Occupational cancer in Britain

PubMed Central

Van Tongeren, Martie; Jimenez, Araceli S; Hutchings, Sally J; MacCalman, Laura; Rushton, Lesley; Cherrie, John W

2012-01-01

To estimate the current occupational cancer burden due to past exposures in Britain, estimates of the number of exposed workers at different levels are required, as well as risk estimates of cancer due to the exposures. This paper describes the methods and results for estimating the historical exposures. All occupational carcinogens or exposure circumstances classified by the International Agency for Research on Cancer as definite or probable human carcinogens and potentially to be found in British workplaces over the past 20–40 years were included in this study. Estimates of the number of people exposed by industrial sector were based predominantly on two sources of data, the CARcinogen EXposure (CAREX) database and the UK Labour Force Survey. Where possible, multiple and overlapping exposures were taken into account. Dose–response risk estimates were generally not available in the epidemiological literature for the cancer–exposure pairs in this study, and none of the sources available for obtaining the numbers exposed provided data by different levels of exposure. Industrial sectors were therefore assigned using expert judgement to ‘higher'- and ‘lower'-exposure groups based on the similarity of exposure to the population in the key epidemiological studies from which risk estimates had been selected. Estimates of historical exposure prevalence were obtained for 41 carcinogens or occupational circumstances. These include exposures to chemicals and metals, combustion products, other mixtures or groups of chemicals, mineral and biological dusts, physical agents and work patterns, as well as occupations and industries that have been associated with increased risk of cancer, but for which the causative agents are unknown. There were more than half a million workers exposed to each of six carcinogens (radon, solar radiation, crystalline silica, mineral oils, non-arsenical insecticides and 2,3,7,8-tetrachlorodibenzo-p-dioxin); other agents to which a large

The burden of mortality with costs in productivity loss from occupational cancer in Italy.

PubMed

Binazzi, Alessandra; Scarselli, Alberto; Marinaccio, Alessandro

2013-11-01

The costs of productivity loss due to occupational cancer mortality are rarely investigated. An estimate of occupational cancer deaths in Italy in 2006 and an approximation of the resultant costs from medical and non-medical expenditures together with figures of remuneration lost are provided. Occupational cancer deaths, obtained from the application of the attributable fraction (AF) to mortality data (source: Italian National Institute of Statistics), were used to calculate the Potential Years of Life Lost (PYLLs), the Potential Years of Working Life Lost (PYWLLs) and the costs of the loss of productive life. The health care costs for any cancer was applied to the estimated number of occupational cancer cases to obtain the total cost. Around 8,000-8,500 deaths/year from occupational cancer are estimated to occur in Italy, corresponding to 170,000 PYLLs and more than 16,000 PYWLLs, leading to around 360,000,000 euros in indirect economic loss. Health care costs of occupational cancer are estimated at 456,000,000 euros. Occupational cancer is of major concern in terms of mortality and economic productivity loss. Preventive efforts in evaluating ongoing risks and current exposures are strongly recommended to health policy-makers. Copyright © 2013 Wiley Periodicals, Inc.

The burden of occupationally-related cutaneous malignant melanoma in Britain due to solar radiation.

PubMed

Rushton, Lesley; J Hutchings, Sally

2017-02-14

Increasing evidence highlights the association of occupational exposure and cutaneous malignant melanoma (CMM). We estimated the burden of CMM and total skin cancer burden in Britain due to occupational solar radiation exposure. Attributable fractions (AF) and numbers were estimated for CMM mortality and incidence using risk estimates from the published literature and national data sources for proportions exposed. We extended existing methods to account for the exposed population age structure. The estimated total AF for CMM is 2.0% (95% CI: 1.4-2.7%), giving 48 (95% CI: 33-64) deaths in (2012) and 241 (95% CI: 168-325) registrations (in 2011) attributable to occupational exposure to solar radiation. Higher exposure and larger numbers exposed led to much higher numbers for men than women. Industries of concern are construction, agriculture, public administration and defence, and land transport. These results emphasise the urgent need to develop appropriate strategies to reduce this burden.

The future excess fraction of occupational cancer among those exposed to carcinogens at work in Australia in 2012.

PubMed

Carey, Renee N; Hutchings, Sally J; Rushton, Lesley; Driscoll, Timothy R; Reid, Alison; Glass, Deborah C; Darcey, Ellie; Si, Si; Peters, Susan; Benke, Geza; Fritschi, Lin

2017-04-01

Studies in other countries have generally found approximately 4% of current cancers to be attributable to past occupational exposures. This study aimed to estimate the future burden of cancer resulting from current occupational exposures in Australia. The future excess fraction method was used to estimate the future burden of occupational cancer (2012-2094) among the proportion of the Australian working population who were exposed to occupational carcinogens in 2012. Calculations were conducted for 19 cancer types and 53 cancer-exposure pairings, assuming historical trends and current patterns continued to 2094. The cohort of 14.6 million Australians of working age in 2012 will develop an estimated 4.8 million cancers during their lifetime, of which 68,500 (1.4%) are attributable to occupational exposure in those exposed in 2012. The majority of these will be lung cancers (n=26,000), leukaemias (n=8000), and malignant mesotheliomas (n=7500). A significant proportion of future cancers will result from occupational exposures. This estimate is lower than previous estimates in the literature; however, our estimate is not directly comparable to past estimates of the occupational cancer burden because they describe different quantities - future cancers in currently exposed versus current cancers due to past exposures. The results of this study allow us to determine which current occupational exposures are most important, and where to target exposure prevention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Trends in compensation for deaths from occupational cancer in Canada: a descriptive study

PubMed Central

Del Bianco, Ann

2013-01-01

Background Occupational cancer is the leading cause of work-related deaths, yet it is often unrecognized and under reported, and associated claims for compensation go unfiled. We sought to examine trends in deaths from occupational cancer, high-risk industries and exposures, and commonly compensated categories of occupational cancers. In addition, we compared deaths from occupational lung cancer for which compensation had been given with total deaths from lung cancer. Methods We used data from the Association of Workers’ Compensation Boards of Canada pertaining to the nature and source of the injury or disease and the industry in which it occurred (by jurisdiction) to describe trends in compensated claims for deaths from occupational cancer in Canada for the period 1997–2010. We used data published by the Canadian Cancer Society in Canadian Cancer Statistics to compare compensated occupational lung cancer deaths with total estimated lung cancer deaths for the period between 2006 and 2010. Results Compensated claims for deaths from occupational cancer have increased in recent years and surpassed those for traumatic injuries and disorders in Canada, particularly in Ontario. Between 1997 and 2010, one-half of all compensated deaths from occupational cancer in Canada were from Ontario. High-risk industries for occupational cancer include manufacturing, construction, mining and, more recently, government services. Deaths from lung cancer and mesothelioma comprise most of the compensated claims for deaths from occupational cancer in Ontario and Canada. These diseases are usually the result of asbestos exposure. The burden of other occupational carcinogens is not reflected in claims data. Interpretation Although the number of accepted claims for deaths from occupational cancers has increased in recent years, these claims likely only represent a fraction of the true burden of this problem. Increased education of patients, workers at high risk of exposure and health

Trends in compensation for deaths from occupational cancer in Canada: a descriptive study.

PubMed

Del Bianco, Ann; Demers, Paul A

2013-09-01

Occupational cancer is the leading cause of work-related deaths, yet it is often unrecognized and under reported, and associated claims for compensation go unfiled. We sought to examine trends in deaths from occupational cancer, high-risk industries and exposures, and commonly compensated categories of occupational cancers. In addition, we compared deaths from occupational lung cancer for which compensation had been given with total deaths from lung cancer. We used data from the Association of Workers' Compensation Boards of Canada pertaining to the nature and source of the injury or disease and the industry in which it occurred (by jurisdiction) to describe trends in compensated claims for deaths from occupational cancer in Canada for the period 1997-2010. We used data published by the Canadian Cancer Society in Canadian Cancer Statistics to compare compensated occupational lung cancer deaths with total estimated lung cancer deaths for the period between 2006 and 2010. Compensated claims for deaths from occupational cancer have increased in recent years and surpassed those for traumatic injuries and disorders in Canada, particularly in Ontario. Between 1997 and 2010, one-half of all compensated deaths from occupational cancer in Canada were from Ontario. High-risk industries for occupational cancer include manufacturing, construction, mining and, more recently, government services. Deaths from lung cancer and mesothelioma comprise most of the compensated claims for deaths from occupational cancer in Ontario and Canada. These diseases are usually the result of asbestos exposure. The burden of other occupational carcinogens is not reflected in claims data. Although the number of accepted claims for deaths from occupational cancers has increased in recent years, these claims likely only represent a fraction of the true burden of this problem. Increased education of patients, workers at high risk of exposure and health care providers is needed to ensure that people

[Psychosocial burdens in teaching proffession--initial results of Questionnaire of Occupational Burdens in Teaching (QOBT)].

PubMed

Pyzalski, Jacek

2008-01-01

This article presents the results obtained using a new tool for measuring psychosocial burdens in teaching profession--the Questionnaire of Occupational Burdens in Teaching (QOBT). In its first theoretical part, some typologies of stressors in teaching, developed in other countries, are presented and the need to construct a new tool in Poland is discussed. In this part, the construction process of the new tool and its three scales comprising: Conflict Situations, Organizational Burdens and Lack of Work Sense are described. The psychometric features of the new questionnaire (e.g., Cronbach a = 0.63-0.84) are also given. The results are based on a large random sample of teachers from the Łódz voivodeship. The results did not show significant differences in the level of occupational burdens between men and women. Generally, neither are seniority and age related to the level of burdens. One exception are Organizational burdens that slightly more affect older teachers. The study also showed the need to incorporate the activities at the organizational level into programs on occupational stress.

Occupational lung cancer in US women, 1984-1998.

PubMed

Robinson, Cynthia F; Sullivan, Patricia A; Li, Jia; Walker, James T

2011-02-01

Lung cancer is the leading cause of cancer death in US women, accounting for 72,130 deaths in 2006. In addition to smoking cessation, further reduction of the burden of lung cancer mortality can be made by preventing exposure to occupational lung carcinogens. Data for occupational exposures and health outcomes of US working women are limited. Population-based mortality data for 4,570,711 women who died between 1984 and 1998 in 27 US States were used to evaluate lung cancer proportionate mortality over time by the usual occupation and industry reported on death certificates. Lung cancer proportionate mortality ratios were adjusted for smoking, using data from the National Health Interview Survey (NHIS) and the American Cancer Society's Cancer Prevention Study II. Analyses revealed that 194,382 white, 18,225 Black and 1,515 Hispanic women died 1984-1998 with lung cancer reported as the underlying cause of death. Following adjustment for smoking, significant excess proportionate lung cancer mortality was observed among US women working in the US manufacturing; transportation; retail trade; agriculture, forestry, and fishing; and nursing/personal care industries. Women employed in precision production, technical, managerial, professional specialty, and administrative occupations experienced some of the highest significantly excess proportionate lung cancer mortality during 1984-1998. The results of our study point to significantly elevated risks for lung cancer after adjustment for smoking among women in several occupations and industries. Because 6-17% of lung cancer in US males is attributable to known exposures to occupational carcinogens, and since synergistic interactions between cigarette smoke and other occupational lung carcinogens have been noted, it is important to continue research into the effects of occupational exposures on working men and women. Copyright © 2010 Wiley-Liss, Inc.

[Occupational burdens in special educators working with intellectually disabled students].

PubMed

Plichta, Piotr

2014-01-01

The article presents the results of psychosocial burdens in special educators (specialists in the field of oligophrenopedagogy) with intellectually disabled students. In theoretical part, specific context of occupational stress in special educators was introduced. Additionally, the need of broader research context regarding occupational stress and the risk of burnout in special educators working with intellectually disabled individuals were included. The results were obtained using Plichta and Pyzalski's Questionnaire of Occupational Burdens in Teaching (QOBT). The presented results are based on a research sample (N = 100) of special educators (female) teaching intellectually disabled students attending special schools in the city of Lódz. The obtained results were compared with the results coming from a large random sample of public school teachers working with non-intellectually disabled children from the Lodi voivodeship (N = 429) and referred to the norms of QOBT. The results show significant percentage of respondents obtaining high level of occupational burdens (conflict situations - 45%, organizational burdens - 31%, lack of work sense - 40%, global score - 40%). Seniority is not related to the level of burdens. Some significant differences concerning the level of occupational burdens between both groups of teachers were found. The study showed e.g. the strong need for supporting special educators in the workplace context and the need of implementing preventive and remedial measures at both individual and organizational levels (especially in terms of improving personal relationships in a workplace). Generally, the results show similarity of the stressors' ranking in special educators and school teachers working with non-intellectually disabled children.

Occupational and environmental exposures and cancers in developing countries.

PubMed

Hashim, Dana; Boffetta, Paolo

2014-01-01

Over the past few decades, there has been a decline in cancers attributable to environmental and occupational carcinogens of asbestos, arsenic, and indoor and outdoor air pollution in high-income countries. For low- to middle-income countries (LMICs), however, these exposures are likely to increase as industrialization expands and populations grow. The aim of this study was to review the evidence on the cancer risks and burdens of selected environmental and occupational exposures in less-developed economies. A causal association has been established between asbestos exposure and mesothelioma and lung cancer. For arsenic exposure, there is strong evidence of bladder, skin, lung, liver, and kidney cancer effects. Women are at the highest risk for lung cancer due to indoor air pollution exposure; however, the carcinogenic effect on the risk for cancer in children has not been studied in these countries. Cancer risks associated with ambient air pollution remain the least studied in LMICs, although reported exposures are higher than World Health Organization, European, and US standards. Although some associations between lung cancer and ambient air pollutants have been reported, studies in LMICs are weak or subject to exposure misclassification. For pulmonary cancers, tobacco smoking and respiratory diseases have a positive synergistic effect on cancer risks. A precise quantification of the burden of human cancer attributable to environmental and occupational exposures in LMICs is uncertain. Although the prevalence of carcinogenic exposures has been reported to be high in many such countries, the effects of the exposures have not been studied due to varying country-specific limitations, some of which include lack of resources and government support. Copyright © 2014 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

A current global view of environmental and occupational cancers.

PubMed

Yang, Mihi

2011-07-01

This review is focused on current information of avoidable environmental pollution and occupational exposure as causes of cancer. Approximately 2% to 8% of all cancers are thought to be due to occupation. In addition, occupational and environmental cancers have their own characteristics, e.g., specific chemicals and cancers, multiple factors, multiple causation and interaction, or latency period. Concerning carcinogens, asbestos/silica/wood dust, soot/polycyclic aromatic hydrocarbons [benzo(a) pyrene], heavy metals (arsenic, chromium, nickel), aromatic amines (4-aminobiphenyl, benzidine), organic solvents (benzene or vinyl chloride), radiation/radon, or indoor pollutants (formaldehyde, tobacco smoking) are mentioned with their specific cancers, e.g., lung, skin, and bladder cancers, mesothelioma or leukemia, and exposure routes, rubber or pigment manufacturing, textile, painting, insulation, mining, and so on. In addition, nanoparticles, electromagnetic waves, and climate changes are suspected as future carcinogenic sources. Moreover, the aspects of environmental and occupational cancers are quite different between developing and developed countries. The recent follow-up of occupational cancers in Nordic countries shows a good example for developed countries. On the other hand, newly industrializing countries face an increased burden of occupational and environmental cancers. Developing countries are particularly suffering from preventable cancers in mining, agriculture, or industries without proper implication of safety regulations. Therefore, industrialized countries are expected to educate and provide support for developing countries. In addition, citizens can encounter new environmental and occupational carcinogen nominators such as nanomaterials, electromagnetic wave, and climate exchanges. As their carcinogenicity or involvement in carcinogenesis is not clearly unknown, proper consideration for them should be taken into account. For these purposes, new

Impact of occupational carcinogens on lung cancer risk in a general population

PubMed Central

De Matteis, Sara; Consonni, Dario; Lubin, Jay H; Tucker, Margaret; Peters, Susan; Vermeulen, Roel CH; Kromhout, Hans; Bertazzi, Pier Alberto; Caporaso, Neil E; Pesatori, Angela C; Wacholder, Sholom; Landi, Maria Teresa

2012-01-01

Background Exposure to occupational carcinogens is an important preventable cause of lung cancer. Most of the previous studies were in highly exposed industrial cohorts. Our aim was to quantify lung cancer burden attributable to occupational carcinogens in a general population. Methods We applied a new job–exposure matrix (JEM) to translate lifetime work histories, collected by personal interview and coded into standard job titles, into never, low and high exposure levels for six known/suspected occupational lung carcinogens in the Environment and Genetics in Lung cancer Etiology (EAGLE) population-based case–control study, conducted in Lombardy region, Italy, in 2002–05. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in men (1537 cases and 1617 controls), by logistic regression adjusted for potential confounders, including smoking and co-exposure to JEM carcinogens. The population attributable fraction (PAF) was estimated as impact measure. Results Men showed an increased lung cancer risk even at low exposure to asbestos (OR: 1.76; 95% CI: 1.42–2.18), crystalline silica (OR: 1.31; 95% CI: 1.00–1.71) and nickel–chromium (OR: 1.18; 95% CI: 0.90–1.53); risk increased with exposure level. For polycyclic aromatic hydrocarbons, an increased risk (OR: 1.64; 95% CI: 0.99–2.70) was found only for high exposures. The PAFs for any exposure to asbestos, silica and nickel–chromium were 18.1, 5.7 and 7.0%, respectively, equivalent to an overall PAF of 22.5% (95% CI: 14.1–30.0). This corresponds to about 1016 (95% CI: 637–1355) male lung cancer cases/year in Lombardy. Conclusions These findings support the substantial role of selected occupational carcinogens on lung cancer burden, even at low exposures, in a general population. PMID:22467291

Impact of occupational carcinogens on lung cancer risk in a general population.

PubMed

De Matteis, Sara; Consonni, Dario; Lubin, Jay H; Tucker, Margaret; Peters, Susan; Vermeulen, Roel Ch; Kromhout, Hans; Bertazzi, Pier Alberto; Caporaso, Neil E; Pesatori, Angela C; Wacholder, Sholom; Landi, Maria Teresa

2012-06-01

Exposure to occupational carcinogens is an important preventable cause of lung cancer. Most of the previous studies were in highly exposed industrial cohorts. Our aim was to quantify lung cancer burden attributable to occupational carcinogens in a general population. We applied a new job-exposure matrix (JEM) to translate lifetime work histories, collected by personal interview and coded into standard job titles, into never, low and high exposure levels for six known/suspected occupational lung carcinogens in the Environment and Genetics in Lung cancer Etiology (EAGLE) population-based case-control study, conducted in Lombardy region, Italy, in 2002-05. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in men (1537 cases and 1617 controls), by logistic regression adjusted for potential confounders, including smoking and co-exposure to JEM carcinogens. The population attributable fraction (PAF) was estimated as impact measure. Men showed an increased lung cancer risk even at low exposure to asbestos (OR: 1.76; 95% CI: 1.42-2.18), crystalline silica (OR: 1.31; 95% CI: 1.00-1.71) and nickel-chromium (OR: 1.18; 95% CI: 0.90-1.53); risk increased with exposure level. For polycyclic aromatic hydrocarbons, an increased risk (OR: 1.64; 95% CI: 0.99-2.70) was found only for high exposures. The PAFs for any exposure to asbestos, silica and nickel-chromium were 18.1, 5.7 and 7.0%, respectively, equivalent to an overall PAF of 22.5% (95% CI: 14.1-30.0). This corresponds to about 1016 (95% CI: 637-1355) male lung cancer cases/year in Lombardy. These findings support the substantial role of selected occupational carcinogens on lung cancer burden, even at low exposures, in a general population.

[Analysis of occupational chronic n-hexane poisoning economic burden].

PubMed

Yu, Xintian; Qiu, Xingyuan; Bian, Huanfeng; Zhang, Suli; Zhu, Zhiliang; Wu, Junhua

2014-07-01

To study the economic burden caused by occupational chronic n-hexane poisoning. Information about the cost of treatment, compensation, board, wage, diagnosis, escorts, transportation and the days off work were collected in a 34 cases of occupational chronic n-hexane poisoning accident to estimate the economic burden. There were 4 mild, 19 moderate, 11 severe in the 34 cases and the total cost was 6 084 809 yuan. The hospitalization days was respectively (204.0 ± 3.7) d, (226.6 ± 78.3) d and (417.6 ± 94.1) d, averaging (285.8 ± 96.3) d. The treatment cost was respectively 62 525.8, 69 409.7 and 128 155.6 yuan. The compensation was respectively 20 000.0, 20 052.6 and 30 290.9 yuan. The wage was respectively 23 460.0, 26 062.6 and 47 644.0 yuan. The board was respectively 17 566.5, 19 499.8 and 36 230.1 yuan. The days of work was respectively (176.8 ± 3.2) d, (196.4 ± 67.9) d and (361.4 ± 81.6) d, averaging (247.7 ± 83.5). The lost productivity was respectively 1 809 724.8, 2 010 350.4 and 3 699 290.4 yuan. The economic burden of occupational chronic n-hexane poisoning was so heavy that prevention measures should be strengthened.

Occupation and thyroid cancer.

PubMed

Aschebrook-Kilfoy, Briseis; Ward, Mary H; Della Valle, Curt T; Friesen, Melissa C

2014-05-01

Numerous occupational and environmental exposures have been shown to disrupt thyroid hormones, but much less is known about their relationships with thyroid cancer. Here we review the epidemiology studies of occupations and occupational exposures and thyroid cancer incidence to provide insight into preventable risk factors for thyroid cancer. The published literature was searched using the Web of Knowledge database for all articles through August 2013 that had in their text 'occupation' 'job' 'employment' or 'work' and 'thyroid cancer'. After excluding 10 mortality studies and 4 studies with less than 5 exposed incident cases, we summarised the findings of 30 articles that examined thyroid cancer incidence in relation to occupations or occupational exposure. The studies were grouped by exposure/occupation category, study design and exposure assessment approach. Where available, gender-stratified results are reported. The most studied (19 of 30 studies) and the most consistent associations were observed for radiation-exposed workers and healthcare occupations. Suggestive, but inconsistent, associations were observed in studies of pesticide-exposed workers and agricultural occupations. Findings for other exposures and occupation groups were largely null. The majority of studies had few exposed cases and assessed exposure based on occupation or industry category, self-report, or generic (population-based) job exposure matrices. The suggestive, but inconsistent findings for many of the occupational exposures reviewed here indicate that more studies with larger numbers of cases and better exposure assessment are necessary, particularly for exposures known to disrupt thyroid homeostasis.

Occupational Respiratory Cancer in Korea

PubMed Central

Kim, Hyoung Ryoul

2010-01-01

Malignant mesothelioma and lung cancer are representative examples of occupational cancer. Lung cancer is the leading cause of cancer death, and the incidence of malignant mesothelioma is expected to increase sharply in the near future. Although information about lung carcinogen exposure is limited, it is estimated that the number of workers exposed to carcinogens has declined. The first official case of occupational cancer was malignant mesothelioma caused by asbestos exposure in the asbestos textile industry in 1992. Since then, compensation for occupational respiratory cancer has increased. The majority of compensated lung cancer was due to underlying pneumoconiosis. Other main causative agents of occupational lung cancer included asbestos, hexavalent chromium, and crystalline silica. Related jobs included welders, foundry workers, platers, plumbers, and vehicle maintenance workers. Compensated malignant mesotheliomas were associated with asbestos exposure. Epidemiologic studies conducted in Korea have indicated an elevated risk of lung cancer in pneumoconiosis patients, foundry workers, and asbestos textile workers. Occupational respiratory cancer has increased during the last 10 to 20 yr though carcinogen-exposed population has declined in the same period. More efforts to advance the systems for the investigation, prevention and management of occupational respiratory cancer are needed. PMID:21258597

Occupation and lung cancer mortality in a nationally representative U.S. Cohort: The National Health Interview Survey (NHIS).

PubMed

Lee, David J; Fleming, Lora E; Leblanc, William G; Arheart, Kristopher L; Chung-Bridges, Katherine; Christ, Sharon L; Caban, Alberto J; Pitman, Terry

2006-08-01

The objective of this study was to assess the risk of lung cancer mortality in a nationally representative sample of U.S. workers by occupation. National Death Index linkage identified 1812 lung cancer deaths among 143,863 workers who participated in the 1987, 1988, and 1990-1994 National Health Interview Surveys. Current and former smoking status was predictive of lung cancer mortality (hazard ratio [HR] = 15.1 and 3.8, respectively). Occupations with significantly higher risk for age- and smoking-adjusted lung cancer mortality included heating/air/refrigeration mechanics (HR = 3.0); not specified mechanics and repairers (HR = 2.8); financial records processing occupations (HR = 1.8); freight, stock, and materials handlers (HR = 1.5); and precision production occupations (HR = 1.4). Although tobacco use continues to be the single most important risk factor for lung cancer mortality, occupational exposure to lung carcinogens should be targeted as well to further reduce the burden of lung cancer.

