示风险增加。NOS和GRADE评估大多得出低至极低质量的结果。
本综述未提供职业性苯暴露与男性生殖系统癌症风险之间存在关联的明确证据。亚组分析表明高质量研究中前列腺癌风险增加。然而，必须承认现有研究的方法学局限性。需要进一步分析，包括方法学合理的研究，以证实这些发现。
