Usual adult occupation and risk of Prostate Cancer in West African men: The Ghana Prostate Study Público
Adler, Colin (Spring 2018)
Abstract
Background: Established PCa (PCa) risk factors include age, family history of PCa in a first degree relative, and African ancestry. Some studies have also suggested that employment in certain occupations, including among farmers and men in military, may be associated with higher risk. These studies have been conducted mostly among highly screened, European ancestry-based populations. Here, we evaluated the association between usual adult occupation and PCa risk in a case-control study of Ghanaian men.
Methods: We analyzed data from a case-control study conducted from 2002-2007 in n=749 PCa cases n=964 controls from Ghana. Structured questionnaires were conducted to assess longest job held by participants. Industrial hygienists classified job titles into occupational categories using the 2010 Standard Occupational Classification (SOC) system. Unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between longest held occupation and PCa risk, adjusting for birth year, education, region, medical insurance, and smoking. ORs were calculated for PCa overall and for aggressive PCa, defined as Gleason score ≥7.
Results: PCa risk were higher among those in management occupations (SOC 11-0, overall PCa OR = 2.2, 95% CI: 1.4, 3.2 and aggressive PCa OR = 2.2, 95% CI: 1.3, 3.5) and military specific occupations (SOC 55-0, overall PCa OR = 3.4, 95% CI: 1.7, 7.0 aggressive PCa OR = 3.5, 95% CI: 1.5, 8.3). For both management and military occupations, risks were uniformly elevated for jobs based on 3-digit level SOC definitions including for: chief executives, advertising/marketing, operations managers and other management occupations, military officers/special and tactical operations leaders, and specialists and crew members. Sensitivity analyses taking into account possible access to medical care (possible cancer screening), did not show significant differences.
Conclusions: Our study provides some evidence for an increased risk of PCa among men whose longest held job was in management and military occupations. These findings are consistent with the published literature in European populations. However, more studies are needed to adequately address occupational risk factors, and the specific exposures that may be responsible for the observed increased risk for PCa.
Table of Contents
Tables of Contents
Abstract…………………………………………………………………………………...4
Chapter I: Literature Review ………………………………………………………......9
1.1 Risk Factors ….……………….………………………………………….9
a. Age ………………………………………………………………10
b. Race ……………………………………………………………..11
c. First Degree Family History…………………………………...11
d. Occupation………………………………………………………12
1.2 Occupational Risk and Types …………...……………….................... 12
e. Farming and Agricultural ……………………………………..13
f. Military Specific ………………………………………………..13
g. White-Collar ……………………………………………………14
Chapter II: Manuscript …………………………….………………………………….16
2.1 Introduction …………………………………………………………….16
2.2 Methods …………………………………………………………………17
2.3 Results …………………………………………………………………..19
2.4 Discussion ……………………………………………………………....21
2.5 Tables …………………………………………………………………...25
Chapter III: Summary, Public Health Implications, Possible Future Directions …31
3.1 References ………………………………………………………………34
Appendices………………………………………………………………………………37
4.1 Appendix A ……………………………………………………………..37
4.2 Appendix B ……………………………………………………………..39
4.3 Appendix C ……………………………………………………………..40
4.4 Appendix D ……………………………………………………………..42
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