Economic Burden of Colorectal Cancer in Korea

PubMed Central

Byun, Ju-Young; Oh, In-Hwan; Kim, Young Ae; Seo, Hye-Young; Lee, Yo-Han

2014-01-01

Objectives The incidence and survival rate of colorectal cancer in Korea are increasing because of improved screening, treatment technologies, and lifestyle changes. In this aging population, increases in economic cost result. This study was conducted to estimate the economic burden of colorectal cancer utilizing claims data from the Health Insurance Review and Assessment Service. Methods Economic burdens of colorectal cancer were estimated using prevalence data and patients were defined as those who received ambulatory treatment from medical institutions or who had been hospitalized due to colorectal cancer under the International Classification of Disease 10th revision codes from C18-C21. The economic burdens of colorectal cancer were calculated as direct costs and indirect costs. Results The prevalence rate (per 100 000 people) of those who were treated for colorectal cancer during 2010 was 165.48. The economic burdens of colorectal cancer in 2010 were 3 trillion and 100 billion Korean won (KRW), respectively. Direct costs included 1 trillion and 960 billion KRW (62.85%), respectively and indirect costs were 1 trillion and 160 billion (37.15%), respectively. Conclusions Colorectal cancer has a large economic burden. Efforts should be made to reduce the economic burden of the disease through primary and secondary prevention. PMID:24744825

Occupation and Thyroid Cancer

PubMed Central

Aschebrook-Kilfoy, Briseis; Ward, Mary H.; Valle, Curt T. Della; Friesen, Melissa C.

2014-01-01

Objectives Numerous occupational and environmental exposures have been shown to disrupt thyroid hormones, but much less is known about their relationships with thyroid cancer. Here we review the epidemiology studies of occupations and occupational exposures and thyroid cancer incidence to provide insight into preventable risk factors for thyroid cancer. Methods The published literature was searched using the Web of Knowledge database for all articles through August 2013 that had in their text “occupation” “job” ”employment” or “work” and “thyroid cancer”. After excluding 10 mortality studies and 4 studies with less than 5 exposed incident cases, we summarized the findings of 30 articles that examined thyroid cancer incidence in relation to occupations or occupational exposure. The studies were grouped by exposure/occupation category, study design, and exposure assessment approach. Where available, gender stratified results are reported. Results The most studied (19 of 30 studies) and the most consistent associations were observed for radiation-exposed workers and health care occupations. Suggestive, but inconsistent, associations were observed in studies of pesticide-exposed workers and agricultural occupations. Findings for other exposures and occupation groups were largely null. The majority of studies had few exposed cases and assessed exposure based on occupation or industry category, self-report, or generic (population-based) job exposure matrices. Conclusion The suggestive, but inconsistent findings for many of the occupational exposures reviewed here indicate that more studies with larger numbers of cases and better exposure assessment are necessary, particularly for exposures known to disrupt thyroid homeostasis. PMID:24604144

Occupational cancer in Italy.

PubMed Central

Merler, E; Vineis, P; Alhaique, D; Miligi, L

1999-01-01

This article is a discussion of occupational cancer in Italy. The introduction provides the necessary context of Italian industrialization and occupational health regulation. This is followed by a review of Italian epidemiologic studies of occupational cancer risks considered in terms of relative measures of risk and attributable risk of carcinogenic agents or exposure circumstances. We attempt to establish the number of workers exposed to carcinogens in Italy and the intensity of their exposures. Finally, the Italian system of compensation for occupational cancer is discussed. Several cohort and case-control studies have addressed the issue of occupational risks, mostly among male workers. The results of these studies suggest that the growing incidence of and mortality by mesothelioma is explained by the widespread and intense exposure to asbestos in some Italian industrial settings. A high attributable risk of lung tumors among male populations in industrial areas of northern Italy is explained by occupational exposures. However, insufficient data are available for clear definition of the extent and intensity of occupational exposure to carcinogenic substances. In Italy, we must prioritize and maximize resources in occupational cancer epidemiology and revitalize the role of national institutions. Recent legislation has established new regulations on the handling of carcinogenic substances in industrial settings, a new list of occupational diseases, and a national registry of mesothelioma linked to asbestos exposure. These legislative changes are expected to have positive effects. PMID:10350509

Occupational cancer in Spain.

PubMed Central

González, C A; Agudo, A

1999-01-01

The knowledge of specific problems of occupational cancer in Spain is scarce. The environment of the workplace has improved over the last few years after a long period distinguished by bad working conditions, incomplete legislation, and insufficient safety measures and control. It has been estimated that 3,083,479 workers (25.4% of employees) were exposed to carcinogens. The most common occupational exposures to carcinogenic agents were solar radiation, environmental tobacco smoke, silica, and wood dust. The highest number of employees were exposed to silica crystalline (404,729), diesel engine exhaust (274,321), rubber products (99,804), benzene (89,932), ethylene dibromide (81,336), agents used in furniture and cabinet making (72,068), and formaldehyde (71,189). The percentage of total cancer deaths attributed to occupational exposure was 4% (6% in men, 0.9% in women). Compared with other European countries, the incidence of lung cancer and leukemia in Spain are one of the lowest, but it is rapidly increasing. The incidence of urinary bladder and larynx cancer, on the contrary, are one of the highest. Few studies on occupational cancer have been conducted in Spain. The main problems are the availability of death certificates and the quality of the information on occupation in mortality of statistics. It is necessary to improve methods of assessment of exposures using expert hygienists and biologic markers of exposure and diseases. Reduction of cancer by limiting or avoiding exposure to known occupational carcinogens is still necessary. PMID:10350510

[Skin cancer as occupational disease].

PubMed

Bauer, A

2016-11-01

The incidence of epithelial skin neoplasms, such as squamous cell carcinoma and basal cell carcinoma is significantly increasing worldwide. Leisure time solar UV exposure is causative in the overwhelming majority of cases in the general population; however, occupational exposure is responsible for a certain percentage of cases. Employees with a relevant exposure to polycyclic aromatic hydrocarbons in soot, raw paraffin, coal tar, anthracene, pitch or similar substances, to sunlight in outdoor occupations as well as to arsenic and ionizing radiation have a significantly increased risk to develop occupational skin cancer compared to the general population. In the official occupational disease list in the appendix of the German by-law on occupational diseases, the following occupational diseases concerning skin cancer are listed: BK 5102 "skin cancer and carcinoma in situ caused by soot, raw paraffin, coal tar, anthracene, pitch or similar substances" (e.g. various solid paraffins, asphalt and mazut as well as mineral oils, grease, cylinder and drilling oils), BK 5103 "squamous cell carcinoma or multiple actinic keratosis caused by natural UV radiation", BK 1108 "diseases caused by arsenic and its compounds" and BK 2402 "diseases caused by ionizing radiation". For further occupational exposure to carcinogenic substances and potential occupationally acquired skin tumors, no official lists are currently available. These cancers might be considered under a special opt out paragraph in the German Social Law (§ 9 para 2 SGB VII). Tumors in scars after occupational skin trauma or occupational burns are compensated as consequences of work accidents. The current official list of occupational skin cancers and new developments for expert opinions are described in this article.

Occupational skin cancer: Systematic review.

PubMed

Sena, Jéssica Suellen; Girão, Régio José Santiago; Carvalho, Sionara Melo Figueiredo de; Tavares, Rosielly Melo; Fonseca, Fernando Luiz Affonso; Silva, Patrícia Barros Aquino; Barbosa, Maria Clara Fortes Portela

2016-01-01

To analyze the epidemiological profile, risk factors in the workplace environment and prevention methods for professionals at risk of skin cancer. A systematic review of articles on occupational skin cancer, published in the Lilacs, Scielo, Medline and Cochrane Library from January 1st, 2008, to December 31st, 2013, was performed. The search included the following terms: "neoplasias cutâneas" (DeCS), "exposição ocupacional" (DeCS), "epidemiologia" (DeCS) as well as the keyword "prevenção", and their equivalents in English. After analyzing the titles and summaries of articles, the search strategy resulted in 83 references, of which 22 articles met the eligibility criteria. We found that sun exposure is the main occupational risk factor for skin cancer, causing outdoor workers to be the most vulnerable to developing occupational skin cancer. Professionals with low levels of education and European descent are at increased risk of developing this cancer. Outdoor workers are more vulnerable to developing occupational skin cancer, estimating that professionals with low level of education and European descent are at increased risk of developing this cancer. Therefore, companies need to invest more in the health of workers by providing protective equipment and thus preventing occupational skin cancer.

The burden of cancer at work: estimation as the first step to prevention.

PubMed

Rushton, L; Hutchings, S; Brown, T

2008-12-01

Work-related cancers are largely preventable. The overall aim of this project is to estimate the current burden of cancer in Great Britain attributable to occupational factors, and identify carcinogenic agents, industries and occupations for targeting risk prevention. Attributable fractions and numbers were estimated for mortality and incidence for bladder, lung, non-melanoma skin, and sinonasal cancers, leukaemia and mesothelioma for agents and occupations classified as International Agency for Research on Cancer (IARC) Group 1 and 2A carcinogens with "strong" or "suggestive" evidence for carcinogenicity at the specific cancer site in humans. Risk estimates were obtained from published literature and national data sources used for estimating proportions exposed. In 2004, 78,237 men and 71,666 women died from cancer in Great Britain. Of these, 7317 (4.9%) deaths (men: 6259 (8%); women: 1058 (1.5%)) were estimated to be attributable to work-related carcinogens for the six cancers assessed. Incidence estimates were 13,338 (4.0%) registrations (men: 11,284 (6.7%); women 2054 (1.2%)). Asbestos contributed over half the occupational attributable deaths, followed by silica, diesel engine exhaust, radon, work as a painter, mineral oils in metal workers and in the printing industry, environmental tobacco smoke (non-smokers), work as a welder and dioxins. Occupational exposure to solar radiation, mineral oils and coal tars/pitches contributed 2557, 1867 and 550 skin cancer registrations, respectively. Industries/occupations with large numbers of deaths and/or registrations include construction, metal working, personal and household services, mining (not metals), land transport and services allied to transport, roofing, road repair/construction, printing, farming, the Armed Forces, some other service industry sectors and manufacture of transport equipment, fabricated metal products, machinery, non-ferrous metals and metal products, and chemicals. Estimates for all but

The Dark Side of Workers' Compensation: Burdens and Benefits in Occupational Disease Coverage.

ERIC Educational Resources Information Center

Robblee, Richard

1978-01-01

The imposition of legal proof requirements to detect occupational disease and the burden that this places on compensation claimants and the medical profession are examined, along with various court decisions, present legislation, and revision proposals to improve disease diagnosis and the legal treatment of occupationally disabled workers. (MF)

Tobacco and the Escalating Global Cancer Burden

PubMed Central

Oppeltz, Richard F.; Jatoi, Ismail

2011-01-01

The global burden of cancer is escalating as a result of dramatic increases in the use of tobacco in the developing world. The use of tobacco is linked to the development of a broad variety of cancers, mainly lung cancer, the single most common cancer in the world. Tobacco smoking-attributable deaths extends beyond cancer and include stroke, heart attack and COPD. Widening disparities in cancer-related mortality have shifted towards a more dramatic burden in the developing world. Appropriate interventions must be implemented to reduce tobacco use and prevent global mortality that has escalated to epidemic levels. Tobacco control policies, including public health advertisement campaigns, warning labels, adoption of smoke-free laws, comprehensive bans and tax policies are highly effective measures to control tobacco use. Clinicians and academic institutions have to be actively committed to support tobacco control initiatives. The reduction in cancer related morbidity and mortality should be viewed as a global crisis and definitive results will depend on a multilevel effort to effectively reduce the burden of cancer, particularly in underprivileged regions of the world. PMID:21869888

Managing the changing burden of cancer in Asia.

PubMed

Sankaranarayanan, Rengaswamy; Ramadas, Kunnambath; Qiao, You-lin

2014-01-08

Asia accounts for 60% of the world population and half the global burden of cancer. The incidence of cancer cases is estimated to increase from 6.1 million in 2008 to 10.6 million in 2030, due to ageing and growing populations, lifestyle and socioeconomic changes. Striking variations in ethnicity, sociocultural practices, human development index, habits and dietary patterns are reflected in the burden and pattern of cancer in different regions. The existing and emerging cancer patterns and burden in different regions of Asia call for political recognition of cancer as an important public health problem and for balanced investments in public and professional awareness. Prevention as well as early detection of cancers leads to both better health outcomes and considerable savings in treatment costs. Cancer health services are still evolving, and require substantial investment to ensure equitable access to cancer care for all sections of the population. In this review, we discuss the changing burden of cancer in Asia, along with appropriate management strategies. Strategies should promote healthy ageing via healthy lifestyles, tobacco and alcohol control measures, hepatitis B virus (HBV) and human papillomavirus (HPV) vaccination, cancer screening services, and vertical investments in strengthening cancer healthcare infrastructure to improve equitable access to services.

Managing the changing burden of cancer in Asia

PubMed Central

2014-01-01

Asia accounts for 60% of the world population and half the global burden of cancer. The incidence of cancer cases is estimated to increase from 6.1 million in 2008 to 10.6 million in 2030, due to ageing and growing populations, lifestyle and socioeconomic changes. Striking variations in ethnicity, sociocultural practices, human development index, habits and dietary patterns are reflected in the burden and pattern of cancer in different regions. The existing and emerging cancer patterns and burden in different regions of Asia call for political recognition of cancer as an important public health problem and for balanced investments in public and professional awareness. Prevention as well as early detection of cancers leads to both better health outcomes and considerable savings in treatment costs. Cancer health services are still evolving, and require substantial investment to ensure equitable access to cancer care for all sections of the population. In this review, we discuss the changing burden of cancer in Asia, along with appropriate management strategies. Strategies should promote healthy ageing via healthy lifestyles, tobacco and alcohol control measures, hepatitis B virus (HBV) and human papillomavirus (HPV) vaccination, cancer screening services, and vertical investments in strengthening cancer healthcare infrastructure to improve equitable access to services. PMID:24400922

Occupational therapy use by older adults with cancer.

PubMed

Pergolotti, Mackenzi; Cutchin, Malcolm P; Weinberger, Morris; Meyer, Anne-Marie

2014-01-01

Occupational therapy may significantly improve cancer survivors' ability to participate in activities, thereby improving quality of life. Little is known, however, about the use of occupational therapy services by adults with cancer. The objective of this study was to understand what shapes patterns of occupational therapy use to help improve service delivery. We examined older (age >65 yr) adults diagnosed with breast, prostate, lung, or melanoma (skin) cancer between 2004 and 2007 (N = 27,131) using North Carolina Central Cancer Registry data linked to Medicare billing claims. Survivors who used occupational therapy within 1 yr before their cancer diagnosis were more likely to use occupational therapy after diagnosis but also experienced the highest levels of comorbidities. Survivors with Stage 4 cancers or lung cancer were less likely to use occupational therapy. These findings suggest possible disparities in utilization of occupational therapy by older adults with cancer. Copyright © 2014 by the American Occupational Therapy Association, Inc.

Occupational exposure and risk of breast cancer

PubMed Central

FENGA, CONCETTINA

2016-01-01

Breast cancer is a multifactorial disease and the most commonly diagnosed cancer in women. Traditional risk factors for breast cancer include reproductive status, genetic mutations, family history and lifestyle. However, increasing evidence has identified an association between breast cancer and occupational factors, including environmental stimuli. Epidemiological and experimental studies demonstrated that ionizing and non-ionizing radiation exposure, night-shift work, pesticides, polycyclic aromatic hydrocarbons and metals are defined environmental factors for breast cancer, particularly at young ages. However, the mechanisms by which occupational factors can promote breast cancer initiation and progression remains to be elucidated. Furthermore, the evaluation of occupational factors for breast cancer, particularly in the workplace, also remains to be explained. The present review summarizes the occupational risk factors and the associated mechanisms involved in breast cancer development, in order to highlight new environmental exposures that could be correlated to breast cancer and to provide new insights for breast cancer prevention in the occupational settings. Furthermore, this review suggests that there is a requirement to include, through multidisciplinary approaches, different occupational exposure risks among those associated with breast cancer development. Finally, the design of new epigenetic biomarkers may be useful to identify the workers that are more susceptible to develop breast cancer. PMID:26998264

Occupational sedentariness and breast cancer risk.

PubMed

Johnsson, Anna; Broberg, Per; Johnsson, Anders; Tornberg, Åsa B; Olsson, Håkan

2017-01-01

Epidemiological studies have indicated that physical activity reduces the risk of developing breast cancer. More recently, sedentary behavior has been suggested as a risk factor independent of physical activity level. The purpose of the present study was to investigate occupational sedentariness and breast cancer risk in pre- and postmenopausal women. In a population-based prospective cohort study (n = 29 524), working history was assessed by a questionnaire between 1990 and 1992. Participants were classified as having: (1) sedentary occupations only; (2) mixed occupations or (3) non-sedentary occupations only. The association between occupational sedentariness and breast cancer incidence was analyzed by Cox regression, adjusted for known risk factors and participation in competitive sports. Women with a working history of occupational sedentariness had a significantly increased risk of breast cancer (adjusted HR 1.20; 95% CI 1.05, 1.37) compared with those with mixed or non-sedentary occupations. The association was stronger among women younger than 55 years (adjusted HR 1.54; 95% CI 1.20, 1.96), whereas no association was seen in women 55 years or older. Adjustment for participation in competitive sports did not change the association. We found that occupational sedentariness was associated with increased breast cancer risk, especially in women younger than 55 years. This may be a modifiable risk factor by planning breaks during the working day. Whether this reduces the risk of breast cancer needs to be further studied.

Occupational Therapy Use by Older Adults With Cancer

PubMed Central

Pergolotti, Mackenzi; Cutchin, Malcolm P.; Weinberger, Morris; Meyer, Anne-Marie

2014-01-01

Occupational therapy may significantly improve cancer survivors’ ability to participate in activities, thereby improving quality of life. Little is known, however, about the use of occupational therapy services by adults with cancer. The objective of this study was to understand what shapes patterns of occupational therapy use to help improve service delivery. We examined older (age >65 yr) adults diagnosed with breast, prostate, lung, or melanoma (skin) cancer between 2004 and 2007 (N = 27,131) using North Carolina Central Cancer Registry data linked to Medicare billing claims. Survivors who used occupational therapy within 1 yr before their cancer diagnosis were more likely to use occupational therapy after diagnosis but also experienced the highest levels of comorbidities. Survivors with Stage 4 cancers or lung cancer were less likely to use occupational therapy. These findings suggest possible disparities in utilization of occupational therapy by older adults with cancer. PMID:25184473

Occupation and educational inequalities in laryngeal cancer: the use of a job index

PubMed Central

2013-01-01

Background Previous studies tried to assess the association between socioeconomic status and laryngeal cancer. Alcohol and tobacco consumption explain already a large part of the social inequalities. Occupational exposures might explain a part of the remaining but the components and pathways of the socioeconomic contribution have yet to be fully disentangled. The aim of this study was to evaluate the role of occupation using different occupational indices, differentiating between physical, psycho-social and toxic exposures and trying to summarize the occupational burden into one variable. Methods A population-based case–control study conducted in Germany in 1998–2000 included 208 male cases and 702 controls. Information on occupational history, smoking, alcohol consumption and education was collected with face-to-face interviews. A recently developed job-classification index was used to account for the occupational burden. A sub-index focussed on jobs involving potentially carcinogenic agents (CAI) for the upper aero digestive tract. Results When adjusted for smoking and alcohol consumption, higher odds ratios (ORs) were found for lower education. This OR decreased after further adjustment using the physical and psycho-social job indices (OR = 3.2, 95%-CI: 1.5-6.8), similar to the OR using the sub-index CAI (OR = 3.0, 95%-CI: 1.4-6.5). Conclusions The use of an easily applicable control variable, simply constructed on standard occupational job classifications, provides the possibility to differentiate between educational and occupational contributions. Such an index might indirectly reflect the effect of carcinogenic agents, which are not collected in many studies. PMID:24246148

Curbing the burden of lung cancer.

PubMed

Urman, Alexandra; Hosgood, H Dean

2016-06-01

Lung cancer contributes substantially to the global burden of disease and healthcare costs. New screening modalities using low-dose computerized tomography are promising tools for early detection leading to curative surgery. However, the screening and follow-up diagnostic procedures of these techniques may be costly. Focusing on prevention is an important factor to reduce the burden of screening, treatment, and lung cancer deaths. The International Agency for Research on Cancer has identified several lung carcinogens, which we believe can be considered actionable when developing prevention strategies. To curb the societal burden of lung cancer, healthcare resources need to be focused on early detection and screening and on mitigating exposure(s) of a person to known lung carcinogens, such as active tobacco smoking, household air pollution (HAP), and outdoor air pollution. Evidence has also suggested that these known lung carcinogens may be associated with genetic predispositions, supporting the hypothesis that lung cancers attributed to differing exposures may have developed from unique underlying genetic mechanisms attributed to the exposure of interest. For instance, smokingattributed lung cancer involves novel genetic markers of risk compared with HAP-attributed lung cancer. Therefore, genetic risk markers may be used in risk stratification to identify subpopulations that are at a higher risk for developing lung cancer attributed to a given exposure. Such targeted prevention strategies suggest that precision prevention strategies may be possible in the future; however, much work is needed to determine whether these strategies will be viable.

Burden of cancer in Korea during 2000-2020.

PubMed

Park, Jae-Hyun; Lee, Kwang-Sig; Choi, Kyu-Sik

2013-08-01

This study estimates the burden of cancer in Korea during 2000-2020, ameliorating the Global Burden of Disease Study Group (GBD) method with the Incidence-Prevalence-Mortality (IPM) Model. Besides using the GBD approach to calculate the Years of Life Lost in Korea during 2000-2020, this research calculates the Years Lived with Disability (YLDs) of major cancers based on the combination of the GBD method and the IPM Model. Colon, breast and thyroid cancers became more significant in terms of Disability Adjusted Life Years during 2000-2010 and this will continue during 2010-2020, colon cancer leading the pack instead of stomach cancer in 2020. The rise of colon cancer is more evident for the older age group and the opposite is true for breast and thyroid cancers. Indeed, stomach and liver cancers were resilient in terms of DALYs during 2000-2010 and this will continue during 2010-2020. Overall, the burden of cancer in Korea is characterized by an increasing centrality of YLDs (chronic components) as in other advanced nations. Korea's convergence with other advanced nations in cancer burden might reflect their convergence in living standards, the age structure, health behavior and medical technology during the past four decades. These transitions have been reflected in the Second 10-Year Plan for Cancer Control in Korea during 2006-2015, government policy consisting of four main programs, i.e., primary prevention, early detection, diagnosis/treatment and palliative care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Economic Burden for Lung Cancer Survivors in Urban China.

PubMed

Zhang, Xin; Liu, Shuai; Liu, Yang; Du, Jian; Fu, Wenqi; Zhao, Xiaowen; Huang, Weidong; Zhao, Xianming; Liu, Guoxiang; Mao, Zhengzhong; Hu, Teh-Wei

2017-03-15

With the rapid increase in the incidence and mortality of lung cancer, a growing number of lung cancer patients and their families are faced with a tremendous economic burden because of the high cost of treatment in China. This study was conducted to estimate the economic burden and patient responsibility of lung cancer patients and the impact of this burden on family income. This study uses data from a retrospective questionnaire survey conducted in 10 communities in urban China and includes 195 surviving lung cancer patients diagnosed over the previous five years. The calculation of direct economic burden included both direct medical and direct nonmedical costs. Indirect costs were calculated using the human capital approach, which measures the productivity lost for both patients and family caregivers. The price index was applied for the cost calculation. The average economic burden from lung cancer was $43,336 per patient, of which the direct cost per capita was $42,540 (98.16%) and the indirect cost per capita was $795 (1.84%). Of the total direct medical costs, 35.66% was paid by the insurer and 9.84% was not covered by insurance. The economic burden for diagnosed lung cancer patients in the first year following diagnosis was $30,277 per capita, which accounted for 171% of the household annual income, a percentage that fell to 107% after subtracting the compensation from medical insurance. The economic burden for lung cancer patients is substantial in the urban areas of China, and an effective control strategy to lower the cost is urgently needed.

