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Occupation and risk of esophageal and gastric cardia adenocarcinoma
Author(s) -
Engel Lawrence S.,
Vaughan Thomas L.,
Gammon Marilie D.,
Chow WongHo,
Risch Harvey A.,
Dubrow Robert,
Mayne Susan T.,
Rotterdam Heidrun,
Schoenberg Janet B.,
Stanford Janet L.,
West A. Brian,
Blot William J.,
Fraumeni Joseph F.
Publication year - 2002
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.10077
Subject(s) - medicine , adenocarcinoma , odds ratio , incidence (geometry) , population , confidence interval , esophagus , logistic regression , cancer , demography , surgery , environmental health , physics , sociology , optics
Background Adenocarcinomas of the esophagus and gastric cardia have risen dramatically in incidence over the past few decades, however, little research has been conducted on the occupational risk factors for these cancers. Methods In this population‐based case‐control study, lifetime job histories were compared between cases of esophageal adenocarcinoma (n = 283), gastric cardia adenocarcinoma (n = 259), and population controls (n = 689). Odds ratios (OR) and 95% confidence intervals (CI) for ever employment and by duration in various occupational and industrial categories were calculated using unconditional logistic regression. Results The risk of esophageal adenocarcinoma was elevated for persons ever employed in administrative support (OR = 1.5; 95%CI = 1.0–2.1); financial, insurance, and real estate (OR = 1.6; 95%CI = 1.0–2.4); and health services (OR = 2.2; 95%CI = 1.2–3.9). The risk of gastric cardia adenocarcinoma was increased among transportation workers (OR = 1.7; 95%CI = 1.1–2.6), as well as among carpenters (OR = 1.8; 95%CI = 0.9–3.9) and workers in the furniture manufacturing industry (OR = 2.4; 95%CI = 0.9–6.3). However, we observed few duration–response relations between length of employment in any category and cancer risk. Conclusions This study revealed associations of esophageal adenocarcinoma with employment in administrative support, health services, and a category of financial, insurance, and real estate industries, and of gastric cardia adenocarcinoma with transportation and certain woodworking occupations. Some of these findings may be due to the play of chance associated with the multiple comparisons made in this study. Our results suggest that, overall, workplace exposures play a minor role in the etiology and upward trend of esophageal and gastric cardia adenocarcinomas. Am. J. Ind. Med. 42:11–22, 2002. Published 2002 Wiley‐Liss, Inc.