The role of modifiable risk factors in incident cancer in transport, rescue, and security industries
Menée à partir de données de registres danois portant sur 302 789 personnes ayant travaillé dans les secteurs du transport, du sauvetage et de la sécurité entre 2001 et 2015 (durée moyenne de suivi : 13,4 ans), cette étude analyse la part des cancers attribuable à des facteurs de risque modifiables (22 116 cas)
Purpose: Examine the risk for site-specific incident cancer across representative transport, rescue, and security industries. Methods: We conducted a nationwide study using Danish registers including all 302,789 workers from transport, rescue and security industries from 2001 through 2015 and 2,230,877 individuals aged 18-64 years from a total sample of the economically active population for comparison. Cox models were used to estimate the hazard ratios (HRs) of incident cancers. We categorized site-specific cancers by using population-attributable fraction (PAF) estimates from the previous literature. Results: During an average follow-up of 13.4 years, 22,116 incident cancer cases were recorded in transport, rescue, and security industries. Compared with the reference population, the age-adjusted cancer incidence with a high PAF was higher among men in seafaring (HR 1.28; 95% CI 1.14-1.43), and land transport (HR 1.32; 95% CI: 1.26-1.37), and among women in seafaring (HR 1.26; 95% CI: 1.01-1.57), land transport (HR 1.21; 95% CI: 1.12-1.32), aviation (HR 1.22; 95% CI: 1.05-1.41), and police force (HR 1.21; 95% CI: 1.04-1.40). In general terms, tobacco and physical inactivity were the most significant risk factors of cancer. Conclusions: Regardless of considerable disparities in incident cancer attributable to modifiable risk factors between workers across industries, the total incident cancer rate was elevated in all industries both in men and women. More attention should thus be paid to the management of cancer risk factors related to modifiable health behaviours and work environment, especially in individuals who work in transport industries.