Occupation, industry, and the risk of prostate cancer: a case-control study in Montréal, Canada

Jean-François Sauvé,Marie-Élise Parent,Jérôme Lavoué

doi:10.1186/s12940-016-0185-1

Abstract

BackgroundAge, family history and ancestry are the only recognized risk factors for prostate cancer (PCa) but a role for environmental factors is suspected. Due to the lack of knowledge on the etiological factors for PCa, studies that are both hypothesis-generating and confirmatory are still needed. This study explores relationships between employment, by occupation and industry, and PCa risk.MethodsCases were 1937 men aged ≤75 years with incident PCa diagnosed across Montreal French hospitals in 2005-2009. Controls were 1994 men recruited concurrently from electoral lists of French-speaking Montreal residents, frequency-matched to cases by age. In-person interviews elicited occupational histories. Unconditional logistic regression estimated odds ratios (OR) and 95 % confidence intervals (CI) for the association between employment across 696 occupations and 613 industries and PCa risk, adjusting for potential confounders. Multinomial logistic models assessed risks by PCa grade. Semi-Bayes (SB) adjustment accounted for the large number of associations evaluated.ResultsConsistently positive associations—and generally robust to SB adjustment—were found for occupations in forestry and logging (OR 1.9, 95 % CI: 1.2–3.0), social sciences (OR 1.6, 95 % CI: 1.1–2.2) and for police officers and detectives (OR: 1.8, 95 % CI 1.1–2.9). Occupations where elevated risk of high grade PCa was found included gasoline station attendants (OR 4.3, 95 % CI 1.8–10.4) and textile processing occupations (OR 1.8, 95 % CI 1.1–3.2). Aside from logging, industries with elevated PCa risk included provincial government and financial institutions. Occupations with reduced risk included farmers (OR 0.6, 95 % CI 0.4–1.0) and aircraft maintenance workers (OR 0.1, 95 % CI 0.0–0.7).ConclusionsExcess PCa risks were observed across several occupations, including predominantly white collar workers. Further analyses will focus on specific occupational exposures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-016-0185-1) contains supplementary material, which is available to authorized users.

Highlights

Age, family history and ancestry are the only recognized risk factors for prostate cancer (PCa) but a role for environmental factors is suspected
524 were classified as having high grade PCa, 1405 low grade and 8 had insufficient information to be classified in either category
The proportion of controls screened at least once by prostatic specific antigen (PSA) and/or digital rectal examination (DRE) in the 2 years preceding the date of interview was relatively high at 76 %

Summary

Introduction

Family history and ancestry are the only recognized risk factors for prostate cancer (PCa) but a role for environmental factors is suspected. Due to the lack of knowledge on the etiological factors for PCa, studies that are both hypothesis-generating and confirmatory are still needed. This study explores relationships between employment, by occupation and industry, and PCa risk. Recognized risk factors for PCa are limited to age, first-degree family. Sauvé et al Environmental Health (2016) 15:100 among farmers have been documented since the 1980s Studies such as the Agricultural Health Study (AHS) in the United States have provided some clues as to agents that might be implicated, mainly organochlorines and organophosphates. Preliminary results from an American case-control study [18] found relationships between employment in truck driving or gardening occupations and aggressive PCa relative to lower PCa grade. Associations between aggressive PCa and selected organochlorine and organophosphate pesticides were found in the AHS [19] which, in the case of Diazinon, was not apparent when looking at total PCa [20]

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