Occupational Risk for Oral Cancer in Nordic Countries.

PubMed

Tarvainen, Laura; Suojanen, Juho; Kyyronen, Pentti; Lindqvist, Christian; Martinsen, Jan Ivar; Kjaerheim, Kristina; Lynge, Elsebeth; Sparen, Par; Tryggvadottir, Laufey; Weiderpass, Elisabete; Pukkala, Eero

2017-06-01

To evaluate occupational risk for cancer of the tongue, oral cavity or pharynx after adjustment for alcohol and tobacco use. The data covered 14.9 million people and 28,623 cases of cancer of the tongue, oral cavity and pharynx in the Nordic countries 1961-2005. Alcohol consumption by occupation was estimated based on mortality from liver cirrhosis and incidence of liver cancer. Smoking by occupation was estimated based on the incidence of lung cancer. Only few occupations had relative risks of over 1.5 for cancer of the tongue, oral cavity and pharynx. These occupations included dentists, artistic workers, hairdressers, journalists, cooks and stewards, seamen and waiters. Several occupational categories, including dentists, had an increased relative risk of tongue cancer. This new finding remains to be explained but could be related to occupational chemical exposures, increased consumption of alcohol and tobacco products, or infection with human papilloma virus. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

The global cancer burden and human development: A review.

PubMed

Fidler, Miranda M; Bray, Freddie; Soerjomataram, Isabelle

2018-02-01

This review examines the links between human development and cancer overall and for specific types of cancer, as well as cancer-related risk-factors and outcomes, such as disability and life expectancy. To assess human development, the Human Development Index was utilized continuously and according to four levels (low, medium, high, very high), where the low and very high categories include the least and most developed countries, respectively. All studies that assessed aspects of the global cancer burden using this measure were reviewed. Although the present cancer incidence burden is greater in higher Human Development Index countries, a greater proportion of the global mortality burden is observed in less developed countries, with a higher mean fatality rate in the latter countries. Further, the future cancer burden is expected to disproportionally affect less developed regions; in particular, it has been estimated that low and medium Human Development Index countries will experience a 100% and 81% increase in cancer incidence from 2008 to 2030, respectively. Disparities were also observed in risk factors and average health outcomes, such as a greater number of years of life lost prematurely and fewer cancer-related gains in life expectancy observed in lower versus higher Human Development Index settings. From a global perspective, there remain clear disparities in the cancer burden according to national Human Development Index scores. International efforts are needed to aid countries in social and economic transition in order to efficiently plan, implement and evaluate cancer control initiatives as a means to reduce the widening gap in cancer occurrence and survival worldwide.

The Population Burden of Cancer: Research Driven by the Catchment Area of a Cancer Center.

PubMed

Tai, Caroline G; Hiatt, Robert A

2017-01-01

Cancer centers, particularly those supported by the National Cancer Institute, are charged with reducing the cancer burden in their catchment area. However, methods to define both the catchment area and the cancer burden are diverse and range in complexity often based on data availability, staff resources, or confusion about what is required. This article presents a review of the current literature identifying 4 studies that have defined various aspects of the cancer burden in a defined geographical area and highlights examples of how some cancer centers and other health institutions have defined their catchment area and characterized the cancer burden within it. We then present a detailed case study of an approach applied by the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center to define its catchment area and its population cancer burden. We cite examples of how the Cancer Center research portfolio addresses the defined cancer burden. Our case study outlines a systematic approach to using publicly available data, such as cancer registry data, that are accessible by all cancer centers. By identifying gaps and formulating future research directions based on the needs of the population within the catchment area, epidemiologic studies and other types of cancer research can be directed to the population served. This review can help guide cancer centers in developing an approach to defining their own catchment area as mandated and applying research findings to this defined population. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Priorities for development of research methods in occupational cancer.

PubMed Central

Ward, Elizabeth M; Schulte, Paul A; Bayard, Steve; Blair, Aaron; Brandt-Rauf, Paul; Butler, Mary Ann; Dankovic, David; Hubbs, Ann F; Jones, Carol; Karstadt, Myra; Kedderis, Gregory L; Melnick, Ronald; Redlich, Carrie A; Rothman, Nathaniel; Savage, Russell E; Sprinker, Michael; Toraason, Mark; Weston, Ainsley; Olshan, Andrew F; Stewart, Patricia; Zahm, Sheila Hoar

2003-01-01

Occupational cancer research methods was identified in 1996 as 1 of 21 priority research areas in the National Occupational Research Agenda (NORA). To implement NORA, teams of experts from various sectors were formed and given the charge to further define research needs and develop strategies to enhance or augment research in each priority area. This article is a product of that process. Focus on occupational cancer research methods is important both because occupational factors play a significant role in a number of cancers, resulting in significant morbidity and mortality, and also because occupational cohorts (because of higher exposure levels) often provide unique opportunities to evaluate health effects of environmental toxicants and understand the carcinogenic process in humans. Despite an explosion of new methods for cancer research in general, these have not been widely applied to occupational cancer research. In this article we identify needs and gaps in occupational cancer research methods in four broad areas: identification of occupational carcinogens, design of epidemiologic studies, risk assessment, and primary and secondary prevention. Progress in occupational cancer will require interdisciplinary research involving epidemiologists, industrial hygienists, toxicologists, and molecular biologists. PMID:12524210

Economic burden of occupational injury and illness in the United States.

PubMed

Leigh, J Paul

2011-12-01

, medical cost estimates were $67 billion (27% of the total), and indirect costs were almost $183 billion (73%). Injuries comprised 77 percent of the total, and diseases accounted for 23 percent. The total estimated costs were approximately $250 billion, compared with the inflation-adjusted cost of $217 billion for 1992. The medical and indirect costs of occupational injuries and illnesses are sizable, at least as large as the cost of cancer. Workers' compensation covers less than 25 percent of these costs, so all members of society share the burden. The contributions of job-related injuries and illnesses to the overall cost of medical care and ill health are greater than generally assumed. © 2011 Milbank Memorial Fund.

Economic Burden of Occupational Injury and Illness in the United States

PubMed Central

Leigh, J Paul

2011-01-01

and diseases combined, medical cost estimates were $67 billion (27% of the total), and indirect costs were almost $183 billion (73%). Injuries comprised 77 percent of the total, and diseases accounted for 23 percent. The total estimated costs were approximately $250 billion, compared with the inflation-adjusted cost of $217 billion for 1992. Conclusions The medical and indirect costs of occupational injuries and illnesses are sizable, at least as large as the cost of cancer. Workers’ compensation covers less than 25 percent of these costs, so all members of society share the burden. The contributions of job-related injuries and illnesses to the overall cost of medical care and ill health are greater than generally assumed. PMID:22188353

Occupational cancer in the United Kingdom.

PubMed Central

Coggon, D

1999-01-01

Most of the known occupational hazards of cancer have occurred in the United Kingdom. Over recent decades a contraction of manufacturing industry and legal controls on carcinogens have led to reductions in exposure, but cases continue to occur, often as a consequence of exposures 20 or more years ago. By far the most important occupational cause of cancer in the United Kingdom is asbestos, which currently accounts for some 600 cases of mesothelioma and perhaps 100 cases of bronchial carcinoma per year. Recent trends suggest that the number of mesothelioma cases attributable to asbestos will increase over the next few decades. Exposure to sunlight in outdoor work may cause several hundred cases of nonmelanomatous skin cancer per year, and occupational exposure to polycyclic aromatic hydrocarbons could be responsible for a similar number of skin and lung tumors. Other known occupational hazards of cancer are unlikely to account for more than 100 cases per year in total. PMID:10350506

Occupation and gastric cancer

PubMed Central

Raj, A; Mayberry, J; Podas, T

2003-01-01

Gastric cancer is a cause of significant morbidity and mortality. There are several risk factors, with occupation emerging as one of these. There is considerable evidence that occupations in coal and tin mining, metal processing, particularly steel and iron, and rubber manufacturing industries lead to an increased risk of gastric cancer. Other "dusty" occupations—for example, wood processing, or work in high temperature environments have also been implicated but the evidence is not strong. The mechanism of pathogenesis of gastric cancer is unclear and the identification of causative agents can be difficult. Dust is thought to be a contributor to the pathological process, but well known carcinogens such as N-nitroso compounds have been detected in some environments. Further research on responsible agents is necessary and screening for detection of precursor gastric cancer lesions at the workplace merits consideration. PMID:12782770

Overview of occupational cancer in painters in Korea.

PubMed

Myong, Jun-Pyo; Cho, Younmo; Choi, Min; Kim, Hyoung-Ryoul

2018-01-01

Comprehensive consideration is necessary for setting guidelines to evaluate evidence of occupational cancer in painters due to work-related exposure to carcinogens in paint (a phenomenon termed herein as "work-relatedness"). The aim of the present research is to perform a comprehensive review and to suggest criteria for the provision of compensation for occupational neoplasm among painters in Korea. In order to perform a comprehensive review, this study assessed and evaluated scientific reports of carcinogenicities from the International Agency for Research on Cancer (IARC) and the Industrial Injuries Advisory Council (IIAC), as well as reviewed the existing literature about occupational exposure among painters in Korea and the epidemiologic investigations of claimed cases of cancer among painters in Korea. The IARC declares that occupational exposures in commercial painting are classified as Group 1 carcinogens for lung cancer and bladder cancer among painters. The epidemiologic studies show consistent causal relationships between occupational exposure in painters and cancers such as lung cancer [meta relative risk: 1.34 (95% confidence intervals (CIs): 1.23-1.41)] and bladder cancer [meta relative risk: 1.24 (95% CIs: 1.16-1.33)]. In reviewing occupational cancer risks for commercial painters, the Industrial Injuries Advisory Council (IIAC) confirms occupational cancer risks for lung and bladder cancer among commercial painters. According to the IIAC, however, the elevated cancer risks reported in existing literature are not doubled in either lung or bladder cancer in commercial painters relative to the risks of these cancers in the general population. Based on our review of existing Korean articles on the topic, painters are exposed to potential carcinogens including polycyclic aromatic hydrocarbons (PAHs), benzene, hexavalent chrome, crystalized silica, asbestos, and other agents, and relative levels are estimated within commercial painting processes. However

Family rituals, financial burden, and mothers' adjustment in pediatric cancer.

PubMed

Santos, Susana; Crespo, Carla; Canavarro, M Cristina; Alderfer, Melissa A; Kazak, Anne E

2016-12-01

The financial burden of childhood cancer may contribute to the distress that parents experience during and after treatment. Inconsistent relationships between financial burden and parental psychological distress highlight the need to identify psychosocial factors that may moderate this relationship. In this study, we aimed to determine if family ritual meaning moderates the relationship between financial burden and anxiety and depression symptoms among mothers of children with cancer. Portuguese mothers of children with cancer on-treatment and off-treatment (N = 244) completed measures of financial burden, anxiety and depression symptoms, and family ritual meaning. Moderating effects were tested using hierarchical multiple regression analyses. Family ritual meaning buffered the effect of financial burden on anxiety, but not on depression symptoms. The relationship between financial burden and anxiety symptoms was not significant when mothers endorsed higher levels of family ritual meaning. Although preliminary, the current findings suggest that high levels of perceived family ritual meaning may constitute a protective factor against the effect of financial burden on mothers' anxiety symptoms. Promoting family ritual meaning might be an effective approach to reducing anxiety symptoms of mothers of children with cancer in the context of financial burden. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The burden of cancer in Mexico, 1990-2013.

PubMed

Gómez-Dantés, Héctor; Lamadrid-Figueroa, Héctor; Cahuana-Hurtado, Lucero; Silverman-Retana, Omar; Montero, Pablo; González-Robledo, María Cecilia; Fitzmaurice, Christina; Pain, Amanda; Allen, Christine; Dicker, Daniel J; Hamavid, Hannah; López, Alan; Murray, Christopher; Naghavi, Mohsen; Lozano, Rafael

2016-04-01

To analyze mortality and incidence for 28 cancers by deprivation status, age and sex from 1990 to 2013. The data and methodological approaches provided by the Global Burden of Disease (GBD 2013) were used. Trends from 1990 to 2013 show important changes in cancer epidemiology in Mexico. While some cancers show a decreasing trend in incidence and mortality (lung, cervical) others emerge as relevant health priorities (prostate, breast, stomach, colorectal and liver cancer). Age standardized incidence and mortality rates for all cancers are higher in the northern states while the central states show a decreasing trend in the mortality rate. The analysis show that infection related cancers like cervical or liver cancer play a bigger role in more deprived states and that cancers with risk factors related to lifestyle like colorectal cancer are more common in less marginalized states. The burden of cancer in Mexico shows complex regional patterns by age, sex, types of cancer and deprivation status. Creation of a national cancer registry is crucial.

Occupational risk of bladder cancer among Iranian male workers

PubMed Central

Aminian, Omid; Saburi, Amin; Mohseni, Hossein; Akbari, Hamed; Chavoshi, Farzaneh; Akbari, Hesam

2014-01-01

Background: Approximately 5-10% of human cancers are thought to be caused by occupational exposure to carcinogens. Compare to other cancers, bladder cancer is most strongly linked to occupational exposure to chemical toxins. This study has been performed to understand which occupations and exposures are related to bladder cancer in Iran. Materials and Methods: This study is a case-control study which is conducted on cases with bladder cancer (160 cases) diagnosed in Baharlou hospital in 2007-2009. One hundred sixty cases without any occupational exposure were considered as controls matched for demographic characteristics. Demographic data and characteristics of occupation were compared. Results: Mean age of cases and controls were 63.7 and 64 years, respectively (P = 0.841). History of urinary tract stone had significantly difference in two groups (P = 0.039). Occupations such as bus and truck driving, road and asphalt making, mechanics, working in refinery and Petrochemical, plastic, metal manufactory, welding, and pipeline founded a higher risk for bladder cancer rather than controls. Conclusion: Our findings on Iranian workers are concurrent and compatible with findings of previous reports about occupational and environmental risk factors of bladder cancer. Although our study population was PMID:24833825

Occupational risks for colon cancer in Sweden.

PubMed

Chow, W H; Malker, H S; Hsing, A W; McLaughlin, J K; Weiner, J A; Stone, B J; Ericsson, J L; Blot, W J

1994-06-01

Using the Cancer-Environment Registry of Sweden, which links census information (1960) with cancer incidence data (1961 to 1979), we conducted a systematic, population-based assessment of colon cancer incidence among cohorts defined by industry and occupation for all employed persons in Sweden. Small but statistically significant excesses of colon cancer were observed among white-collar occupations, including administrators, professionals, and clerical and sales workers, whereas a reduction in incidence was found among workers in agricultural and related jobs, such as farmers, fishermen, and hunters. Analysis by subsite within the colon revealed little difference in results. The observed risk patterns are consistent with previous reports on colon cancer risk and occupational physical activity levels, ie, elevated risk among sedentary white-collar workers and reduced risk among agricultural workers. Few craftsman and production processing jobs were linked to colon cancer, although statistically significant excesses were observed among shoe and leather workers, metal smiths, and foundry workers in the metal manufacturing industry. The findings indicate that occupation in general is likely to play a relatively small role in colon cancer etiology, with perhaps its major contribution an indirect one via physical activity.

'Tablet burden' in patients with metastatic breast cancer.

PubMed

Milic, Marina; Foster, Anna; Rihawi, Karim; Anthoney, Alan; Twelves, Chris

2016-03-01

The implications for patients with cancer, of the 'tablet burden' resulting from increasing use of oral anticancer drugs and medication for co-morbidities have not previously been well explored. We sought to (i) quantify tablet burden in women with metastatic breast cancer (MBC), (ii) establish which groups of drug contribute most to this burden and (iii) gain insight into patients' attitudes towards oral anti-cancer treatment. One hundred patients with MBC anonymously completed a questionnaire describing their medication histories and attitudes towards their tablets. The patients (mean age 60, range 31-95) were all female and taking a median of six tablets (range 0-31) daily; 37 patients were taking >10 tablets. Oral anticancer treatment constituted the category of treatment taken by the highest proportion of patients, followed by symptomatic cancer treatments, proton pump inhibitors and cardiovascular medication. Numerically, however, symptomatic drugs accounted for 44% of all tablets and specific anti-cancer treatment for 15%; medication not directly related to the cancer accounted for the remaining 40% of tablets. A quarter of patients reported inconvenience in taking their tablets, the main reason being tablet size and one third reported forgetting their tablets at least once a week. Nearly two thirds of patients expressing a preference favoured oral anticancer treatment, the commonest reason being greater convenience. Tablet burden is considerable for many patients with MBC and can be problematic. A significant proportion of tablets represent treatment for co-morbidities, the significance of which may be questionable in women with MBC. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Burden of Parents of Pediatric Cancer Patients in Pediatric-oncological Rehabilitation].

PubMed

Inhestern, Laura; Beierlein, Volker; Krauth, Konstantin A; Rolfes, Ursula; Schulte, Thomas; Berger, Dieter; Koch, Uwe; Bergelt, Corinna

2017-03-01

Burden of Parents of Pediatric Cancer Patients in Pediatric-oncological Rehabilitation All family members experience high burden in case of paediatric cancer. Family-oriented rehabilitation (FOR) aims to improve the physical and mental situation of the families. We investigated anxiety and depression (HADS) and cancer-related burden of parents (n = 69) before and after FOR and analysed its association with quality of life of the ill children. At beginning of FOR 70 % of the parents showed moderate to high anxiety scores and 47 % moderate to high depression scores. They reported cancer-related burden such as exhaustion, cancer-related fears and a burden of family's daily life due to the cancer disease. At the end of FOR 40 % of the parents showed moderate to high anxiety scores and 30 % moderate to high depression. Cancer-related burden measured with self-developed items also decreased after FOR. Compared to age- and gender-adapted norm values, mothers show significantly higher anxiety and depression scores, whereas fathers show no differences in depression scores compared to norm values at the end of FOR. Quality of life of ill children and anxiety and depression scores in the parents are significantly associated with each other. Results of the study show that parents stabilise after FOR and improve their mental situation. However, the results also underline the need for long-term psychosocial support for all family members.

Estimation of benefit of prevention of occupational cancer for comparative risk assessment: methods and examples.

PubMed

Lee, Lukas Jyuhn-Hsiarn; Chang, Yu-Yin; Liou, Saou-Hsing; Wang, Jung-Der

2012-08-01

To quantify the life years gained and financial savings by preventing a case of occupational cancer. The authors retrieved data from the Taiwan Cancer Registry and linked them with the National Mortality Registry to estimate the survival functions for major occupational cancers: lung, pleural mesothelioma, urinary bladder and leukaemia. Assuming a constant excess hazard for each type of cancer, the authors extrapolated lifetime survival functions by the Monte Carlo method. For each patient with cancer, the authors simulated an age- and gender-matched person without cancer based on vital statistics of Taiwan to estimate life expectancy and expected years of life lost (EYLL). By using the reimbursement data from the National Health Insurance Research Database, the authors calculated the average monthly healthcare expenditures, which were summed to estimate the lifetime healthcare expenditures after adjusting for the corresponding monthly survival probability. A total of 51,408, 136, 12,891 and 5285 new cases of lung, pleural mesothelioma, bladder and leukaemia cancers, respectively, were identified during 1997-2005 and followed until the end of 2007. The EYLL was predicted to be 13.7±0.1, 18.9±0.7, 4.7±0.3 and 19.4±0.5 years for these cancers, respectively, and the lifetime healthcare expenditures with a 3% annual discount were predicted to be US$22,359, US$14,900, US$51,987 and US$59,741, respectively. The burden of these occupational cancers, in terms of EYLL and lifetime healthcare expenditures, was substantial. Such estimates may provide useful empirical evidence for comparative risk assessment that can be applied in health policy-making and clinical decision-making.

Factors contributing to economic burden in lung cancer spousal caregivers.

PubMed

Kavanaugh, Melinda; Kramer, Betty J; Walsh, Matthew Cunningham; Trentham-Dietz, Amy

2015-06-01

The determinates of economic burden in lung cancer caregivers are poorly understood. Of particular interest is the role patient symptoms play in caregiver economic burden. Guided by a stress process conceptual framework, this study examined the predictors of economic burden reported by lung cancer spousal caregivers. Our study focused on the pathway of contextual and stressor variables leading to economic burden in lung cancer caregivers. Relying on survey data from 138 spouses, structural equation modeling was employed to examine the determinants of economic burden measured using the Family Impact Survey. Contextual variables included age, gender, education, and income; and stressor variables included patient physical and mental symptoms, as well as number of children in the home. A significant indirect path between age and economic distress through patient symptoms (p = 0.05) indicates younger spouses providing care for patients with more symptoms and reporting greater economic burden. Direct effects between contextual variables and economic burden revealed that caregivers with less education (p = 0.02) and those with more children at home (p = 0.01) reported more adverse economic outcomes. Numerous factors impact spousal caregivers' economic burden, including the presence of children at home, being a younger caregiver, and lower educational attainment by caregivers. Moreover, the direct effects between age and economic burden were not significant, supporting the clear role patient symptoms play in the path to economic burden in spousal caregivers. These results underscore the need for healthcare providers to address psychosocial factors when dealing with patients and families with lung cancer. Specifically, the results highlight the importance of addressing patient symptoms early before they threaten the family's economic well-being.

Symptom Burden in Cancer Survivors One Year after Diagnosis: A Report from the American Cancer Society’s Studies of Cancer Survivors

PubMed Central

Shi, Qiuling; Smith, Tenbroeck G.; Michonski, Jared D.; Stein, Kevin D.; Kaw, Chiew Kwei; Cleeland, Charles S.

2011-01-01

Background Few studies have examined risk for severe symptoms during early cancer survivorship. Using baseline data from the American Cancer Society’s Study of Cancer Survivors-I, we examined cancer survivors with high symptom burden, identified risk factors associated with high symptom burden, and evaluated the impact of high symptom burden on health-related quality of life (HRQoL) 1 year post-diagnosis. Methods Participants were enrolled from 11 state cancer registries approximately 1 year after diagnosis and surveyed by telephone or mail. Outcomes measures were the Modified Rotterdam Symptom Checklist and Profile of Mood States-37 (to assess symptom burden) and the Satisfaction with Life Domains Scale-Cancer (to assess HRQoL). Results Of 4903 survivors, 4512 (92%) reported symptoms related to their cancer and/or its treatment. Two-step clustering yielded 2 sub-groups, one with low symptom burden (n=3113) and one with high symptom burden (n=1399). Variables associated with high symptom burden included metastatic cancer (odds ratio [OR], 2.05), number of comorbid conditions (OR, 1.76), remaining on active chemotherapy (OR, 1.93), younger age (OR, 2.31), lacking insurance/being underinsured (OR, 1.57), having lower income (OR, 1.61), being unemployed (OR, 1.27), or being less educated (OR, 1.29). Depression, fatigue, and pain had the greatest impact on HRQoL in survivors with high symptom burden, who also had lower HRQoL (P < .0001). Conclusions More than 1 in 4 cancer survivors had high symptom burden 1 year post-diagnosis, even after treatment termination. These results indicate a need for continued symptom monitoring and management in early posttreatment survivorship, especially for the underserved. PMID:21495026

[The burden of disease from cancer in Cuba, 1990-2002].

PubMed

Alonso, Emma Domínguez; Jo, Armando H Seuc; Galán, Yaima

2009-11-01

To describe the burden of disease, using morbidity and mortality in Cuba from 1990-2002, by cancer type and location. A descriptive study of the disease burden in the years 1990, 1995, 2000, and 2002, by Cuba's most frequently associated cancer types and locations. Official Cuban sources were used to calculate years of potential life lost (YPLL) due to mortality (based on life expectancy) and morbidity (based on the incidence, average duration, and severity of the disease), as well as years of potential life lost per death (YPLL/D) and the disability-adjusted life years (DALY), for each cancer type and location, by sex and age group. The locations with higher YPLL were also those with the greatest total burden: lung, breast, prostate, colon and rectum, and cervix, and showed an upward trend for all cancer types and locations, except leukemia. The morbidity-related YPLL were concentrated in: breast, lung, prostate, colon and rectum, and cervix. In men, the highest mortality-related YPLL values were in the oral cavity and oropharynx, esophagus, stomach, lung, bladder, melanoma, lymphoma, and leukemia; women were more affected by cancer of the colon and rectum. The highest YPLL/D values were observed for cervix, breast, ovaries, leukemia, and lymphoma. The cancer types and locations with more DALYs were: lung, breast, prostate, colon and rectum, cervix, and endometrium. The burden of disease from cancer increased in Cuba from 1990-2002, mostly due to a rise in the mortality burden.

