Occupational Risks of Esophageal Cancer in Taiwanese Men

Abstract

ISEE-0358 Background: In Taiwan, esophageal cancer was the sixth leading cause of cancer death among men in 2006. Previous studies from our group have found several lifestyle risk factors for esophageal cancer; however, we have not studied extensively the possible associations between occupation and risk for this disease. Purpose: The aim of this study was to explore the relationships between occupation and esophageal squamous cell carcinoma in Taiwan. Methods: In a hospital-based case-control study, we administered interview questionnaires to 326 patients with esophageal squamous cell carcinoma and 386 matched controls. All subjects completed a questionnaire regarding occupation, substance use (smoking, alcohol drinking, and areca chewing) and demographic information. Relative risks for this disease were estimated by odds ratios (OR) with 95% confidence intervals (CI), based on conditional logistic regression, adjusting for potential confounders. Results: We found concrete and construction workers and farm and garden workers to be at significant risk for esophageal squamous cell carcinoma (OR 5.143, 95% CI 2.34–11.33, P < 0.0001 and OR 2.86, 95% CI 1.67 to 4.90, P < 0.0001, respectively). After adjusting for substance use, this association remained significant for farm and garden workers (AOR 2.22, 95% CI 1.08–4.54), but not for concrete and construction workers (AOR 2.14, 95% CI 0.78–5.80). The results of our linear trend analysis showed a significant relationship between esophageal cancer and how long one worked in farming and gardening as well as concrete and construction work (OR = 1.03, 95%CI 1.02–1.05, P = 0.0003; OR = 1.09, 95%CI 1.04–1.14, P = 0.0004, respectively). Conclusions: We conclude that farmers and gardeners may be at greater risk of esophageal squamous cell carcinoma that those working in other occupations in Taiwan. Over time, however, the risk of developing this disease increased for this occupation as well as for those working in concrete and construction.