Does economic burden influence quality of life in breast cancer survivors?

PubMed

Meneses, Karen; Azuero, Andres; Hassey, Lauren; McNees, Patrick; Pisu, Maria

2012-03-01

Economic burden is emerging as a crucial dimension in our understanding of adjustment to cancer during treatment. Yet, economic burden is rarely examined in cancer survivorship. The goal of this paper is to describe the effect of economic hardship and burden among women with breast cancer. We examined baseline and follow-up (3 and 6 month) data reported by 132 stage I and II breast cancer survivors assigned to the Wait Control arm of the Breast Cancer Education Intervention (BCEI), a clinical trial of education and support interventions. Repeated measures models fitted with linear mixed models were used to examine relationships between aspects of economic burden and overall quality of life (QOL) scores. Structural equation models (SEM) were used to examine the relationship between overall economic burden and QOL. Nineteen economic events were reported. The proportion of survivors who reported increase in insurance premiums increased in the 6-month study period (p=.022). The proportion of survivors reporting change in motivation (p=.016), productivity (p=.002), quality of work (p=.01), days missed from work (p<.001) and sacrificing other things (p=.001) declined. An increase in economic events was significantly associated with poorer quality of life at each of the study time points. Economic burden of breast cancer extends into post-treatment survivorship. Better understanding of economic impact and managing economic burden may help maintain QOL. Copyright © 2011 Elsevier Inc. All rights reserved.

The Global Burden of Cancer 2013.

PubMed

Fitzmaurice, Christina; Dicker, Daniel; Pain, Amanda; Hamavid, Hannah; Moradi-Lakeh, Maziar; MacIntyre, Michael F; Allen, Christine; Hansen, Gillian; Woodbrook, Rachel; Wolfe, Charles; Hamadeh, Randah R; Moore, Ami; Werdecker, Andrea; Gessner, Bradford D; Te Ao, Braden; McMahon, Brian; Karimkhani, Chante; Yu, Chuanhua; Cooke, Graham S; Schwebel, David C; Carpenter, David O; Pereira, David M; Nash, Denis; Kazi, Dhruv S; De Leo, Diego; Plass, Dietrich; Ukwaja, Kingsley N; Thurston, George D; Yun Jin, Kim; Simard, Edgar P; Mills, Edward; Park, Eun-Kee; Catalá-López, Ferrán; deVeber, Gabrielle; Gotay, Carolyn; Khan, Gulfaraz; Hosgood, H Dean; Santos, Itamar S; Leasher, Janet L; Singh, Jasvinder; Leigh, James; Jonas, Jost B; Jonas, Jost; Sanabria, Juan; Beardsley, Justin; Jacobsen, Kathryn H; Takahashi, Ken; Franklin, Richard C; Ronfani, Luca; Montico, Marcella; Naldi, Luigi; Tonelli, Marcello; Geleijnse, Johanna; Petzold, Max; Shrime, Mark G; Younis, Mustafa; Yonemoto, Naohiro; Breitborde, Nicholas; Yip, Paul; Pourmalek, Farshad; Lotufo, Paulo A; Esteghamati, Alireza; Hankey, Graeme J; Ali, Raghib; Lunevicius, Raimundas; Malekzadeh, Reza; Dellavalle, Robert; Weintraub, Robert; Lucas, Robyn; Hay, Roderick; Rojas-Rueda, David; Westerman, Ronny; Sepanlou, Sadaf G; Nolte, Sandra; Patten, Scott; Weichenthal, Scott; Abera, Semaw Ferede; Fereshtehnejad, Seyed-Mohammad; Shiue, Ivy; Driscoll, Tim; Vasankari, Tommi; Alsharif, Ubai; Rahimi-Movaghar, Vafa; Vlassov, Vasiliy V; Marcenes, W S; Mekonnen, Wubegzier; Melaku, Yohannes Adama; Yano, Yuichiro; Artaman, Al; Campos, Ismael; MacLachlan, Jennifer; Mueller, Ulrich; Kim, Daniel; Trillini, Matias; Eshrati, Babak; Williams, Hywel C; Shibuya, Kenji; Dandona, Rakhi; Murthy, Kinnari; Cowie, Benjamin; Amare, Azmeraw T; Antonio, Carl Abelardo; Castañeda-Orjuela, Carlos; van Gool, Coen H; Violante, Francesco; Oh, In-Hwan; Deribe, Kedede; Soreide, Kjetil; Knibbs, Luke; Kereselidze, Maia; Green, Mark; Cardenas, Rosario; Roy, Nobhojit; Tillmann, Taavi; Tillman, Taavi; Li, Yongmei; Krueger, Hans; Monasta, Lorenzo; Dey, Subhojit; Sheikhbahaei, Sara; Hafezi-Nejad, Nima; Kumar, G Anil; Sreeramareddy, Chandrashekhar T; Dandona, Lalit; Wang, Haidong; Vollset, Stein Emil; Mokdad, Ali; Salomon, Joshua A; Lozano, Rafael; Vos, Theo; Forouzanfar, Mohammad; Lopez, Alan; Murray, Christopher; Naghavi, Mohsen

2015-07-01

Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. The general methodology of the Global Burden of Disease (GBD) 2013 study was used. Cancer registries were the source for cancer incidence data as well as mortality incidence (MI) ratios. Sources for cause of death data include vital registration system data, verbal autopsy studies, and other sources. The MI ratios were used to transform incidence data to mortality estimates and cause of death estimates to incidence estimates. Cancer prevalence was estimated using MI ratios as surrogates for survival data; YLDs were calculated by multiplying prevalence estimates with disability weights, which were derived from population-based surveys; YLLs were computed by multiplying the number of estimated cancer deaths at each age with a reference life expectancy; and DALYs were calculated as the sum of YLDs and YLLs. In 2013 there were 14.9 million incident cancer cases, 8.2 million deaths, and 196.3 million DALYs. Prostate cancer was the leading cause for cancer incidence (1.4 million) for men and breast cancer for women (1.8 million). Tracheal, bronchus, and lung (TBL) cancer was the leading cause for cancer death in men and women, with 1.6 million deaths. For men, TBL cancer was the leading cause of DALYs (24.9 million). For women, breast cancer was the leading cause of DALYs (13.1 million). Age-standardized incidence rates (ASIRs) per 100 000 and age-standardized death rates (ASDRs) per 100 000 for both sexes in 2013 were higher in developing vs developed countries for stomach cancer (ASIR, 17 vs 14; ASDR, 15 vs 11), liver cancer (ASIR, 15 vs 7; ASDR, 16 vs 7), esophageal cancer (ASIR, 9 vs 4

The Global Burden of Cancer 2013

PubMed Central

2015-01-01

IMPORTANCE Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. OBJECTIVE To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. EVIDENCE REVIEW The general methodology of the Global Burden of Disease (GBD) 2013 study was used. Cancer registries were the source for cancer incidence data as well as mortality incidence (MI) ratios. Sources for cause of death data include vital registration system data, verbal autopsy studies, and other sources. The MI ratios were used to transform incidence data to mortality estimates and cause of death estimates to incidence estimates. Cancer prevalence was estimated using MI ratios as surrogates for survival data; YLDs were calculated by multiplying prevalence estimates with disability weights, which were derived from population-based surveys; YLLs were computed by multiplying the number of estimated cancer deaths at each age with a reference life expectancy; and DALYs were calculated as the sum of YLDs and YLLs. FINDINGS In 2013 there were 14.9 million incident cancer cases, 8.2 million deaths, and 196.3 million DALYs. Prostate cancer was the leading cause for cancer incidence (1.4 million) for men and breast cancer for women (1.8 million). Tracheal, bronchus, and lung (TBL) cancer was the leading cause for cancer death in men and women, with 1.6 million deaths. For men, TBL cancer was the leading cause of DALYs (24.9 million). For women, breast cancer was the leading cause of DALYs (13.1 million). Age-standardized incidence rates (ASIRs) per 100 000 and age-standardized death rates (ASDRs) per 100 000 for both sexes in 2013 were higher in developing vs developed countries for stomach cancer (ASIR, 17 vs 14; ASDR, 15 vs 11), liver cancer (ASIR, 15 vs 7; ASDR, 16

Burden of disease due to cancer in Spain

PubMed Central

Fernández de Larrea-Baz, Nerea; Álvarez-Martín, Elena; Morant-Ginestar, Consuelo; Gènova-Maleras, Ricard; Gil, Ángel; Pérez-Gómez, Beatriz; López-Abente, Gonzalo

2009-01-01

Background Burden of disease is a joint measure of mortality and morbidity which makes it easier to compare health problems in which these two components enjoy different degrees of relative importance. The objective of this study is ascertaining the burden of disease due to cancer in Spain via the calculation of disability-adjusted life years (DALYs). Methods DALYs are the sum of years of life lost due to premature mortality and years lost due to disability. World Health Organization methodology and the following sources of data were used: the Mortality Register and Princeton Model Life Table for Years of life lost due to premature mortality and population, incidence estimates (Spanish tumour registries and fitting of generalized linear mixed models), duration (from data of survival in Spain from the EUROCARE-3 study and fitting of Weibull distribution function) and disability (weights published in the literature) for Years lost due to disability. Results There were 828,997 DALYs due to cancer (20.5 DALYs/1,000 population), 61% in men. Of the total, 51% corresponded to lung, colorectal, breast, stomach and prostate cancers. Mortality (84% of DALYs) predominated over disability. Subjects aged under 20 years accounted for 1.6% and those aged over 70 years accounted for 30.1% of DALYs. Conclusion Lung, colorectal and breast cancers are responsible for the highest number of DALYs in Spain. Even if the burden of disease due to cancer is predominantly caused by mortality, some cancers have a significant weight of disability. Information on 2000 burden of disease due to cancer can be useful to assess how it has evolved over time and the impact of medical advances on it in terms of mortality and disability. PMID:19183440

Occupational Therapy for Adults With Cancer: Why It Matters

PubMed Central

Williams, Grant R.; Campbell, Claudine; Munoz, Lauro A.; Muss, Hyman B.

2016-01-01

Adults with cancer may be at risk for limitations in functional status and quality of life (QOL). Occupational therapy is a supportive service with the specific mission to help people functionally engage in life as safely and independently as possible with the primary goal of improving QOL. Unfortunately, for people with cancer, occupational therapy remains underused. The overall purpose of this review is to provide an understanding of what occupational therapy is and its relevance to patients with cancer, highlight the reasons to refer, and, last, provide general advice on how to access services. Implications for Practice: Adults with cancer are at risk for functional decline, which can lead to increased hospitalization, poor tolerance of cancer treatment, and increased health-care costs. Occupational therapy is specifically designed to evaluate and treat functional deficits, yet it remains underused in cancer care. This article describes what occupational therapy is, how to identify those who may need it, and how to access services. PMID:26865588

[Disease burden of liver cancer in the Chinese population, in 1990 and 2013].

PubMed

Wang, L J; Yin, P; Liu, Y N; Liu, J M; Qi, J L; Zhou, M G

2016-06-01

To analyze the disease burden of liver cancer in the Chinese population in 1990 and 2013. Data from Global Burden of Diseases 2013 (GBD2013) was used to analyze the disease burden of liver cancer in China. The main outcome measurements would include mortality and disability-adjusted life years (DALY). Again, GBD global standard population in 2013 was used as the reference population to calculate the age-standardized rate. Related changes on percentage from 1990 to 2013 were calculated to analyze the changing patterns of disease burden for liver cancer in China. In 2013, a total of 358 100 people died of liver cancer, with the crude death rate as 25.85/100 000, in China. Number of deaths due to liver cancer secondary to hepatitis B was 163 600 (accounting for 45.69%). Number of deaths due to liver cancer secondary to hepatitis C was 134 200 (accounting for 37.48%) with DALY due to liver cancer appeared as 40.80 million person years. In 2013, the leading causes of DALY related to liver cancer was liver cancer secondary to hepatitis B, followed by liver cancer secondary to hepatitis C, liver cancer secondary to alcohol use, other liver cancers, with related DALYs as 4 652.0, 3 394.3, 964.3 and 592.1 thousands person years, respectively. The disease burdens of liver cancer secondary to various kinds of liver cancer were significantly higher in males than in females. Compared with 1990, the standardized mortality of liver cancer reduced by 25.00%, the DALY attributable to liver cancer increased by 16.95% and the standardized DALY rate attributable to liver cancer reduced by 33.47%. The burden of liver cancer secondary to hepatitis C became more serious and the standardized death rate increased by 106.18%, together with the standardized DALY rate increased by 91.68% in the past 23 years. Disease burden of liver cancer among young adults and the elderly were most serious. When comparing with the data in 1990, the standardized DALY rate showed declining trend in all the

Occupation, Gender, Race, and Lung Cancer

PubMed Central

Amr, Sania; Wolpert, Beverly; Loffredo, Christopher A.; Zheng, Yun-Ling; Shields, Peter G.; Jones, Raymond; Harris, Curtis C.

2008-01-01

Objective To examine associations between occupation and lung cancer by gender and race. Methods We used data from the Maryland Lung Cancer Study of nonsmall cell lung carcinoma (NSCLC), a multicenter case control study, to estimate odds ratios (ORs) of NSCLC in different occupations. Results After adjusting for smoking, environmental tobacco smoke, and other covariates, NSCLC ORs among women but not men were elevated in clerical-sales, service, and transportation-material handling occupations; ORs were significantly increased in all three categories (OR [95% confidence interval]: 4.07 [1.44 to 11.48]; 5.15 [1.62 to 16.34]; 7.82 [1.08 to 56.25], respectively), among black women, but only in transportation-material handling occupations (OR [95% confidence interval[: 3.43 [1.02 to 11.50]) among white women. Conclusions Women, especially black women, in certain occupations had increased NSCLC ORs. PMID:18849762

[Recognition of occupational cancers: review of existing methods and perspectives].

PubMed

Vandentorren, Stéphanie; Salmi, L Rachid; Brochard, Patrick

2005-09-01

Occupational risk factors represent a significant part of cancer causes and are involved in all type of cancers. Nonetheless, the frequency of these cancers is largely under-estimated. Parallel to the epidemiological approach (collective), the concept of occupational cancer is often linked (at the individual level) to the compensation of occupational diseases. To give rise to a financial compensation, the occupational origin of the exposition has to be established for a given cancer. Whatever the method used to explore an occupational cause, the approach is that of an imputation. The aim of this work is to synthesize and describe the main principles of recognition of occupational cancers, to discuss the limits of available methods and to consider the research needed to improve these methods. In France, the recognition of a cancer's occupational origin consists in tables of occupational diseases that are based on presumption of causality. These tables consist in medical, technical and administrative conditions that are necessary and sufficient for the recognition of an occupational disease and its financial compensation. Whenever causality presumption does not apply, imputation is based on case analyses run by experts within regional committees of occupational diseases recognition that lack reproducibility. They do not allow statistical quantization and do not always take into account the weight of associated factors. Nonetheless, reliability and validity of the expertise could be reinforced by the use of formal consensus techniques. This process could ideally lead to the generation of decision-making algorithms that could guide the user towards the decision of imputing or not the cancer to an occupational exposure. This would be adapted to the build-up of new tables. The imputation process would be better represented by statistical methods based on the use of Bayes' theorem. The application of these methods to occupational cancers is promising but remains limited

Occupational Engagement in Low-Income Latina Breast Cancer Survivors.

PubMed

Sleight, Alix G

This qualitative study examined the experience of occupational engagement in low-income Latina breast cancer survivors and suggests the potential for occupational therapy practitioners to improve health outcomes in this vulnerable and underserved population. Semistructured interviews were conducted with 9 participants. Inductive analysis was used to code for themes and patterns related to occupational engagement and quality of life (QOL). Lack of occupational engagement negatively affected QOL, but participation in occupations such as religious activity and caregiving promoted well-being. Financial concerns and communication barriers decreased QOL. Breast cancer can have a negative impact on occupational engagement in low-income Latina breast cancer survivors; however, some occupations may increase QOL. Socioeconomic status and cultural values influence occupational engagement and QOL. Occupational therapy practitioners can improve health outcomes in this population through awareness of relevant sociocultural factors and attention to appropriate patient communication. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Emotional Problems, Quality of Life, and Symptom Burden in Patients With Lung Cancer.

PubMed

Morrison, Eleshia J; Novotny, Paul J; Sloan, Jeff A; Yang, Ping; Patten, Christi A; Ruddy, Kathryn J; Clark, Matthew M

2017-09-01

Lung cancer is associated with a greater symptom burden than other cancers, yet little is known about the prevalence of emotional problems and how emotional problems may be related to the physical symptom burden and quality of life in newly diagnosed patients with lung cancer. This study aimed to identify the patient and disease characteristics of patients with lung cancer experiencing emotional problems and to examine how emotional problems relate to quality of life and symptom burden. A total of 2205 newly diagnosed patients with lung cancer completed questionnaires on emotional problems, quality of life, and symptom burden. Emotional problems at diagnosis were associated with younger age, female gender, current cigarette smoking, current employment, advanced lung cancer disease, surgical or chemotherapy treatment, and a lower Eastern Cooperative Oncology Group performance score. Additionally, strong associations were found between greater severity of emotional problems, lower quality of life, and greater symptom burden. Certain characteristics place patients with lung cancer at greater risk for emotional problems, which are associated with a reduced quality of life and greater symptom burden. Assessment of the presence of emotional problems at the time of lung cancer diagnosis provides the opportunity to offer tailored strategies for managing negative mood, and for improving the quality of life and symptom burden management of patients with lung cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

Paternal occupational exposures and childhood cancer.

PubMed Central

Feychting, M; Plato, N; Nise, G; Ahlbom, A

2001-01-01

The objective of the study described here was to test the hypothesis that paternal occupational exposure near conception increases the risk of cancer in the offspring. We conducted a cohort study based on a population of 235,635 children born shortly after two different censuses in Sweden. The children were followed from birth to 14 years, and cases of cancer were identified in the Swedish Cancer Registry. Occupational hygienists assessed the probability of exposure to different agents in each combination of the father's industry and occupation as reported in the censuses. We also analyzed individual job titles. We compared the cancer incidence among children of exposed fathers to that among children of unexposed fathers using Cox proportional hazards modeling. The main findings were an increased risk of nervous system tumors related to paternal occupational exposure to pesticides [relative risk (RR) = 2.36; 95% confidence interval (CI), 1.27-4.39] and work as a painter (RR = 3.65; 95% CI, 1.71-7.80), and an increased risk of leukemia related to wood work by fathers (RR = 2.18; 95% CI, 1.26-3.78). We found no associations between childhood leukemia and paternal exposure to pesticides or paint. Our results support previous findings of an increased risk of childhood brain tumors and leukemia associated with certain paternal occupational exposures. Some findings in previous studies were not confirmed in this study. PMID:11266332

The financial burden of cancer: estimates from patients undergoing cancer care in a tertiary care hospital.

PubMed

Zaidi, Adnan A; Ansari, Tayyaba Z; Khan, Aziz

2012-10-15

The emotional burden associated with the diagnosis of cancer is sometimes overshadowed by financial burden sustained by patient and the family. This is especially relevant for a developing country as there is limited state support for cancer treatment. We conducted this study to estimate the cost of cancer care for two major types of cancer and to assess the perception of patients and families regarding the burden of the cost for undergoing cancer treatment at a private tertiary care hospital. This cross-sectional study was conducted at day care and radiotherapy unit of Aga Khan University, Hospital (AKUH) Karachi, Pakistan. All adult patients with breast and head & neck cancers diagnosed for 3 months or more were included. Data was collected using a structured questionnaire and analysed using SPSS. Sixty seven patients were interviewed during the study period. The mean and median monthly income of these patients was 996.4 USD and 562.5 USD respectively. Comparatively the mean and median monthly cost of cancer care was 1093.13 USD and 946.42 USD respectively. The cost of the treatment either fully or partially was borne by the family in most cases (94%). The financial burden of cancer was perceived as significant by 28 (42%) patients and unmanageable by 18 (27%) patients. This perceived level of burden was associated significantly with average monthly income (p = <0.001). Our study indicates that the financial burden of cancer care is substantial and can be overwhelming. There is a desperate need for treatment support programs either by the government or other welfare organisations to support individuals and families who are already facing a difficult and challenging situation.

Predictors of caregiver burden in Iranian family caregivers of cancer patients.

PubMed

Mirsoleymani, Seyed Reza; Rohani, Camelia; Matbouei, Mahsa; Nasiri, Malihe; Vasli, Parvaneh

2017-01-01

Caregiver burden threatens the psychological, emotional, functional and even physical health of caregivers. The aims of this study were to determine caregiver burden and family distress and the relationship between them, also to explore predictors of caregiver burden in a sample of Iranian family caregivers of cancer patients. This is a cross-sectional study with correlational design. A total of 104 family caregivers of cancer patients were asked to respond to the Caregiver Burden Inventory (CBI) and the Family Distress Index (FDI) together with a sociodemographic questionnaire. For evaluating the relationship between CBI and FDI scores, the Pearson's product-moment correlation was used. In addition, multiple linear regression analysis was applied to explore the predictive factors of caregiver burden. A high burden was experienced by almost half of the caregivers (48.1%). The FDI mean score was 9.76 ± 5.40 ranged from 0 to 24. A strong positive correlation was found between the caregiver burden and family distress ( r = 0.76). Multiple linear regression results showed the predictive role of FDI score (β = 0.71, P = 0.001), patient's gender (β = -0.25, P = 0.001), and early cancer diagnosis (β =0.13, P = 0.027) in caregiver burden. They could explain 65% of variance in the level of burden in family caregivers. Family nurses should consider the caregivers burden and vulnerability of families with cancer patient, especially if the patient is a male or has a new diagnosis. They should also design special programs for the whole family as a system that family can adapt to the new situation.

Disparities in cancer screening by occupational characteristics.

PubMed

Fedewa, Stacey A; Sauer, Ann Goding; DeSantis, Carol; Siegel, Rebecca L; Jemal, Ahmedin

2017-12-01

Cancer screening patterns according to occupation characteristics in the United States are not well known, but could be used to help inform cancer control efforts. We examined cervical (CC), breast (BC) and colorectal cancer (CRC) screening prevalence and prevalence ratios (PR) by occupational characteristics in 2010, 2013 and 2015 National Health Interview Surveys (NHIS) among eligible US workers (CC women 21-65years; n=20,997), (BC women ≥40years; n=14,258) and (CRC men and women ≥50years; n=17,333). Cervical, breast and colorectal cancer screening prevalence among US workers was 84.0%, 68.9%, and 56.8%, respectively. Unadjusted prevalence ratios for cervical (PR=0.92, 95%CI 0.90, 0.94), breast (PR=0.86, 95%CI 0.83, 0.90) and colorectal cancer screening (PR=0.83, 95%CI 0.80, 0.87) were lower among workers in small (<25 employees) compared to large organizations (≥500 employees). People in food service, construction, production, and sales occupations were 13-26%, 17-28% and 9-30% less likely to be up to date with cervical, breast, and colorectal cancer screening, respectively, compared to healthcare professionals. Adjustment for socioeconomic factors and insurance status eliminated most associations. Disparities in cancer screening by occupational characteristics were mostly attributed to lower socioeconomic status and lack of insurance. These findings underscore the need for innovative public health strategies to improve cancer screening in vulnerable populations. Copyright © 2017 Elsevier Inc. All rights reserved.

Estimation of benefit of prevention of occupational cancer for comparative risk assessment: methods and examples

PubMed Central

Lee, Lukas Jyuhn-Hsiarn; Chang, Yu-Yin; Liou, Saou-Hsing

2012-01-01

Objectives To quantify the life years gained and financial savings by preventing a case of occupational cancer. Methods The authors retrieved data from the Taiwan Cancer Registry and linked them with the National Mortality Registry to estimate the survival functions for major occupational cancers: lung, pleural mesothelioma, urinary bladder and leukaemia. Assuming a constant excess hazard for each type of cancer, the authors extrapolated lifetime survival functions by the Monte Carlo method. For each patient with cancer, the authors simulated an age- and gender-matched person without cancer based on vital statistics of Taiwan to estimate life expectancy and expected years of life lost (EYLL). By using the reimbursement data from the National Health Insurance Research Database, the authors calculated the average monthly healthcare expenditures, which were summed to estimate the lifetime healthcare expenditures after adjusting for the corresponding monthly survival probability. Results A total of 51 408, 136, 12 891 and 5285 new cases of lung, pleural mesothelioma, bladder and leukaemia cancers, respectively, were identified during 1997–2005 and followed until the end of 2007. The EYLL was predicted to be 13.7±0.1, 18.9±0.7, 4.7±0.3 and 19.4±0.5 years for these cancers, respectively, and the lifetime healthcare expenditures with a 3% annual discount were predicted to be US$22 359, US$14 900, US$51 987 and US$59 741, respectively. Conclusions The burden of these occupational cancers, in terms of EYLL and lifetime healthcare expenditures, was substantial. Such estimates may provide useful empirical evidence for comparative risk assessment that can be applied in health policy-making and clinical decision-making. PMID:22576592

Occupational Lymphohematopoietic Cancer in Korea

PubMed Central

Lee, Won Jin; Son, Mia; Kang, Seong-Kyu

2010-01-01

The purpose of this study was to review the existing studies on lymphohematopoietic (LHP) cancer in Korea, estimate the prevalence of workers exposed to carcinogens, and determine the population attributable fraction (PAF) of leukemia. Two case series and 4 case reports were reviewed. Using official statistics, the prevalence of benzene exposure and ionizing radiation exposure was estimated. Based on the prevalence of exposure and the relative risk, The PAF of leukemia was calculated. Between 1996 and 2005, 51 cases of LHP cancer were reported from the compensation system. Greater than 50% of occupational LHP cancer was leukemia, and the most important cause was benzene. In a cohort study, the standardized incidence ratio was 2.71 (95% CI, 0.56-7.91). The prevalence of exposure was 2.5% and 2.2% in 1995 and 2000, respectively. Using the 1995 prevalence, 3.6-4.8% and 0.1% of cases with leukemia were attributable to benzene and ionizing radiation exposure, respectively, which resulted in 39.7-51.4 cases per year. Benzene is the most important cause of occupational leukemia in Korea. Considering the estimated PAF in this study, the annual number of occupational LHP cancer (51 cases during 10-yr period), might be underreported within the compensation system. PMID:21258598

Economic Burden for Informal Caregivers of Lung and Colorectal Cancer Patients

PubMed Central

Ramsey, Scott D.; Hornbrook, Mark C.; Atienza, Audie A.; van Ryn, Michelle

2010-01-01

Background. Informal care provides many benefits to cancer patients, but can be costly to caregivers. This study quantified the economic burden for informal caregivers of lung cancer (LC) and colorectal cancer (CRC) patients, examining differences by cancer type, phase of disease, stage at diagnosis, patient age, and relationship. Methods. A cross-sectional survey of caregivers of LC and CRC patients participating in the Share Thoughts on Care survey was conducted. Economic burden was calculated using the opportunity cost of caregiver time, the value of work hours lost, and out-of-pocket expenditures. Factors associated with economic burden to caregivers were modeled using fixed-effects generalized least squares estimation. Results. Informal caregivers (1,629) completed mailed surveys. Of these, 663, 822, and 144 were surveyed during the patient's initial phase (first year after diagnosis, not within 6 months of death), continuing phase (after 1 year, not within 6 months of death), and terminal phase (within 6 months of death) of disease, respectively. The accumulated economic burdens for caregivers were $7,028, $19,701, and $14,234 for those evaluated during the patient's initial phase, continuing phase, and terminal phase of disease, respectively. Economic burden was higher for caregivers of LC patients than CRC patients (p = .044) and for caregivers of patients diagnosed at stage 4 versus stage 1 (p = .001). Spouses faced higher economic burden than other relatives (p = .000) or friends (p = .000). Conclusions. Economic burden for informal caregivers of LC and CRC patients is substantial and should be included in estimates of the societal cost of cancer care. PMID:20667966

Childhood cancer and occupational radiation exposure in parents.

PubMed

Hicks, N; Zack, M; Caldwell, G G; Fernbach, D J; Falletta, J M

1984-04-15

To test the hypothesis that a parent's job exposure to radiation affects his or her child's risk of cancer, the authors compared this exposure during the year before the child's birth for parents of children with and without cancer. Parents of children with cancer were no more likely to have worked in occupations, industries, or combined occupations and industries with potential ionizing radiation exposure. Bone cancer and Wilms' tumor occurred more frequently among children of fathers in all industries with moderate potential ionizing radiation exposure. Children with cancer more often had fathers who were aircraft mechanics (odds ratio (OR) = infinity, one-sided 95% lower limit = 1.5; P = 0.04). Although four of these six were military aircraft mechanics, only children whose fathers had military jobs with potential ionizing radiation exposure had an increased cancer risk (OR = 2.73; P = 0.01). Four cancer types occurred more often among children of fathers in specific radiation-related occupations: rhabdomyosarcoma among children whose fathers were petroleum industry foremen; retinoblastoma among children whose fathers were radio and television repairmen; central nervous system cancers and other lymphatic cancers among children of Air Force fathers. Because numbers of case fathers are small and confidence limits are broad, the associations identified by this study need to be confirmed in other studies. Better identification and gradation of occupational exposure to radiation would increase the sensitivity to detect associations.

Financial Burden of Pediatric Cancer for Patients and Their Families.

PubMed

Warner, Echo L; Kirchhoff, Anne C; Nam, Gina E; Fluchel, Mark

2015-01-01

Cancer treatment may cause financial stress for pediatric oncology patients and their families. We evaluated pediatric cancer caregivers' perceived financial burden related to socioeconomic factors (eg, parental employment) and health care use factors (eg, unexpected hospitalizations). A single-site, cross-sectional survey of primary caretakers of patients with childhood cancer was performed from July 2010 to July 2012. Eligible patients were treated at a pediatric cancer hospital, diagnosed at age ≤ 21 years and were ≤ 5 years from diagnosis (N = 254). Financial burden was rated on a visual analog scale of 0 to 100. Multivariable linear regression models were used to calculate coefficients and 95% CIs of financial burden by time since diagnosis. Mean age at diagnosis was 6.8 years (SD = 5.5 years), and average time since diagnosis was 1.6 years (SD = 1.4 years). The most common diagnosis was leukemia (41.9%). When adjusted for sex, age at diagnosis, insurance status, and rural residence, caregivers whose child was 1 to 5 years from diagnosis with ≥ 5 unexpected hospitalizations experienced 24.9 (95% CI, 9.1 to 40.7; P < .01) points higher financial burden than those with no unexpected hospitalizations. In addition, when compared with families without employment disruptions, families of children 1 to 5 years from diagnosis in which a caregiver had quit or changed jobs reported 13.4 (95% CI, 3.2 to 23.6; P = .01) points higher financial burden. Efforts to reduce unexpected hospitalizations and employment disruptions by providing more comprehensive supportive care for pediatric patients with cancer could help ease families' financial burden. Copyright © 2015 by American Society of Clinical Oncology.

Stomach cancer and occupation in Sweden: 1971–89

PubMed Central

Aragones, N; Pollan, M; Gustavsson, P

2002-01-01

Objectives: To examine the relation between gastric cancer and occupation among men and women gainfully employed in 1970 in Sweden for the period 1971–89 and, more specifically, to evaluate whether any excess of incidence of gastric cancer had also occurred among the subcohort of people reporting the same occupation in 1960 and 1970. Methods: In both sexes and cohorts, relative risks adjusted for age, period of diagnosis, and geographical risk area were computed for occupational codes specified at one, two, or three level (occupational sector, occupational group, and occupation, respectively). Relative risks were calculated with all other occupations as reference and then, to take socioeconomic status into account, solely other occupations within the same occupational sector were used. Results: Among men, occupations with increased risk included miners and quarrymen, construction and metal processing workers, supporting the possible causative role of dusty environments in stomach cancer. In men, the results also provide support for increased risks among electrical and mechanical engineers, fishermen, petrol station workers, motor vehicle drivers, butchers and meat preparers, dockers, freight handlers, launderers and dry cleaners. Furthermore, it is worth noting interesting results for women, whose occupational risks have been studied less. Excess risks were found for practical nurses, cashiers, bank employees, engineering and electronic industry workers, food industry, housekeeping and cleaning workers. Due to the many occupations studied, several significant associations may be expected by chance. Conclusions: The study is explorative but provides support for the relations suggested previously between occupational exposure to dusty environments and stomach cancer, together with some new high risk occupations which should be further studied. PMID:11983848

The economic burden of cancer care in Canada: a population-based cost study

PubMed Central

de Oliveira, Claire; Weir, Sharada; Rangrej, Jagadish; Krahn, Murray D.; Mittmann, Nicole; Hoch, Jeffrey S.; Chan, Kelvin K.W.; Peacock, Stuart

2018-01-01

Background: Resource and cost issues are a growing concern in health care. Thus, it is important to have an accurate estimate of the economic burden of care. Previous work has estimated the economic burden of cancer care for Canada; however, there is some concern this estimate is too low. The objective of this analysis was to provide a comprehensive revised estimate of this burden. Methods: We used a case-control prevalence-based approach to estimate direct annual cancer costs from 2005 to 2012. We used patient-level administrative health care data from Ontario to correctly attribute health care costs to cancer. We employed the net cost method (cost difference between patients with cancer and control subjects without cancer) to account for costs directly and indirectly related to cancer and its sequelae. Using average patient-level cost estimates from Ontario, we applied proportions from national health expenditures data to obtain the economic burden of cancer care for Canada. All costs were adjusted to 2015 Canadian dollars. Results: Costs of cancer care rose steadily over our analysis period, from $2.9 billion in 2005 to $7.5 billion in 2012, mostly owing to the increase in costs of hospital-based care. Most expenditures for health care services increased over time, with chemotherapy and radiation therapy expenditures accounting for the largest increases over the study period. Our cost estimates were larger than those in the Economic Burden of Illness in Canada 2005-2008 report for every year except 2005 and 2006. Interpretation: The economic burden of cancer care in Canada is substantial. Further research is needed to understand how the economic burden of cancer compares to that of other diseases. PMID:29301745

Occupational stress and its association with early retirement and subjective need for occupational rehabilitation in cancer patients.

PubMed

Böttcher, Hilke M; Steimann, Monika; Rotsch, Martin; Zurborn, Karl-Heinz; Koch, Uwe; Bergelt, Corinna

2013-08-01

Returning to work often plays an important role for cancer survivors. Occupational stress may hamper a successful return to work, so cancer survivors should be given the opportunity to address occupational stress issues before returning to work. We investigated the amount of occupational stress among cancer patients and whether it is associated with their well-being, their subjective need for occupational rehabilitation and elevations in their risk of early retirement. At the beginning of rehabilitation, we asked cancer patients to respond to occupation-related and health-related questionnaires. We used t-tests, chi-square tests, and logistic regression analyses to address our research questions. A total of 477 patients participated in the study. Of these, 19% were occupationally stressed, and 26% reported subjective need for occupational rehabilitation. Patients who reported work-related stress had a diminished quality of life, were more likely to report subjective need for occupational rehabilitation (OR = 2.16), and had a higher risk of early retirement (OR = 5.44). Furthermore, cancer patients reported deficits in both active coping abilities and mental stability at work. Because occupational stress is associated with a higher risk of early retirement, both patients and physicians should take work-related problems seriously. Screening patients for occupational stress may help physicians identify patients who are at risk of experiencing problematic work re-entries. Furthermore, the results of the study suggest that cancer patients might have problems maintaining confidence in their abilities to solve work-related problems. Therefore, facilitating the development of a perception of self-efficacy might be an important treatment goal. Copyright © 2012 John Wiley & Sons, Ltd.

Occupational exposure and ovarian cancer risk.

PubMed

Le, Nhu D; Leung, Andy; Brooks-Wilson, Angela; Gallagher, Richard P; Swenerton, Kenneth D; Demers, Paul A; Cook, Linda S

2014-07-01

Relatively little work has been done concerning occupational risk factors in ovarian cancer. Although studies conducted in occupational settings have reported positive associations, their usefulness is generally limited by the lack of information on important confounders. In a population-based case-control study, we assessed risk for developing epithelial ovarian cancer (EOC) associated with occupational exposure while accounting for important confounders. Participants were identified through provincial population-based registries. Lifetime occupational history and information on potential confounding factors were obtained through a self-administered questionnaire. Unconditional logistic regression and the likelihood ratio test were used to assess EOC risk with each occupation (or industry), relative to all other occupations (or industries), adjusting for potential confounders including body mass index, oral contraceptive use, menopausal hormone therapy, parity, age at first childbirth, age at menarche, age at menopause, family history of breast and ovarian cancer in mother and sister(s), tubal ligation, partial oophorectomy, and hysterectomy. Occupations and industries were coded according to the Canadian Standard Occupational Classification (SOC) and Standard Industrial Classification (SIC). Significant excess risk was observed for several groups of teaching occupations, including SOC 27, teaching and related (adjusted OR 1.77, 95% CI 1.15-2.81) and SOC 279, other teaching and related (adjusted OR 3.11, 95% CI 1.35-8.49). Significant excess was also seen for a four-digit occupational group SOC 4131, bookkeepers and accounting clerks (adjusted OR 2.80, 95% CI 1.30-6.80). Industrial sub-groups showing significant excess risk included SIC 65, other retail stores (adjusted OR 2.19, 95 % CI 1.16-4.38); SIC 85, educational service (adjusted OR 1.45, 95% CI 1.00-2.13); and SIC 863, non-institutional health services (adjusted OR 2.54, 95% CI 1.13-6.52). Our study found

Addressing Breast Cancer's Unequal Burden | NIH MedlinePlus the Magazine

MedlinePlus

... of this page please turn JavaScript on. Feature: Breast Cancer Addressing Breast Cancer's Unequal Burden Past Issues / Winter 2017 Table of ... What are trends in African-American women and breast cancer? Breast cancer is the most commonly diagnosed cancer ...

Financial Burden in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

PubMed

Nipp, Ryan D; Kirchhoff, Anne C; Fair, Douglas; Rabin, Julia; Hyland, Kelly A; Kuhlthau, Karen; Perez, Giselle K; Robison, Leslie L; Armstrong, Gregory T; Nathan, Paul C; Oeffinger, Kevin C; Leisenring, Wendy M; Park, Elyse R

2017-10-20

Purpose Survivors of childhood cancer may experience financial burden as a result of health care costs, particularly because these patients often require long-term medical care. We sought to evaluate the prevalence of financial burden and identify associations between a higher percentage of income spent on out-of-pocket medical costs (≥ 10% of annual income) and issues related to financial burden (jeopardizing care or changing lifestyle) among survivors of childhood cancer and a sibling comparison group. Methods Between May 2011 and April 2012, we surveyed an age-stratified, random sample of survivors of childhood cancer and a sibling comparison group who were enrolled in the Childhood Cancer Survivor Study. Participants reported their household income, out-of-pocket medical costs, and issues related to financial burden (questions were adapted from national surveys on financial burden). Logistic regression identified associations between participant characteristics, a higher percentage of income spent on out-of-pocket medical costs, and financial burden, adjusting for potential confounders. Results Among 580 survivors of childhood cancer and 173 siblings, survivors of childhood cancer were more likely to have out-of-pocket medical costs ≥ 10% of annual income (10.0% v 2.9%; P < .001). Characteristics of the survivors of childhood cancer that were associated with a higher percentage of income spent on out-of-pocket costs included hospitalization in the past year (odds ratio [OR], 2.3; 95% CI, 1.1 to 4.9) and household income < $50,000 (OR, 5.5; 95% CI, 2.4 to 12.8). Among survivors of childhood cancer, a higher percentage of income spent on out-of-pocket medical costs was significantly associated with problems paying medical bills (OR, 8.9; 95% CI, 4.4 to 18.0); deferring care for a medical problem (OR, 3.0; 95% CI, 1.6 to 5.9); skipping a test, treatment, or follow-up (OR, 2.1; 95% CI, 1.1 to 4.0); and thoughts of filing for bankruptcy (OR, 6.6; 95% CI, 3.0 to

A comparison of cancer burden and research spending reveals discrepancies in the distribution of research funding.

PubMed

Carter, Ashley J R; Nguyen, Cecine N

2012-07-17

Ideally, the distribution of research funding for different types of cancer should be equitable with respect to the societal burden each type of cancer imposes. These burdens can be estimated in a variety of ways; "Years of Life Lost" (YLL) measures the severity of death in regard to the age it occurs, "Disability-Adjusted Life-Years" (DALY) estimates the effects of non-lethal disabilities incurred by disease and economic metrics focus on the losses to tax revenue, productivity or direct medical expenses. We compared research funding from the National Cancer Institute (NCI) to a variety of burden metrics for the most common types of cancer to identify mismatches between spending and societal burden. Research funding levels were obtained from the NCI website and information for societal health and economic burdens were collected from government databases and published reports. We calculated the funding levels per unit burden for a wide range of different cancers and burden metrics and compared these values to identify discrepancies. Our analysis reveals a considerable mismatch between funding levels and burden. Some cancers are funded at levels far higher than their relative burden suggests (breast cancer, prostate cancer, and leukemia) while other cancers appear underfunded (bladder, esophageal, liver, oral, pancreatic, stomach, and uterine cancers). These discrepancies indicate that an improved method of health care research funding allocation should be investigated to better match funding levels to societal burden.

Cancer research priorities and gaps in Iran: the influence of cancer burden on cancer research outputs between 1997 and 2014.

PubMed

Majidi, A; Salimzadeh, H; Beiki, O; Delavari, F; Majidi, S; Delavari, A; Malekzadeh, R

2017-03-01

As a developing country, Iran is experiencing the increasing burden of cancers, which are currently the third leading cause of mortality in Iran. This study aims to demonstrate that cancer research in Iran concentrates on the cancer research priorities based on the global burden of disease (GBD) reports. Descriptive evaluation of all cancers disability-adjusted life years (DALYs) was performed using GBD data. Also a comprehensive search was conducted using cancer-associated keywords to obtain all cancer-related publications from Iran, indexed in Web of Science. Multiple regression analysis and correlation coefficients (R 2 ) were used to evaluate the possible associations between cancer research publications and GBD. During 1996-2014, the majority of cancer-related publications in Iran focused on breast cancer, leukaemia and stomach cancer, respectively. This study found hypothetical correlations between cancer publications in Iran in line with the burden of cancer as reported by GBD. Particularly, correlations between years lived with disability (YLD) and cancer-related publications were more obvious. This study introduces a new outline in setting cancer research priorities in the region. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Dealing with the financial burden of cancer: perspectives of older breast cancer survivors.

PubMed

Pisu, Maria; Martin, Michelle Y; Shewchuk, Richard; Meneses, Karen

2014-11-01

Financial burden among cancer survivors is often overlooked in survivorship care planning. Cancer survivors with limited incomes may be particularly affected. Yet, little data are available to address financial issues among them. Eliciting the survivors' perspectives on how to deal with this financial burden is a first crucial step to identifying the means to provide this supportive care. In this pilot study, three nominal group technique (NGT) sessions were conducted with a convenience sample of 23 older breast cancer survivors (age 52 to 83) recruited from a county safety net hospital and a Comprehensive Cancer Center. One single NGT question was posed in these sessions, namely "What could help women deal with the financial burden that cancer brings to them and their families?" Survivors responded in an iterative fashion and then ranked the most relevant responses. The most relevant responses addressed the (1) need for affordable insurance; (2) need to have prompt information on treatment costs patients will face, insurance coverage, and agencies or programs that provide needed products and services; and (3) need to access social workers, navigators, support groups, or others knowledgeable about available resources. Survivors also suggested that physicians become aware of cancer costs and financial issues faced by patients and consider costs in their treatment plans. Older survivors face financial challenges for which there are few available resources. They suggested several avenues to address cancer-related financial issues that may be considered in developing supportive interventions.

A comparison of cancer burden and research spending reveals discrepancies in the distribution of research funding

PubMed Central

2012-01-01

Background Ideally, the distribution of research funding for different types of cancer should be equitable with respect to the societal burden each type of cancer imposes. These burdens can be estimated in a variety of ways; “Years of Life Lost” (YLL) measures the severity of death in regard to the age it occurs, "Disability-Adjusted Life-Years" (DALY) estimates the effects of non-lethal disabilities incurred by disease and economic metrics focus on the losses to tax revenue, productivity or direct medical expenses. We compared research funding from the National Cancer Institute (NCI) to a variety of burden metrics for the most common types of cancer to identify mismatches between spending and societal burden. Methods Research funding levels were obtained from the NCI website and information for societal health and economic burdens were collected from government databases and published reports. We calculated the funding levels per unit burden for a wide range of different cancers and burden metrics and compared these values to identify discrepancies. Results Our analysis reveals a considerable mismatch between funding levels and burden. Some cancers are funded at levels far higher than their relative burden suggests (breast cancer, prostate cancer, and leukemia) while other cancers appear underfunded (bladder, esophageal, liver, oral, pancreatic, stomach, and uterine cancers). Conclusions These discrepancies indicate that an improved method of health care research funding allocation should be investigated to better match funding levels to societal burden. PMID:22800364

Occupational risks for nasal cancer in Sweden.

PubMed

Hemelt, Marjolein; Granström, Charlotta; Hemminki, Kari

2004-10-01

An elevated risk of nasal cancer (NC) has been associated with numerous occupations but with contradicting results. We sought to address recent and current risks of NC in a nationwide study. The nationwide Swedish Family-Cancer Database was used to calculate standardized incidence ratios (SIRs) for 52 occupational groups. SIRs were adjusted for age and socioeconomic status. Among 739 male cases, significantly elevated SIRs for nasal adenocarcinoma were observed in woodworkers, teachers, and fishermen. In woodworkers, the risk increased with a longer occupational history in exposure to softwood in combination with hardwood. Electrical workers had a significant elevated risk for squamous cell carcinoma. Among 182 female cases, significantly elevated SIRs were observed in glass, ceramic, and tile workers. The study identified some known risk occupations and suggested some new ones.

[Occupational factors influencing lung cancer in women in epidemiological studies].

PubMed

Swiatkowska, Beata

2011-01-01

Lung cancer is the most common cancer in men, although the alarming statistics of recent years indicate that this pathology affects also more likely a group of women and in recent years has become the leading cause of cancer deaths among Polish women. This article presents the main issues relating to occupational determinants of lung cancer in women. The results of the analysis show that the number of neoplastic diseases, including the lung cancer, recognized as an occupational disease in Poland is low, particularly among women. A major factor hampering the certification of occupational etiology of lung cancer is a long latency period, no differences in terms of the clinical and morphological characteristics from lung cancer occurring in the general population, and relatively small number of identified occupational carcinogens. Analysis of the available literature on the adverse workplace conditions shows that only a few epidemiological studies focus on the problem of job-related risk among women, and only some of them provide detailed results for lung cancer. Moreover, the abundant literature on the subject concerning the male workers might not be fully relevant because of possible differences in hormonal, genetic and other gender-related biological differences that may significantly modify the risk of cancer in women. These aspects cause that the true contribution of occupational factors to the risk of lung cancer, particularly in women, is underestimated.

Occupational risk factors for female breast cancer: a review.

PubMed Central

Goldberg, M S; Labrèche, F

1996-01-01

OBJECTIVES: Although progress has been made in identifying personal risk factors and in improving treatment for female breast cancer, incidence rates continue to increase. With women now occupying a sizable fraction of the workforce, it is worth inquiring whether there are occupational risk factors for breast cancer. This is a review of occupational studies on female breast cancer. METHODS: Suitable reports and published articles with associations of female breast cancer and occupation were identified from technical reports, by searching the MEDLINE bibliographic data base, and by reviewing each paper on cancer that was published in 20 major journals during the period from about 1971-94. RESULTS: A total of 115 studies were identified; 19 studies relied exclusively on data collected for administrative purposes, and there were four incident case-control studies and 92 cohort studies. Although data for individual industries, occupations, and exposures were sparse, there was limited evidence of an association with employment in the pharmaceutical industry and among cosmetologists and beauticians. Associations were also found for chemists and occupations with possible exposure to extremely low frequency electromagnetic fields, but potential methodological weaknesses preclude drawing any definite conclusions. There was little support for increased risks among textiles workers, dry cleaning workers, and nuclear industry workers. CONCLUSIONS: Few high quality occupational studies directed specifically toward women have been carried out to allow the unambiguous identification of occupational risk factors for breast cancer. It is suggested that investigations that account for non-occupational risk factors and that assess exposure in a more detailed way be carried out. One strategy already suggested is to conduct population based, case-control studies in which subjects are interviewed about their occupational histories and exposure to chemical and physical agents which are

Occupation and gastric cancer in Spain.

PubMed

González, C A; Sanz, M; Marcos, G; Pita, S; Brullet, E; Vida, F; Agudo, A; Hsieh, C C

1991-08-01

The association between occupational exposure and stomach cancer was investigated in a multicenter case-referent study conducted in Spain on 354 histologically confirmed cases and 354 hospital referents, matched by age, gender, and residence. An increased risk of gastric cancer was found for coal mining workers [odds ratio (OR) 11.8], but the number of workers was small, and therefore the 95% confidence interval (95% CI) was wide (95% CI 1.36-103). An increased risk was observed for wood and furniture workers (OR 1.76), construction workers (OR 1.68), and glass and ceramic workers (OR 2.18), but none of these risks were statistically significant. According to an occupation-exposure linkage system an increased risk was found for occupations associated with exposure to silica and mineral dust (OR 1.80, 95% CI 0.90-3.59). All of the OR estimates were adjusted for the confounding factors socioprofessional status and dietary habits. The possibility of a causal association between stomach cancer and coal and mineral dust is supported by the results.

The clinical and economic burden of a sustained increase in thyroid cancer incidence.

PubMed

Aschebrook-Kilfoy, Briseis; Schechter, Rebecca B; Shih, Ya-Chen Tina; Kaplan, Edwin L; Chiu, Brian C-H; Angelos, Peter; Grogan, Raymon H

2013-07-01

Thyroid cancer incidence is increasing worldwide at an alarming rate, yet little is known of the impact this increase will have on society. We sought to determine the clinical and economic burden of a sustained increase in thyroid cancer incidence in the United States and to understand how these burdens correlate with the National Cancer Institute's (NCI) prioritization of thyroid cancer research funding. We used the NCI's SEER 13 database (1992-2009) and Joinpoint regression software to identify the current clinical burden of thyroid cancer and to project future incidence through 2019. We combined Medicare reimbursement rates with American Thyroid Association guidelines, and our clinical practice to create an economic model of thyroid cancer. We obtained research-funding data from the NCI's Office of Budget and Finance. RESULTS; By 2019, papillary thyroid cancer will double in incidence and become the third most common cancer in women of all ages at a cost of $18 to $21 billion dollars in the United States. Despite these substantial clinical and economic burdens, thyroid cancer research remains significantly underfunded by comparison, and in 2009 received only $14.7 million (ranked 30th) from the NCI. The impact of thyroid cancer on society has been significantly underappreciated, as is evidenced by its low priority in national research funding levels. Increased awareness in the medical community and the general public of the societal burden of thyroid cancer, and substantial increases in research on thyroid cancer etiology, prevention, and treatment are needed to offset these growing concerns.

Higher-Status Occupations and Breast Cancer: A Life-Course Stress Approach

PubMed Central

Pudrovska, Tetyana; Carr, Deborah; McFarland, Michael; Collins, Caitlyn

2013-01-01

Using the 1957-2011 data from 3,682 White non-Hispanic women (297 incident breast cancer cases) in the Wisconsin Longitudinal Study, United States, we explore the effect of occupation in 1975 (at age 36) on breast cancer incidence up to age 72. Our study is motivated by the paradoxical association between higher-status occupations and elevated breast cancer risk, which presents a challenge to the consistent health advantage of higher social class. We found that women in professional occupations had 72%-122% and women in managerial occupations had 57%-89% higher risk of a breast cancer diagnosis than housewives and women in lower-status occupations. We explored an estrogen-related pathway (reproductive history, health behaviors, and life-course estrogen cycle) as well as a social stress pathway (occupational experiences) as potential explanations for the effect of higher-status occupations. The elevated risk of breast cancer among professional women was partly explained by estrogen-related variables but remained large and statistically significant. The association between managerial occupations and breast cancer incidence was fully explained by job authority defined as control over others’ work. Exercising job authority was related to higher breast cancer risk (HR = 1.57, 95% CI: 1.12, 2.18), especially with longer duration of holding the professional/managerial job. We suggest that the assertion of job authority by women in the 1970s involved stressful interpersonal experiences that may have promoted breast cancer development via prolonged dysregulation of the glucocorticoid system and exposure of the breast tissue to adverse effects of chronically elevated cortisol. Our study emphasizes complex biosocial pathways through which women’s gendered occupational experiences become embodied and drive forward physiological repercussions. PMID:23726216

Lost productivity and burden of illness in cancer survivors with and without other chronic conditions.

PubMed

Dowling, Emily C; Chawla, Neetu; Forsythe, Laura P; de Moor, Janet; McNeel, Timothy; Rozjabek, Heather M; Ekwueme, Donatus U; Yabroff, K Robin

2013-09-15

Cancer survivors may experience long-term and late effects from treatment that adversely affect health and limit functioning. Few studies examine lost productivity and disease burden in cancer survivors compared with individuals who have other chronic conditions or by cancer type. We identified 4960 cancer survivors and 64,431 other individuals from the 2008-2010 Medical Expenditure Panel Survey and compared multiple measures of disease burden, including health status and lost productivity, between conditions and by cancer site for cancer survivors. All analyses controlled for the effects of age, sex, race/ethnicity, and number of comorbid conditions. Overall, in adjusted analyses in multiple models, cancer survivors with another chronic disease (heart disease or diabetes) experienced higher levels of burden compared with individuals with a history of cancer only, chronic disease only, and neither cancer, heart disease, nor diabetes across multiple measures (P < .05). Among cancer survivors, individuals with short survival cancers and multiple cancers consistently had the highest levels of burden across multiple measures (P < .0001). Cancer survivors who have another chronic disease experience more limitations and higher levels of burden across multiple measures. Limitations are particularly severe in cancer survivors with short survival cancer and multiple cancers. © 2013 American Cancer Society.

Lost Productivity and Burden of Illness in Cancer Survivors With and Without Other Chronic Conditions

PubMed Central

Dowling, Emily C.; Chawla, Neetu; Forsythe, Laura P.; de Moor, Janet; McNeel, Timothy; Rozjabek, Heather M.; Ekwueme, Donatus U.; Yabroff, K. Robin

2018-01-01

BACKGROUND Cancer survivors may experience long-term and late effects from treatment that adversely affect health and limit functioning. Few studies examine lost productivity and disease burden in cancer survivors compared with individuals who have other chronic conditions or by cancer type. METHODS We identified 4960 cancer survivors and 64,431 other individuals from the 2008–2010 Medical Expenditure Panel Survey and compared multiple measures of disease burden, including health status and lost productivity, between conditions and by cancer site for cancer survivors. All analyses controlled for the effects of age, sex, race/ethnicity, and number of comorbid conditions. RESULTS Overall, in adjusted analyses in multiple models, cancer survivors with another chronic disease (heart disease or diabetes) experienced higher levels of burden compared with individuals with a history of cancer only, chronic disease only, and neither cancer, heart disease, nor diabetes across multiple measures (P <.05). Among cancer survivors, individuals with short survival cancers and multiple cancers consistently had the highest levels of burden across multiple measures (P <.0001). CONCLUSIONS Cancer survivors who have another chronic disease experience more limitations and higher levels of burden across multiple measures. Limitations are particularly severe in cancer survivors with short survival cancer and multiple cancers. PMID:23794146

Setting a health policy research agenda for controlling cancer burden in Korea.

PubMed

Jang, Sung-In; Cho, Kyoung-Hee; Kim, Sun Jung; Lee, Kwang-Sig; Park, Eun-Cheol

2015-04-01

The aim of study was to provide suggestions for prioritizing research in effort to reduce cancer burden in Korea based on a comprehensive analysis of cancer burden and Delphi consensus among cancer experts. Twenty research plans covering 10 topics were selected based on an assessment of the literature, and e-mail surveys were analyzed using a two-round modified Delphi method. Thirty-four out of 79 experts were selected from four organizations to participate in round one, and 21 experts among them had completed round two. Each item had two questions; one regarding the agreement of the topic as a priority item to reduce cancer burden, and the other about the importance of the item on a nine-point scale. A consensus was defined to be an average lower coefficient of variation with less than 30% in importance. Seven plans that satisfied the three criteria were selected as priority research plans for reducing cancer burden. These plans are "research into advanced clinical guidelines for thyroid cancer given the current issue with over-diagnosis," "research into smoking management plans through price and non-price cigarette policy initiatives," "research into ways to measure the quality of cancer care," "research on policy development to expand hospice care," "research into the spread and management of Helicobacter pylori," "research on palliative care in a clinical setting," and "research into alternative mammography methods to increase the accuracy of breast cancer screenings." The seven plans identified in this study should be prioritized to reduce the burden of cancer in Korea. We suggest that policy makers and administrators study and invest significant effort in these plans.

Geography and the burden of care in pediatric cancers.

PubMed

Fluchel, Mark N; Kirchhoff, Anne C; Bodson, Julia; Sweeney, Carol; Edwards, Sandra L; Ding, Qian; Stoddard, Gregory J; Kinney, Anita Y

2014-11-01

Childhood cancers typically require rigorous treatment at specialized centers in urban areas, which can create substantial challenges for families residing in remote communities. We evaluated the impact of residence and travel time on the burden of care for families of childhood cancer patients. We conducted a cross-sectional, self-administered survey of 354 caregivers of pediatric cancer patients at a children's hospital serving a seven state area. Measures included the impact of cancer treatment on relocation, employment, schooling, and finances. We evaluated these domains by rural/urban residence and travel time (>1 hour and >2 hours) to the hospital in multivariable regression models. Of the 29% of caregivers who reported moving residences as their child was diagnosed, 33% reported that the move was due to their child's cancer. Rural and remote (e.g., >1 hour travel time) caregivers missed more days of work during the first month after diagnosis than did urban and local caregivers, however, these differences did not persist over the first 6 months of therapy. One-third of caregivers reported quitting or changing jobs as a direct result of their child being diagnosed with cancer. Rural respondents had greater out-of-pocket travel expenses and reported a significantly greater perceived financial burden. Rural patients missed more school days and were at an increased risk of having to repeat a grade. Childhood cancer has an appreciable impact on the lives of patients and caregivers. The burden is greater for those living far from a treatment center. © 2014 Wiley Periodicals, Inc.

Epidemiologic characteristics of compensated occupational lung cancers among Korean workers.

PubMed

Ahn, Yeon-Soon; Jeong, Kyoung Sook

2014-11-01

An understanding of the characteristics of occupational lung cancer is important to establish policies that prevent carcinogen exposure and to compensate workers exposed to lung carcinogens. This study analyzed the characteristics of occupational lung cancers in workers who were compensated under the Industrial Accident Compensation Insurance Law between 1994 and 2011. A total of 179 occupational lung cancers were compensated. The main carcinogenic exposure was asbestos, followed by crystalline silica and hexavalent chromium. The mean exposure duration and latency were 19.8 and 23.2 yr. The most common industry was manufacturing, followed by construction and transportation. The most common occupation was maintenance and repair, followed by foundry work, welding, painting, and spinning or weaving. Although asbestos was predominant carcinogen, the proportion of these cases was relatively low compared to other developed countries. Proper surveillance system is needed to monitor occupational lung cancer and improve prevention measures.

The growing burden of cancer in India: epidemiology and social context.

PubMed

Mallath, Mohandas K; Taylor, David G; Badwe, Rajendra A; Rath, Goura K; Shanta, V; Pramesh, C S; Digumarti, Raghunadharao; Sebastian, Paul; Borthakur, Bibhuti B; Kalwar, Ashok; Kapoor, Sanjay; Kumar, Shaleen; Gill, Jennifer L; Kuriakose, Moni A; Malhotra, Hemant; Sharma, Suresh C; Shukla, Shilin; Viswanath, Lokesh; Chacko, Raju T; Pautu, Jeremy L; Reddy, Kenipakapatnam S; Sharma, Kailash S; Purushotham, Arnie D; Sullivan, Richard

2014-05-01

Cancer can have profound social and economic consequences for people in India, often leading to family impoverishment and societal inequity. Reported age-adjusted incidence rates for cancer are still quite low in the demographically young country. Slightly more than 1 million new cases of cancer are diagnosed every year in a population of 1.2 billion. In age-adjusted terms this represents a combined male and female incidence of about a quarter of that recorded in western Europe. However, an estimated 600,000-700,000 deaths in India were caused by cancer in 2012. In age-standardised terms this figure is close to the mortality burden seen in high-income countries. Such figures are partly indicative of low rates of early-stage detection and poor treatment outcomes. Many cancer cases in India are associated with tobacco use, infections, and other avoidable causes. Social factors, especially inequalities, are major determinants of India's cancer burden, with poorer people more likely to die from cancer before the age of 70 years than those who are more affluent. In this first of three papers, we examine the complex epidemiology of cancer, the future burden, and the dominant sociopolitical themes relating to cancer in India. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Occupational hazards and bladder cancer].

PubMed

Nizamova, R S

1991-01-01

Occupational exposure to health hazards was studied in 258 industrial workers who had developed cancer of the bladder against 454 matched controls. All the test subjects and controls were residents of the Tambov Province centers of chemical industry. Statistical significance (relative risk-4.7) was established for exposure to aromatic amines. For those contacting with aniline dyes the relative risk (RR) made up 2.4. The risk to develop bladder cancer in powder shops (RR-3.2) was attributed to the hazards of dyes and diphenylamine. In leather-shoe and textile industry the exposure to dyes was not safe (RR-6.1), neither was it to chemicals, oil products, pesticides, overheating (RR-3.2, 1.6, 3.2 and 2.9, respectively). It is stated that in line with a significant risk to develop bladder cancer at exposure to aromatic amines there exist a number of occupational factors contributing to this risk.

Dealing with the financial burden of cancer: perspectives of older breast cancer survivors

PubMed Central

Pisu, Maria; Martin, Michelle Y.; Shewchuk, Richard; Meneses, Karen

2014-01-01

Purpose Financial burden among cancer survivors is often overlooked in survivorship care planning. Cancer survivors with limited incomes may be particularly affected. Yet, little data are available to address financial issues among them. Eliciting the survivors’ perspectives on how to deal with this financial burden is a first crucial step to identifying the means to provide this supportive care. Methods In this pilot study, three Nominal Group Technique (NGT) sessions were conducted with a convenience sample of 23 older breast cancer survivors (age 52 to 83) recruited from a county safety net hospital and a Comprehensive Cancer Center. One single NGT question was posed in these sessions, namely “What could help women deal with the financial burden that cancer brings to them and their families?” Survivors responded in an iterative fashion and then ranked the most relevant responses. Results The most relevant responses addressed the: (1) need for affordable insurance; (2) need to have prompt information on treatment costs patients will face, insurance coverage, and agencies or programs that provide needed products and services; and (3) need to access social workers, navigators, support groups, or others knowledgeable about available resources. Survivors also suggested that physicians become aware of cancer costs and financial issues faced by patients, and consider costs in their treatment plans. Conclusions Older survivors face financial challenges for which there are few available resources. They suggested several avenues to address cancer-related financial issues that may be considered in developing supportive interventions. PMID:24912858

Occupational Therapy for Adults With Cancer: Why It Matters.

PubMed

Pergolotti, Mackenzi; Williams, Grant R; Campbell, Claudine; Munoz, Lauro A; Muss, Hyman B

2016-03-01

Adults with cancer may be at risk for limitations in functional status and quality of life (QOL). Occupational therapy is a supportive service with the specific mission to help people functionally engage in life as safely and independently as possible with the primary goal of improving QOL. Unfortunately, for people with cancer, occupational therapy remains underused. The overall purpose of this review is to provide an understanding of what occupational therapy is and its relevance to patients with cancer, highlight the reasons to refer, and, last, provide general advice on how to access services. ©AlphaMed Press.

The economic burden of cancer in Korea in 2009.

PubMed

Kim, So Young; Park, Jong-Hyock; Kang, Kyoung Hee; Hwang, Inuk; Yang, Hyung Kook; Won, Young-Joo; Seo, Hong-Gwan; Lee, Dukhyoung; Yoon, Seok-Jun

2015-01-01

Cancer imposes a significant economic burden on individuals, families and society. The purpose of this study was to estimate the economic burden of cancer using the healthcare claims and cancer registry data in Korea in 2009. The economic burden of cancer was estimated using the prevalence data where patients were identified in the Korean Central Cancer Registry. We estimated the medical, non-medical, morbidity and mortality cost due to lost productivity. Medical costs were calculated using the healthcare claims data obtained from the Korean National Health Insurance (KNHI) Corporation. Non-medical costs included the cost of transportation to visit health providers, costs associated with caregiving for cancer patients, and costs for complementary and alternative medicine (CAM). Data acquired from the Korean National Statistics Office and Ministry of Labor were used to calculate the life expectancy at the time of death, age- and gender-specific wages on average, adjusted for unemployment and labor force participation rate. Sensitivity analysis was performed to derive the current value of foregone future earnings due to premature death, discounted at 3% and 5%. In 2009, estimated total economic cost of cancer amounted to $17.3 billion at a 3% discount rate. Medical care accounted for 28.3% of total costs, followed by non-medical (17.2%), morbidity (24.2%) and mortality (30.3%) costs. Given that the direct medical cost sharply increased over the last decade, we must strive to construct a sustainable health care system that provides better care while lowering the cost. In addition, a comprehensive cancer survivorship policy aimed at lower caregiving cost and higher rate of return to work has become more important than previously considered.

Higher-status occupations and breast cancer: a life-course stress approach.

PubMed

Pudrovska, Tetyana; Carr, Deborah; McFarland, Michael; Collins, Caitlyn

2013-07-01

Using the 1957-2011 data from 3682 White non-Hispanic women (297 incident breast cancer cases) in the Wisconsin Longitudinal Study, United States, we explore the effect of occupation in 1975 (at age 36) on breast cancer incidence up to age 72. Our study is motivated by the paradoxical association between higher-status occupations and elevated breast cancer risk, which presents a challenge to the consistent health advantage of higher social class. We found that women in professional occupations had 72122% and women in managerial occupations had 57-89% higher risk of a breast cancer diagnosis than housewives and women in lower-status occupations. We explored an estrogen-related pathway (reproductive history, health behaviors, and life-course estrogen cycle) as well as a social stress pathway (occupational experiences) as potential explanations for the effect of higher-status occupations. The elevated risk of breast cancer among professional women was partly explained by estrogen-related variables but remained large and statistically significant. The association between managerial occupations and breast cancer incidence was fully explained by job authority defined as control over others' work. Exercising job authority was related to higher breast cancer risk (HR = 1.57, 95% CI: 1.12, 2.18), especially with longer duration of holding the professional/managerial job. We suggest that the assertion of job authority by women in the 1970s involved stressful interpersonal experiences that may have promoted breast cancer development via prolonged dysregulation of the glucocorticoid system and exposure of the breast tissue to adverse effects of chronically elevated cortisol. Our study emphasizes complex biosocial pathways through which women's gendered occupational experiences become embodied and drive forward physiological repercussions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Estimates of cancer burden in Abruzzo and Molise.

PubMed

Foschi, Roberto; Viviano, Lorena; Rossi, Silvia

2013-01-01

Abruzzo and Molise are two regions located in the south of Italy, currently without population-based cancer registries. The aim of this paper is to provide estimates of cancer incidence, mortality and prevalence for the Abruzzo and Molise regions combined. The MIAMOD method, a back-calculation approach to estimate and project the incidence of chronic diseases from mortality and patient survival, was used for the estimation of incidence and prevalence by calendar year (from 1970 to 2015) and age (from 0 to 99). The survival estimates are based on cancer registry data of southern Italy. The most frequently diagnosed cancers were those of the colon and rectum, breast and prostate, with 1,394, 1,341 and 698 new diagnosed cases, respectively, estimated in 2012. Incidence rates were estimated to increase constantly for female breast cancer, colorectal cancer in men and melanoma in both sexes. For prostate cancer and male lung cancer, the incidence rates increased, reaching a peak, and then decreased. In women the incidence of colorectal and lung cancer stabilized after an initial increase. For stomach and cervical cancers, the incidence rates showed a constant decrease. Prevalence was increasing for all the considered cancer sites with the exception of the cervix uteri. The highest prevalence values were estimated for breast and colorectal cancer with about 12,300 and over 8,200 cases in 2012, respectively. In the 2000s the mortality rates declined for all cancers except skin melanoma and female lung cancer, for which the mortality was almost stable. This paper provides a description of the burden of the major cancers in Abruzzo and Molise until 2015. The increase in cancer survival, added to population aging, will inflate the cancer prevalence. In order to better evaluate the cancer burden in the two regions, it would be important to implement cancer registration.

[Epidemiologic surveillance in occupational bladder cancer: a Tuscan experience].

PubMed

Cosentino, F; Arena, L; Banchini, L; Benvenuti, L; Calabretta, V M; Carnevali, C; Cristaudo, A; Farina, G; Foddis, R; Iaia, T E; Lemmi, M; Ottenga, F; Parrini, L; Piccini, G; Serretti, N; Talini, D

2007-01-01

The percentage of bladder cancer as occupational disease in West-Europe is of 5/10%, but only a few amount of them are recognized as occupational disease from INAIL. The above mentioned research project is realized in order to decrease the gap between expected and claimed cases of occupational disease and it is conducted with the collaboration of ASL of Pisa, ASL of Empoli, Azienda Ospedaliera Universitaria Pisana and INAIL. 677 patients with bladder cancer were interviewed by phone, among them 64 subjects had a working experience compatible with neoplastic risks because had a previous occupational exposure to aromatic amines and metal working fluids. These cases were discussed into a Medical Staff and 40 cases were considered "probable" for occupational disease, 18 "possible", 3 cases are suspended for more research, 3 cases are considered "no professional disease". The research allows finding out a great number of bladder cancer, increasing the total amount of workers with occupational disease. The integrated approach with the collaboration among different institutions is surely the best way to allow and guarantee a suitable and right protection of workers with occupational disease.

Testicular cancer in young men and parental occupational exposure.

PubMed

Kardaun, J W; Hayes, R B; Pottern, L M; Brown, L M; Hoover, R N

1991-01-01

To investigate whether parental occupation, especially during the 12 month period before birth, could be responsible for elevated rates of testicular cancer in young men, we used data from a case-control study of 223 cases and 212 controls conducted in the Washington, DC area. For all histologic types of testicular cancer combined, no significant associations were found for specific occupations, nor for the broad occupational categories of professional, other white collar, or blue collar workers. However, for cases with seminomas, excess risks were seen for those with parents employed in the following occupations: mothers in health-related occupations, O.R. = 4.6 (1.1-19.1), and fathers working in automobile service stations, O.R. = 4.0 (0.6-24.5), manufacturing industries, O.R. = 2.2 (1.0-4.2), and aircraft production and maintenance, O.R. = 5.3 (0.7-24.1). Although these findings for seminoma are intriguing, they do not explain the increase of testicular cancer in young men.

Parental occupation and childhood cancer: review of epidemiologic studies.

PubMed Central

Savitz, D A; Chen, J H

1990-01-01

Parental occupational exposures might affect childhood cancer in the offspring through genetic changes in the ovum or sperm or through transplacental carcinogenesis. The 24 published epidemiologic studies of this association have all used case-control designs, with controls generally selected from birth certificates or from general population sampling. Occupational exposures were inferred from job titles on birth certificates or through interviews. A large number of occupation-cancer associations have been reported, many of which were not addressed or not confirmed in other studies. Several associations have been found with consistency: paternal exposures in hydrocarbon-associated occupations, the petroleum and chemical industries, and especially paint exposures have been associated with brain cancer; paint exposures have also been linked to leukemias. Maternal exposures have received much less attention, but studies have yielded strongly suggestive results linking a variety of occupational exposures to leukemia and brain cancer. The primary limitations in this literature are the inaccuracy inherent in assigning exposure based on job title alone and imprecision due to limited study size. Although no etiologic associations have been firmly established by these studies, the public health concerns and suggestive data warrant continued research. PMID:2272330

[UV-irradiation-induced skin cancer as a new occupational disease].

PubMed

Diepgen, T L; Drexler, H; Elsner, P; Schmitt, J

2015-03-01

With the revision of the German Ordinance on Occupational Diseases, skin cancer due to UV irradiation was amended as a new occupational disease to the list of occupational diseases in Germany. The new occupational disease BK 5103 has the following wording: "Squamous cell carcinoma or multiple actinic keratosis of the skin caused by natural UV irradiation". Actinic keratoses are to be considered as multiple according to this new occupational diseases if they occur as single lesions of more than five annually, or are confluent in an area > 4 cm(2) (field cancerization). It is estimated that more than 2.5 million employees are exposed to natural UV irradiation due to their work (outdoor workers) in Germany and therefore have an increased risk of skin cancer. In this article the medical and technical prerequisites which have to be fulfilled for this new occupational disease in Germany are introduced.

European Code against Cancer 4th Edition: Environment, occupation and cancer.

PubMed

Espina, Carolina; Straif, Kurt; Friis, Søren; Kogevinas, Manolis; Saracci, Rodolfo; Vainio, Harri; Schüz, Joachim

2015-12-01

People are exposed throughout life to a wide range of environmental and occupational pollutants from different sources at home, in the workplace or in the general environment - exposures that normally cannot be directly controlled by the individual. Several chemicals, metals, dusts, fibres, and occupations have been established to be causally associated with an increased risk of specific cancers, such as cancers of the lung, skin and urinary bladder, and mesothelioma. Significant amounts of air pollutants - mainly from road transport and industry - continue to be emitted in the European Union (EU); an increased occurrence of lung cancer has been attributed to air pollution even in areas below the EU limits for daily air pollution. Additionally, a wide range of pesticides as well as industrial and household chemicals may lead to widespread human exposure, mainly through food and water. For most environmental pollutants, the most effective measures are regulations and community actions aimed at reducing and eliminating the exposures. Thus, it is imperative to raise awareness about environmental and occupational carcinogens in order to motivate individuals to be proactive in advocating protection and supporting initiatives aimed at reducing pollution. Regulations are not homogeneous across EU countries, and protective measures in the workplace are not used consistently by all workers all the time; compliance with regulations needs to be continuously monitored and enforced. Therefore, the recommendation on Environment and Occupation of the 4th edition of the European Code against Cancer, focusing on what individuals can do to reduce their cancer risk, reads: "In the workplace, protect yourself against cancer-causing substances by following health and safety instructions." Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd. All rights reserved.

Annual Economic Burden of Productivity Losses Among Adult Survivors of Childhood Cancers.

PubMed

Guy, Gery P; Berkowitz, Zahava; Ekwueme, Donatus U; Rim, Sun Hee; Yabroff, K Robin

2016-11-01

Although adult survivors of childhood cancers have poorer health and greater health limitations than other adults, substantial gaps remain in understanding the economic consequences of surviving childhood cancer. Therefore, we estimated the economic burden of productivity losses among adult survivors of childhood cancers. We examined health status, functional limitations, and productivity loss among adult survivors of childhood cancers (n = 239) diagnosed at ≤14 years of age compared with adults without a history of cancer (n = 304 265) by using the 2004-2014 National Health Interview Survey. We estimated economic burden using the productivity loss from health-related unemployment, missed work days, missed household productivity, and multivariable regression models controlling for age, sex, race/ethnicity, education, comorbidities, and survey year. Childhood cancer survivorship is associated with a substantial economic burden. Adult survivors of childhood cancers are more likely to be in poorer health, need assistance with personal care and routine needs, have work limitations, be unable to work because of health, miss more days of work, and have greater household productivity loss compared with adults without a history of cancer (all P < .05). The annual productivity loss for adult survivors of childhood cancer is $8169 per person compared with $3083 per person for individuals without a history of cancer. These findings underscore the importance of efforts to reduce the health and economic burden among adult survivors of childhood cancer. In addition, this study highlights the potential productivity losses that could be avoided during adulthood from the prevention of childhood cancer in the United States. Copyright © 2016 by the American Academy of Pediatrics.

[Lung Cancer as an Occupational Disease].

PubMed

Baur, X; Woitowitz, H-J

2016-08-01

Lung cancer is one of the most frequently encountered cancer types. According to the latest WHO data, about 10 % of this disease are due to occupational exposure to cancerogens. Asbestos is still the number one carcinogen. Further frequent causes include quarz and ionizing radiation (uranium mining). Probable causes of the disease can be identified only with the help of detailed occupational history taken by a medical specialist and qualified exposure assessment. Without clarifying the cause of the disease, there is neither a correct insurance procedure nor compensation for the victim, and furthermore, required preventive measures cannot be initiated. © Georg Thieme Verlag KG Stuttgart · New York.

Lung Cancer and Occupation in a Population-based Case-Control Study

PubMed Central

Consonni, Dario; De Matteis, Sara; Lubin, Jay H.; Wacholder, Sholom; Tucker, Margaret; Pesatori, Angela Cecilia; Caporaso, Neil E.; Bertazzi, Pier Alberto; Landi, Maria Teresa

2010-01-01

The authors examined the relation between occupation and lung cancer in the large, population-based Environment And Genetics in Lung cancer Etiology (EAGLE) case-control study. In 2002–2005 in the Lombardy region of northern Italy, 2,100 incident lung cancer cases and 2,120 randomly selected population controls were enrolled. Lifetime occupational histories (industry and job title) were coded by using standard international classifications and were translated into occupations known (list A) or suspected (list B) to be associated with lung cancer. Smoking-adjusted odds ratios and 95% confidence intervals were calculated with logistic regression. For men, an increased risk was found for list A (177 exposed cases and 100 controls; odds ratio = 1.74, 95% confidence interval: 1.27, 2.38) and most occupations therein. No overall excess was found for list B with the exception of filling station attendants and bus and truck drivers (men) and launderers and dry cleaners (women). The authors estimated that 4.9% (95% confidence interval: 2.0, 7.8) of lung cancers in men were attributable to occupation. Among those in other occupations, risk excesses were found for metal workers, barbers and hairdressers, and other motor vehicle drivers. These results indicate that past exposure to occupational carcinogens remains an important determinant of lung cancer occurrence. PMID:20047975

Prevention and Early Detection of Occupational Cancers - a View of Information Technology Solutions.

PubMed

Davoodi, Somayeh; Safdari, Reza; Ghazisaeidi, Marjan; Mohammadzadeh, Zeinab; Azadmanjir, Zahra

2015-01-01

Thousands of people die each year from cancer due to occupational causes. To reduce cancer in workers, preventive strategies should be used in the high-risk workplace. The effective prevention of occupational cancer requires knowledge of carcinogen agents. Like other areas of healthcare industry, occupational health has been affected by information technology solutions to improve prevention, early detection, treatment and finally the efficiency and cost effectiveness of the healthcare system. Information technology solutions are thus an important issue in the healthcare field. Information about occupational cancer in information systems is important for policy makers, managers, physicians, patients and researchers; because examples that include high quality data about occupational cancer patients and occupational cancer causes are able to determine the worker groups which require special attention. As a result exposed workers who are vulnerable can undergo screening and be considered for preventive interventions.

The Burden of Cancer in Korea during 2012: Findings from a Prevalence-Based Approach.

PubMed

Gong, Young Hoon; Yoon, Seok Jun; Jo, Min Woo; Kim, Arim; Kim, Young Ae; Yoon, Jihyun; Seo, Hyeyoung; Kim, Dongwoo

2016-11-01

Cancer causes a significant deterioration in health and premature death and is a national socioeconomic burden. This study aimed to measure the burden of cancer using the disability-adjusted life year (DALY) metric based on the newly adopted methodology from the Global Burden of Disease Study in 2010. This study was conducted based on data from the Korean National Cancer Registry. The DALYs were calculated using a prevalence-based method instead of the incidence-based method used by previous studies. The total burden of cancer in 2012 was 3,470.79 DALYs per 100,000 persons. Lung cancer was the most prevalent cancer burden, followed by liver, stomach, colorectal, and breast cancer. The DALYs for lung, liver, stomach, colon and rectum, and pancreatic cancer were high in men, whereas the DALYs for breast, lung, stomach, colorectal, and liver cancer were high in women. Health loss from leukemia and cancer of the brain and nervous system was prevalent for those younger than age 20; from stomach, breast, and liver for those aged 30-50; and from lung, colon and rectum, and pancreas for a large proportion of individuals over the age of 60. The most important differences were that the DALYs were calculated by prevalence and that other components of the DALYs were measured by a population-based perspective. Thus, prevalence-based DALYs could provide more suitable data for decision making in the healthcare field.

Family caregiver burden: the burden of caring for lung cancer patients according to the cancer stage and patient quality of life.

PubMed

Borges, Eliana Lourenço; Franceschini, Juliana; Costa, Luiza Helena Degani; Fernandes, Ana Luisa Godoy; Jamnik, Sérgio; Santoro, Ilka Lopes

2017-01-01

Patients with lung cancer experience different feelings and reactions, based on their family, social, cultural, and religious backgrounds, which are a source of great distress, not only for the patients but also for their family caregivers. This study aimed to evaluate the impact that lung cancer stage and quality of life (QoL) of lung cancer patients have on caregiver burden. This was a prospective cross-sectional study. Consecutive patient-caregiver dyads were selected and asked to complete the Hospital Anxiety and Depression Scale and the Medical Outcomes Study 36-item ShortForm Health Survey (SF-36). Family caregivers also completed the Caregiver Burden Scale. Group-based modeling was used in order to identify patients with early- or advanced-stage cancer (IA to IIIA vs. IIIB to IV) plus non-impaired or impaired QoL (SF36 total score > 50 vs. ≤ 50). Patient-caregiver dyads were stratified into four groups: early-stage cancer+non-impaired QoL; advanced-stage cancer+non-impaired QoL; early-stage cancer+impaired QoL; and advanced-stage cancer+impaired QoL. We included 91 patient-caregiver dyads. The majority of the patients were male and heavy smokers. Family caregivers were younger and predominantly female. The burden, QoL, level of anxiety, and level of depression of caregivers were more affected by the QoL of the patients than by their lung cancer stage. The family caregivers of the patients with impaired QoL showed a higher median burden than did those of the patients with non-impaired QoL, regardless of disease stage. Caregiver burden is more affected by patient QoL than by lung cancer stage. Pacientes com câncer de pulmão vivenciam diferentes sentimentos e reações, dependendo de sua formação familiar, social, cultural e religiosa, que são fonte de grande sofrimento, não só para os pacientes mas também para seus cuidadores familiares. Este estudo objetivou avaliar o impacto do estágio do câncer de pulmão e da qualidade de vida (QV) dos

Occupational Therapy's Role in Cancer Survivorship as a Chronic Condition.

PubMed

Baxter, Mary Frances; Newman, Robin; Longpré, Sheila M; Polo, Katie M

Improved medical care has resulted in a documented increase in cancer survivors in the United States. Cancer survivors face challenges in participation across all facets of life as a result of the cancer and subsequent cancer treatments. Long-term and late-term sequelae can result in impairments in neurological systems, decreased stamina, loss of range of motion, and changes in sensation and cognition. These impairments are often long lasting, which categorizes cancer survivorship as a chronic condition. This categorization presents treatment challenges, especially in creating rehabilitation and habilitation service options that support cancer survivors. Occupational therapy provides a unique focus that can benefit cancer survivors as they face limitations in participation in all aspects of daily living. Research, advocacy, and education efforts are needed to focus on the specific rehabilitation and habilitation needs of cancer survivors to increase access to occupational therapy's distinct value. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Managing occupations in everyday life for people with advanced cancer living at home.

PubMed

Peoples, Hanne; Brandt, Åse; Wæhrens, Eva E; la Cour, Karen

2017-01-01

People with advanced cancer are able to live for extended periods of time. Advanced cancer can cause functional limitations influencing the ability to manage occupations. Although studies have shown that people with advanced cancer experience occupational difficulties, there is only limited research that specifically explores how these occupational difficulties are managed. To describe and explore how people with advanced cancer manage occupations when living at home. A sub-sample of 73 participants from a larger occupational therapy project took part in the study. The participants were consecutively recruited from a Danish university hospital. Qualitative interviews were performed at the homes of the participants. Content analysis was applied to the data. Managing occupations were manifested in two main categories; (1) Conditions influencing occupations in everyday life and (2) Self-developed strategies to manage occupations. The findings suggest that people with advanced cancer should be supported to a greater extent in finding ways to manage familiar as well as new and more personally meaningful occupations to enhance quality of life.

Is the societal burden of fatal occupational injury different among NORA industry sectors?

PubMed

Biddle, Elyce Anne

2013-02-01

Since the implementation of the Occupational Safety and Health Act, safety and health in the work environment has seen marked improvement. Although these improvements are laudable, workplace hazards continue to plague the American worker. Understanding the economic burden of fatalities by industry sector is important to setting broad occupational safety and health research priorities. Cost estimates provide additional information about how fatal injuries affect society and hence can improve injury prevention program planning, policy analysis, evaluation, and advocacy. This study estimated the total, mean, and median societal costs by worker and case characteristic in 2003-2006 for the industry sectors identified in the National Institute for Occupational Safety and Health National Occupational Research Agenda (NORA). Analyses were conducted with restricted access to the Bureau of Labor Statistics Census of Fatal Occupational Injuries data. These data exclude military personnel, decedents with unknown age or sex, and fatalities occurring in New York City. Societal costs were estimated using the cost-of-illness approach, which combines direct and indirect costs to yield an overall cost of an fatal occupational injury. During this period, the cost of the 22,197 fatal occupational injuries exceeded $21 billion. The mean and median costs of these fatalities were $960,000 and $944,000 respectively. Total societal costs by NORA sector ranged from a high of $5.8 billion in Services to a low of $530 million in Healthcare and Social Assistance with mean costs ranging from the nearly $800,000 in Agriculture, Forestry, and Fishing to almost $1.1 million in Mining. The societal costs-total, mean, and median costs-of case and worker characteristics for occupational fatal injuries varied within each NORA sector. To have the greatest societal impact, these costs can be used to target resources for public and private sector research by industry. Published by Elsevier Ltd.

Is the Societal burden of fatal occupational injury different among NORA industry sectors?

PubMed Central

Biddle, Elyce Anne

2015-01-01

Problem Since the implementation of the Occupational Safety and Health Act, safety and health in the work environment has seen marked improvement. Although these improvements are laudable, workplace hazards continue to plague the American worker. Understanding the economic burden of fatalities by industry sector is important to setting broad occupational safety and health research priorities. Cost estimates provide additional information about how fatal injuries affect society and hence can improve injury prevention program planning, policy analysis, evaluation, and advocacy. Method This study estimated the total, mean, and median societal costs by worker and case characteristic in 2003–2006 for the industry sectors identified in the National Institute for Occupational Safety and Health National Occupational Research Agenda (NORA). Analyses were conducted with restricted access to the Bureau of Labor Statistics Census of Fatal Occupational Injuries data. These data exclude military personnel, decedents with unknown age or sex, and fatalities occurring in New York City. Societal costs were estimated using the cost-of-illness approach, which combines direct and indirect costs to yield an overall cost of an fatal occupational injury. Results During this period, the cost of the 22,197 fatal occupational injuries exceeded $21 billion. The mean and median costs of these fatalities were $960,000 and $944,000 respectively. Total societal costs by NORA sector ranged from a high of $5.8 billion in Services to a low of $530 million in Healthcare and Social Assistance with mean costs ranging from the nearly $800,000 in Agriculture, Forestry, and Fishing to almost $1.1 million in Mining. Discussion The societal costs—total, mean, and median costs—of case and worker characteristics for occupational fatal injuries varied within each NORA sector. Impact on Industry To have the greatest societal impact, these costs can be used to target resources for public and private sector

Relationships between family resilience and posttraumatic growth in breast cancer survivors and caregiver burden.

PubMed

Liu, Ye; Li, Yuli; Chen, Lijun; Li, Yurong; Qi, Weiye; Yu, Li

2018-04-01

To examine the relationships between family resilience and posttraumatic growth (PTG) of breast cancer survivors and caregiver burden among principal caregivers in China. Participants in this cross-sectional study comprised 108 women aged 26 to 74 years (M = 49, SD = 9) with early-stage breast cancer and 108 principal caregivers. Participants were recruited from a comprehensive cancer center of a public hospital in Shandong Province, China. The principal caregivers completed the Shortened Chinese Version of the Family Resilience Assessment Scale and the Chinese Version of the Zarit Caregiver Burden Interview; patients completed the Short Form of the Posttraumatic Growth Inventory and questions designed to obtain sociodemographic information. Hierarchical regression analysis was conducted to assess the adjusted association between family resilience and PTG and caregiver burden, while controlling for sociodemographics. Families showed a slightly elevated level of family resilience since the cancer experience, and patients showed a moderate degree of PTG. Principal caregivers reported moderate burden. The Shortened Chinese Version of the Family Resilience Assessment Scale total score was positively related to the Short Form of the Posttraumatic Growth Inventory total score (β = .28, P < .01) and was negatively related to Zarit Caregiver Burden Interview total score (β = -.28, P < .01). Family resilience impacts PTG of breast cancer survivors and caregiver burden. Our findings indicated the necessity of interventions to facilitate family resilience, promote PTG among breast cancer survivors, and decrease family members' caregiver burden. Copyright © 2018 John Wiley & Sons, Ltd.

Occupations and breast cancer risk among Chinese women in urban Shanghai.

PubMed

Gardner, Kathleen M; Ou Shu, Xiao; Jin, Fan; Dai, Qi; Ruan, Zhixian; Thompson, Shirley J; Hussey, James R; Gao, Yu Tang; Zheng, Wei

2002-10-01

Although, an elevated risk of breast cancer has been suggested for a number of occupations, many earlier studies were limited by selection biases, the incomplete assessment of job histories, and the inability to control for confounding. We examined the relationship between occupational history and breast cancer risk using data from a population-based case-control study of 1,458 cases and 1,556 age-matched controls (90% response rate) conducted in Shanghai, China. Unconditional logistic regression models were used to derive odds ratios (ORs) and 95% confidence intervals (95% CIs) of breast cancer risk associated with occupations and duration of employment adjusting for non-occupational risk factors. The following occupations were found to be associated with an increased risk of breast cancer: laboratory technicians (OR 9.94, 95% CI 1.20-82.37), telephone and telegraph operators (OR 4.63, 95% CI 1.85-11.59), leather and fur processors (OR 3.25, 95% CI 1.11-9.53), and glass-manufacturing workers (OR 2.08, 95% CI 1.14-3.82). A dose-response pattern for years of employment was observed for leather and fur processors (P = 0.02) and glass-manufacturing workers (P = 0.01). Stratified analyses also revealed dose-response relationships between the risk of breast cancer and years of employment as inspector and product analysts among pre-menopausal women (P = 0.02), and as farmers among post-menopausal women (P = 0.04). This study found that several occupations are associated with an increased risk of breast cancer among women. Studies examining various occupational exposures in these high-risk occupations are warranted to identify carcinogens that may play a role in the increased breast cancer risk. Copyright 2002 Wiley-Liss, Inc.

The relationship between occupational sun exposure and non-melanoma skin cancer: clinical basics, epidemiology, occupational disease evaluation, and prevention.

PubMed

Fartasch, Manigé; Diepgen, Thomas Ludwig; Schmitt, Jochen; Drexler, Hans

2012-10-01

The cumulative effect of solar ultraviolet (UV) radiation is responsible for the worldwide increase in non-melanoma skin cancer, a category that includes squamous cell carcinoma and its precursors (the actinic keratoses) as well as basal-cell carcinoma. Non-melanoma skin cancer is the most common type of cancer in areas of the world with a light-skinned population. The occupational exposure to UV radiation is high in many outdoor occupations; recent studies suggest that persons working in such occupations are more likely to develop non-melanoma skin cancer. On the basis of a selective review of the literature, we present the current state of knowledge about occupational and non-occupational UV exposure and the findings of meta-analyses on the association of outdoor activity with non-melanoma skin cancer. We also give an overview of the current recommendations for prevention and for medicolegal assessment. Recent meta-analyses have consistently documented a significantly higher risk of squamous cell carcinoma of the skin among persons who work outdoors (odds ratio [OR] 1.77, 95% confidence interval [CI] 1.40-2.22, p<0.001). There is also evidence for an elevated risk of basal-cell carcinoma (OR 1.43, 95% CI 1.23-1.66, p = 0.0001), but the effect is of lesser magnitude and the study findings are not as uniform. The association of occupational exposure to solar UV radiation with squamous cell carcinoma, including actinic keratosis, has been conclusively demonstrated. It follows that, in Germany, suspected non-melanoma skin cancer in persons with high occupational exposure to UV radiation should be reported as an occupational disease under § 9, paragraph 2 of the Seventh Book of the German Social Code (Sozialgesetzbuch, SGB VII). Preventive measures are urgently needed for persons with high occupational exposure to UV radiation.

[Estimates of Attributable Fraction of occupational cancers in the recent epidemiological literature].

PubMed

Merler, Enzo

2009-01-01

The article reviews the estimates of Attributable Fraction (AF) of occupational cancers. Because of their relevance, it starts with a synthesis and a comment on the estimates of avoidable cancers, and among these of cancers due to occupation, as expressed in 1981 by Doll and Peto. The main studies that have brought back into the epidemiological pathway the exercise of producing FA are quoted and the results of the new studies reviewed. The dimension of occupational cancers is of public health importance, because caused by exposures assumed to be avoidable. However, the estimates of AF are prone to uncertainties and limitations. Occupational cancers represent the major killer among deaths due to occupational diseases and injuries and a relevant fraction, especially among males, of total cancers. When related to developed countries, estimates may underestimate the risks, because of the insufficient data on exposures for workers in small firms, the lack of information on exposures in agriculture, the scanty availability of epidemiological studies on cancer risks among women. The trend towards a reduction of employees in industrial activities, the elimination or control of some exposures should suggest, instead, a reduction for occupational cancer. However, the more recent estimates of AF of occupational cancers are still in line with the estimates expressed more that 20 years ago. In developing countries, the estimates of AF are plenty of assumptions. In addition, some characteristics (i.e. the younger age of starting work, the extension of work at older age) suggest the need of better data, whereas information on exposures and events are dramatically lacking.

The burden of rare cancers in the United States.

PubMed

DeSantis, Carol E; Kramer, Joan L; Jemal, Ahmedin

2017-07-08

There are limited published data on the burden of rare cancers in the United States. By using data from the North American Association of Central Cancer Registries and the Surveillance, Epidemiology, and End Results program, the authors provide information on incidence rates, stage at diagnosis, and survival for more than 100 rare cancers (defined as an incidence of fewer than 6 cases per 100,000 individuals per year) in the United States. Overall, approximately 20% of patients with cancer in the United States are diagnosed with a rare cancer. Rare cancers make up a larger proportion of cancers diagnosed in Hispanic (24%) and Asian/Pacific Islander (22%) patients compared with non-Hispanic blacks (20%) and non-Hispanic whites (19%). More than two-thirds (71%) of cancers occurring in children and adolescents are rare cancers compared with less than 20% of cancers diagnosed in patients aged 65 years and older. Among solid tumors, 59% of rare cancers are diagnosed at regional or distant stages compared with 45% of common cancers. In part because of this stage distribution, 5-year relative survival is poorer for patients with a rare cancer compared with those diagnosed with a common cancer among both males (55% vs 75%) and females (60% vs 74%). However, 5-year relative survival is substantially higher for children and adolescents diagnosed with a rare cancer (82%) than for adults (46% for ages 65-79 years). Continued efforts are needed to develop interventions for prevention, early detection, and treatment to reduce the burden of rare cancers. Such discoveries can often advance knowledge for all cancers. CA Cancer J Clin 2017. © 2017 American Cancer Society. CA Cancer J Clin 2017;67:261-272. © 2017 American Cancer Society. © 2017 American Cancer Society.

Developing a Basic Scale for Workers' Psychological Burden from the Perspective of Occupational Safety and Health.

PubMed

Kim, Kyung Woo; Lim, Ho Chan; Park, Jae Hee; Park, Sang Gyu; Park, Ye Jin; Cho, Hm Hak

2018-06-01

Organizations are pursing complex and diverse aims to generate higher profits. Many workers experience high work intensity such as workload and work pressure in this organizational environment. Especially, psychological burden is a commonly used term in workplace of Republic of Korea. This study focused on defining the psychological burden from the perspective of occupational safety and health and tried to develop a scale for psychological burden. The 48 preliminary questionnaire items for psychological burden were prepared by a focus group interview with 16 workers through the Copenhagen Psychosocial Questionnaire II and Mindful Awareness Attention Scale. The preliminary items were surveyed with 572 workers, and exploratory factor analysis, confirmatory factor analysis, and correlation analysis were conducted for a new scale. As a result of the exploratory factor analysis, five factors were extracted: organizational activity, human error, safety and health workload, work attitude, and negative self-management. These factors had significant correlations and reliability, and the stability of the model for validity was confirmed using confirmatory factor analysis. The developed scale for psychological burden can measure workers' psychological burden in relation to safety and health. Despite some limitations, this study has applicability in the workplace, given the relatively small-sized questionnaire.

Differences in Symptom Burden Among Cancer Patients With Different Stages of Cachexia.

PubMed

Zhou, Ting; Yang, Kaixiang; Thapa, Sudip; Liu, Huiquan; Wang, Bangyan; Yu, Shiying

2017-05-01

Cancer patients with cachexia may suffer from significant burden of symptoms and it can severely impair patients' quality of life. However, only few studies have targeted the symptom burden in cancer cachexia patients, and whether the symptom burden differed in different cachexia stages is still unclear. The aims of this study were to evaluate the symptom burden in cancer cachexia patients and to compare the severity and occurrence rates of symptoms among cancer patients with non-cachexia, pre-cachexia, cachexia, and refractory cachexia. Advanced cancer patients (n = 306) were included in this cross-sectional study. Patients were divided into four groups, based on the cachexia stages of the international consensus. The M.D. Anderson Symptom Inventory added with eight more cachexia-specific symptoms were evaluated in our patients. Differences in symptom severity and occurrence rates among the four groups were compared using one-way ANOVA or Kruskal-Wallis test analyses. Lack of appetite, disturbed sleep, fatigue, lack of energy, and distress were the symptoms with highest occurrence rates and severity scores in all four groups and were exacerbated by the severity of cachexia stages. After confounders were adjusted for, significant differences were seen in symptoms of pain, fatigue, disturbed sleep, remembering problems, lack of appetite, dry mouth, vomiting, numbness, feeling dizzy, early satiety, lack of energy, tastes/smell changes, and diarrhea. This study identified higher symptom burden in cancer patients with cachexia and it increased with the stages of cachexia, which emphasized the importance of screening in multiple co-occurring symptoms for cachexia patients. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Residual fibre lung burden among patients with pleural mesothelioma who have been occupationally exposed to asbestos.

PubMed

Merler, Enzo; Somigliana, Anna; Girardi, Paolo; Barbieri, Pietro Gino

2017-03-01

To evaluate the lungs asbestos fibres concentration in participants with malignant pleural mesothelioma (MPM) who have been occupationally exposed. The lung samples were obtained from pleuropneumonectomies or autopsies of 271 male MPMs. The lung samples were examined through scanning electron microscopy. Retrospective assessment was used to assess for asbestos exposure. This study includes 248 MPMs with an occupational exposure defined as either 'definite' or 'probable' or 'possible'. The participants had finished working in asbestos exposure conditions more than 20 years ago (on average 26.1±11.0 years). The fibre burden resulted with a geometric mean equal to 2.0 (95% CI 1.6 to 2.4) million fibres per gram of dry lung tissue. The burden was higher among participants employed in asbestos textiles industry and in shipyards with insulation material, if compared with construction workers or non-asbestos textile workers or participants working in chemicals or as auto mechanics. 91.3% of MPMs had a detectable amount of amphibole fibres. A strong lung clearance capability was evident among workers exposed to chrysotile fibres. Owing to that, the 1997 Helsinki Criteria for occupational exposure were reached in <35% of cases among participant working in construction, in metallurgical industry, in chemical or textile industry and among those performing brake repair activities. The MPM cases are now occurring in Italy in participants who ceased occupational asbestos exposure decades before the analysis. A large majority still shows a residual content of amphibole fibres, but given the lung clearance capability, attribution to occupational exposure cannot rely only on fibres detection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Physical activity and occupational risk of colon cancer in Shanghai, China.

PubMed

Chow, W H; Dosemeci, M; Zheng, W; Vetter, R; McLaughlin, J K; Gao, Y T; Blot, W J

1993-02-01

Using occupational data for over 2000 colon cancer cases diagnosed between 1980 and 1984 in Shanghai, and employment information from the 1982 census for the Shanghai population, standardized incidence ratios (SIR) were computed for occupational groups classified by job types and physical activity levels. Men employed in occupations with low physical activity levels had modest but significantly elevated risks of colon cancer. SIR for jobs with low activity based on sitting time was 121 (95% confidence interval, Cl: 108-135) and based on energy expenditure was 126 (95% Cl: 115-138). Corresponding SIR for women were 99 (95% Cl: 83-118) and 113 (95% Cl: 100-127). The data were also used to screen for specific occupations with elevated SIR to generate leads to occupational colon cancer. Increased incidence was observed for professional and other white collar workers, and male chemical processors and female textile workers. The findings add to the emerging evidence that workplace activity may influence the risk of this common cancer.

The Economic Burden of Breast Cancer in Korea from 2007-2010

PubMed Central

Kim, Young Ae; Oh, In-Hwan; Yoon, Seok-Jun; Kim, Hyun-Jin; Seo, Hye-Young; Kim, Eun-Jung; Lee, Yo Han; Jung, Jae Hun

2015-01-01

Purpose This study estimates the socioeconomic cost and burden for breast cancer patients in Korea between 2007 and 2010. Materials and Methods This study used a prevalence-based approach to estimate the cost of breast cancer. Breast cancer patients were defined as those who were hospitalized or have visited an outpatient clinic during the period from 2007 to 2010. The socioeconomic costs of breast cancer were subdivided into two costs: direct and indirect. Results From 2007 to 2010, the prevalence of treated breast cancer increased from 7.9% to 20.4%. The total socioeconomic costs incurred by breast cancer increased by approximately 40.7% from US $668.49 million in 2007 to US $940.75 million in 2010. The direct medical care costs for 2010 were 1.4 times greater (US $399.22 million) than for 2007 (US $278.71 million). The direct non-medical costs rose from US $50.69 million in 2007 to US $75.83 million in 2010, a 49.6% increase. Regarding the economic burden of breast cancer, the total indirect costs were US $339.09 million in 2007 and increased by 37.3% to US $465.70 million in 2010. In the sensitivity analysis, with the annual discount rate for each year ranging from 0%-5%, the costs increased 1.1-1.2 times. Conclusion Due to the growing incidence of breast cancer, the annual prevalence and related costs are increasing. We must strive to reduce the socioeconomic burden of breast cancer through preventive measures and early screening. PMID:25687860

Occupational outcomes of adult childhood cancer survivors: A report from the childhood cancer survivor study.

PubMed

Kirchhoff, Anne C; Krull, Kevin R; Ness, Kirsten K; Park, Elyse R; Oeffinger, Kevin C; Hudson, Melissa M; Stovall, Marilyn; Robison, Leslie L; Wickizer, Thomas; Leisenring, Wendy

2011-07-01

The authors examined whether survivors from the Childhood Cancer Survivor Study were less likely to be in higher-skill occupations than a sibling comparison and whether certain survivors were at higher risk for lower-skill jobs. The authors created 3 mutually exclusive occupational categories for participants aged ≥ 25 years: Managerial/Professional, Nonphysical Service/Blue Collar, and Physical Service/Blue Collar. The authors examined currently employed survivors (4845) and their siblings (1727) in multivariable generalized linear models to evaluate the likelihood of being in 1 of the 3 occupational categories. Multinomial logistic regression was used among all participants to examine the likelihood of these outcomes compared to being unemployed (survivors, 6671; siblings, 2129). Multivariable linear models were used to assess survivor occupational differences by cancer-  and treatment-related variables. Personal income was compared by occupation. Employed survivors were less often in higher-skilled Managerial/Professional occupations (relative risk, 0.93; 95% confidence interval 0.89-0.98) than their siblings. Survivors who were black, were diagnosed at a younger age, or had high-dose cranial radiation were less likely to hold Managerial/Professional occupations than other survivors. In multinomial models, female survivors' likelihood of being in full-time Managerial/Professional occupations (27%) was lower than male survivors (42%) and female (41%) and male (50%) siblings. Survivors' personal income was lower than siblings within each of the 3 occupational categories in models adjusted for sociodemographic variables. Adult childhood cancer survivors are employed in lower-skill jobs than siblings. Survivors with certain treatment histories are at higher risk for lower-skill jobs and may require vocational assistance throughout adulthood. Copyright © 2011 American Cancer Society.

[Epidemiology of occupational skin cancer due to UV-irradiation].

PubMed

Diepgen, T L; Drexler, H; Schmitt, J

2012-10-01

Skin cancer induced by occupational UV-irradiation is not an official occupational disease number in the appendix of the German ordinance on occupational diseases (Berufskrankheitenverordnung (BKV) but can be recognized as a "virtually" occupational disease according to § 9 (2) of the 7th book of the German Social Code (SGB VII). Epidemiological studies have demonstrated a positive, statistically significant and relevant association between occupational UV-irradiation and the risk of squamous cell carcinoma (SCC) and actinic keratoses (AK). Outdoor workers have on average a 100% higher risk to develop SCC compared to the general population. Therefore, the prerequisites for a new occupational disease are fulfilled and SCC and AK should be reported as an occupational disease if an additional 40% occupationally-related UV-irradiation is documented and the clinical criteria are typical for work- related skin cancer. Epidemiologic evidence also indicates a significant association between work-related UV-irradiation and basal cell carcinoma (BCC) risk: however the results are less consistent and the association is weaker than with SCC. There is an urgent need for further studies in outdoor workers on BCC and lentigo maligna melanoma.

Investments in cancer research awarded to UK institutions and the global burden of cancer 2000-2013: a systematic analysis.

PubMed

Maruthappu, Mahiben; Head, Michael G; Zhou, Charlie D; Gilbert, Barnabas J; El-Harasis, Majd A; Raine, Rosalind; Fitchett, Joseph R; Atun, Rifat

2017-04-20

To systematically categorise cancer research investment awarded to United Kingdom (UK) institutions in the period 2000-2013 and to estimate research investment relative to disease burden as measured by mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs). Systematic analysis of all open-access data. Public and philanthropic funding to all UK cancer research institutions, 2000-2013. Number and financial value of cancer research investments reported in 2013 UK pounds (UK£). Mortality, DALYs and YLDs data were acquired from the Global Burden of Disease Study. A compound metric was adapted to estimate research investment relative to disease burden as measured by mortality, DALYs and YLDs. We identified 4299 funded studies with a total research investment of £2.4 billion. The highest fundings by anatomical sites were haematological, breast, prostate, colorectal and ovarian cancers. Relative to disease burden as determined by a compound metric combining mortality, DALYs and YLDs, gender-specific cancers were found to be highest funded-the five sites that received the most funding were prostate, ovarian, breast, mesothelioma and testicular cancer; the least well-funded sites were liver, thyroid, lung, upper gastrointestinal (GI) and bladder. Preclinical science accounted for 66.2% of award numbers and 62.2% of all funding. The top five areas of primary research focus by funding were pathogenesis, drug therapy, diagnostic, screening and monitoring, women's health and immunology. The largest individual funder was the Medical Research Council. In combination, the five lowest funded site-specific cancers relative to disease burden account for 47.9%, 44.3% and 20.4% of worldwide cancer mortality, DALYs and YLDs. Research funding for cancer is not allocated according to relative disease burden. These findings are in line with earlier published studies. Funding agencies and industry should openly document their research investments to

18F-Fluoride PET/CT tumor burden quantification predicts survival in breast cancer.

PubMed

Brito, Ana E; Santos, Allan; Sasse, André Deeke; Cabello, Cesar; Oliveira, Paulo; Mosci, Camila; Souza, Tiago; Amorim, Barbara; Lima, Mariana; Ramos, Celso D; Etchebehere, Elba

2017-05-30

In bone-metastatic breast cancer patients, there are no current imaging biomarkers to identify which patients have worst prognosis. The purpose of our study was to investigate if skeletal tumor burden determined by 18F-Fluoride PET/CT correlates with clinical outcomes and may help define prognosis throughout the course of the disease. Bone metastases were present in 49 patients. On multivariable analysis, skeletal tumor burden was significantly and independently associated with overall survival (p < 0.0001) and progression free-survival (p < 0.0001). The simple presence of bone metastases was associated with time to bone event (p = 0.0448). We quantified the skeletal tumor burden on 18F-Fluoride PET/CT images of 107 female breast cancer patients (40 for primary staging and the remainder for restaging after therapy). Clinical parameters, primary tumor characteristics and skeletal tumor burden were correlated to overall survival, progression free-survival and time to bone event. The median follow-up time was 19.5 months. 18F-Fluoride PET/CT skeletal tumor burden is a strong independent prognostic imaging biomarker in breast cancer patients.

Occupational risks for bladder cancer among men in Sweden.

PubMed

Malker, H S; McLaughlin, J K; Silverman, D T; Ericsson, J L; Stone, B J; Weiner, J A; Malker, B K; Blot, W J

1987-12-15

With the use of the Swedish Cancer-Environment Registry, census data on employment in 1960 were linked with registry data on bladder cancer during 1961-79. This hypothesis-generating study revealed for the first time associations between bladder cancer and employment in pulp and fiberboard manufacturing, in rope and twine making, and work as a dental technician. Statistically significant increases in risk were also found for several occupations previously associated with bladder cancer, including barbers and beauticians, artistic painters, toolmakers and machinists, and physicians, and employment in butcher shops, industrial chemical making, apparel manufacturing, and plumbing. Etiologic inferences cannot be made from this investigation, but the findings from this large national resource provide further clues to the occupational determinants of bladder cancer.

[Economic burden of cancer in China during 1996-2014: a systematic review].

PubMed

Shi, J F; Shi, C L; Yue, X P; Huang, H Y; Wang, L; Li, J; Lou, P A; Mao, A Y; Dai, M

2016-12-23

Objective: To explore the current status of research on economic burden of cancer in China from 1996 to 2014. Methods: The key words including cancer, economic burden, expenditure, cost were used to retrieve the literatures published in CNKI and Wanfang (the two most commonly used databases for literature in Chinese) and PubMed during 1996-2014. A total of 91 studies were included after several exclusionary procedures. Information on subjects and data source, methodology, main results were structurally abstracted. All the expenditure data were discounted to year of 2013 value using China's health care consumer price indices. Results: More than half of the included studies were published over the past 5 years, 32 of the studies were about lung cancer. Among the 83 individual-based surveys, 77 were hospital-based and obtained data via individually medical record abstraction, and most of which only considered the direct medical expenditure. Expenditure per cancer patient and expenditure per diem were the most commonly used outcome indicators. Majority of the findings on expenditure per cancer patient ranged from 10 thousands to 30 thousands Chinese Yuan (CNY), with larger disparity in lung and breast cancer (ranged from 10 thousands to 90 thousands CNY), narrower difference in esophageal and stomach cancer (ranged from 10 thousands to 50 thousands CNY), and most stable trend in cervical cancer (almost all the values less than 20 thousands CNY). Without exception, the expenditures per diem for all the common cancers were increasing over the period from 1996 to 2014 (3-7 fold increase). Only 8 population-level economic burden studies were included and the reported expenditure of cancer at national level ranged from 32.6 billions to 100.7 billions CNY. Conclusions: Evidence on economic burden of cancer in China from 1996 to 2014 are limited and weakly comparable, particularly at a population level, and the reported expenditure per patient may be underestimated.

Asbestos-related occupational cancers compensated under the Spanish National Insurance System, 1978-2011.

PubMed

García-Gómez, Montserrat; Menéndez-Navarro, Alfredo; López, Rosario Castañeda

2015-01-01

In 1978, asbestos-related occupational cancers were added to the Spanish list of occupational diseases. However, there are no full accounts of compensated cases since their inclusion. To analyze the cases of asbestos-related cancer recognized as occupational in Spain between 1978 and 2011. Cases were obtained from the Spanish Employment Ministry. Specific incidence rates by year, economic activity, and occupation were obtained. We compared mortality rates of mesothelioma and bronchus and lung cancer mortality in Spain and the European Union. Between 1978 and 2011, 164 asbestos-related occupational cancers were recognized in Spain, with a mean annual rate of 0·08 per 10(5) employees (0·13 in males, 0·002 in females). Under-recognition rates were an estimated 93·6% (males) and 99·7% (females) for pleural mesothelioma and 98·8% (males) and 100% (females) for bronchus and lung cancer. In Europe for the year 2000, asbestos-related occupational cancer rates ranged from 0·04 per 10(5) employees in Spain to 7·32 per 10(5) employees in Norway. These findings provide evidence of gross under-recognition of asbestos-related occupational cancers in Spain. Future work should investigate cases treated in the National Healthcare System to better establish the impact of asbestos on health in Spain.

Colorectal cancer in Malaysia: Its burden and implications for a multiethnic country.

PubMed

Veettil, Sajesh K; Lim, Kean Ghee; Chaiyakunapruk, Nathorn; Ching, Siew Mooi; Abu Hassan, Muhammad Radzi

2017-11-01

This study aims to provide an analytical overview of the changing burden of colorectal cancer and highlight the implementable control measures that can help reduce the future burden of colorectal cancer in Malaysia. We performed a MEDLINE search via OVID with the ​Medical Subject Headings (MeSH) terms "Colorectal Neoplasms"[Mesh] and "Malaysia"[Mesh], and PubMed with the key words "colorectal cancer" and "Malaysia" from 1990 to 2015 for studies reporting any clinical, societal, and economical findings associated with colorectal cancer in Malaysia. Incidence and mortality data were retrieved from population-based cancer registries/databases. In Malaysia, colorectal cancer is the second most common cancer in males and the third most common cancer in females. The economic burden of colorectal cancer is substantial and is likely to increase over time in Malaysia owing to the current trend in colorectal cancer incidence. In Malaysia, most patients with colorectal cancer have been diagnosed at a late stage, with the 5-year relative survival by stage being lower than that in developed Asian countries. Public awareness of the rising incidence of colorectal cancer and the participation rates for colorectal cancer screening are low. The efficiency of different screening approaches must be assessed, and an organized national screening program should be developed in a phased manner. It is essential to maintain a balanced investment in awareness programs targeting general population and primary care providers, focused on increasing the knowledge on symptoms and risk factors of colorectal cancer, awareness on benefits of screening, and promotion of healthy life styles to prevent this important disease. Copyright © 2016. Published by Elsevier Taiwan.

Parental occupational exposures and risk of childhood cancer.

PubMed Central

Colt, J S; Blair, A

1998-01-01

Occupational exposures of parents might be related to cancer in their offspring. Forty-eight published studies on this topic have reported relative risks for over 1000 specific occupation/cancer combinations. Virtually all of the studies employed the case-control design. Occupations and exposures of fathers were investigated much more frequently than those of the mother. Information about parental occupations was derived through interviews or from birth certificates and other administrative records. Specific exposures were typically estimated by industrial hygienists or were self-reported. The studies have several limitations related to the quality of the exposure assessment, small numbers of exposed cases, multiple comparisons, and possible bias toward the reporting of positive results. Despite these limitations, they provide evidence that certain parental exposures may be harmful to children and deserve further study. The strongest evidence is for childhood leukemia and paternal exposure to solvents, paints, and employment in motor vehicle-related occupations; and childhood nervous system cancers and paternal exposure to paints. To more clearly evaluate the importance of these and other exposures in future investigations, we need improvements in four areas: a) more careful attention must be paid to maternal exposures; b) studies should employ more sophisticated exposure assessment techniques; c) careful attention must be paid to the postulated mechanism, timing, and route of exposure; and d) if postnatal exposures are evaluated, studies should provide evidence that the exposure is actually transferred from the workplace to the child's environment. PMID:9646055

Occupational skin cancer induced by ultraviolet radiation and its prevention.

PubMed

Diepgen, T L; Fartasch, M; Drexler, H; Schmitt, J

2012-08-01

Skin cancer is by far the most common kind of cancer diagnosed in many western countries and ultraviolet radiation is the most important risk factor for cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). Although employees at several workplaces are exposed to increased levels of UV radiation, skin cancer due to long-term intense occupational exposure to UV radiation is often not considered as occupational disease. The actually available evidence in the epidemiological literature clearly indicates that occupational UV radiation exposure is a substantial and robust risk factor for the development of cutaneous SCC and also clearly shows a significant risk for developing BCC. There is enough scientific evidence that outdoor workers have an increased risk of developing work-related occupational skin cancer due to natural UV radiation exposure and adequate prevention strategies must be implemented. The three measures which are successful and of particular importance in the prevention of nonmelanoma skin cancer in outdoor workers are changes in behaviour regarding awareness of health and disease resulting from exposure to natural UV radiation, protection from direct UV radiation by wearing suitable clothing, and regular and correct use of appropriate sunscreens. © 2012 The Authors. BJD © 2012 British Association of Dermatologists.

Investments in cancer research awarded to UK institutions and the global burden of cancer 2000–2013: a systematic analysis

PubMed Central

Maruthappu, Mahiben; Head, Michael G; Zhou, Charlie D; Gilbert, Barnabas J; El-Harasis, Majd A; Raine, Rosalind; Fitchett, Joseph R; Atun, Rifat

2017-01-01

Objectives To systematically categorise cancer research investment awarded to United Kingdom (UK) institutions in the period 2000–2013 and to estimate research investment relative to disease burden as measured by mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs). Design Systematic analysis of all open-access data. Setting and participants Public and philanthropic funding to all UK cancer research institutions, 2000–2013. Main outcome measures Number and financial value of cancer research investments reported in 2013 UK pounds (UK£). Mortality, DALYs and YLDs data were acquired from the Global Burden of Disease Study. A compound metric was adapted to estimate research investment relative to disease burden as measured by mortality, DALYs and YLDs. Results We identified 4299 funded studies with a total research investment of £2.4 billion. The highest fundings by anatomical sites were haematological, breast, prostate, colorectal and ovarian cancers. Relative to disease burden as determined by a compound metric combining mortality, DALYs and YLDs, gender-specific cancers were found to be highest funded—the five sites that received the most funding were prostate, ovarian, breast, mesothelioma and testicular cancer; the least well-funded sites were liver, thyroid, lung, upper gastrointestinal (GI) and bladder. Preclinical science accounted for 66.2% of award numbers and 62.2% of all funding. The top five areas of primary research focus by funding were pathogenesis, drug therapy, diagnostic, screening and monitoring, women's health and immunology. The largest individual funder was the Medical Research Council. In combination, the five lowest funded site-specific cancers relative to disease burden account for 47.9%, 44.3% and 20.4% of worldwide cancer mortality, DALYs and YLDs. Conclusions Research funding for cancer is not allocated according to relative disease burden. These findings are in line with earlier published studies

Constitutional and occupational risk factors associated with bladder cancer

PubMed Central

Ferrís, J.; Garcia, J.; Berbel, O.; Ortega, J.A.

2016-01-01

Objective Bladder carcinoma (BC) is the fourth most common type of cancer in males from Western countries, with primary prevention an important healthcare challenge. We review the associated constitutional and occupational risk factors (RF), with greater or lesser scientific evidence, in the etiology of BC. Material and methods Literature review of the last 25 years of the constitutional and occupational RF associated with BC, conducted on MedLine, CancerLit, Science Citation Index and Embase. The search profiles were Risk factors/Genetic factors/Genetic polymorphisms/Epidemiology/Occupational factors and Bladder cancer. Results The main RF were (a) age and gender (diagnosed at age 65 and over, with a 4:1 ratio of males to females); (b) race, ethnicity and geographic location (predominantly in Caucasians and in Southern European countries); (c) genetic (N-acetyltransferase-2 and glutathione s-transferase M1 gene mutations, which significantly increase the risk for BC); (d) occupational, which represent 5–10% of BC RF; and (f) occupations with high BC risk, such as aluminum production, the manufacture of dyes, paints and colourings, the rubber industry and the extraction and industrial use of fossil fuels. Conclusions BC is the end result of the variable combination of constitutional and environmental RF, the majority of which are unknown. The most significant constitutional RF are related to age, gender, race, ethnicity geographic location and genetic polymorphisms. The main occupational RF are those related to aromatic amines and polycyclic aromatic hydrocarbons. PMID:23664103

Constitutional and occupational risk factors associated with bladder cancer.

PubMed

Ferrís, J; Garcia, J; Berbel, O; Ortega, J A

2013-09-01

Bladder carcinoma (BC) is the fourth most common type of cancer in males from Western countries, with primary prevention an important healthcare challenge. We review the associated constitutional and occupational risk factors (RF), with greater or lesser scientific evidence, in the aetiology of BC. Literature review of the last 25 years of the constitutional and occupational RF associated with BC, conducted on MedLine, CancerLit, Science Citation Index and Embase. The search profiles were Risk factors/Genetic factors/Genetic polymorphisms/Epidemiology/Occupational factors and Bladder cancer. The main RF were a) age and gender (diagnosed at age 65 and over, with a 4:1 ratio of males to females); b) race, ethnicity and geographic location (predominantly in Caucasians and in Southern European countries); c) genetic (N-acetyltransferase-2 and glutathione s-transferase M1 gene mutations, which significantly increase the risk for BC); d) occupational, which represent 5%-10% of BC RF; and f) occupations with high BC risk, such as aluminium production, the manufacture of dyes, paints and colourings, the rubber industry and the extraction and industrial use of fossil fuels. BC is the end result of the variable combination of constitutional and environmental RF, the majority of which are unknown. The most significant constitutional RF are related to age, gender, race, ethnicity geographic location and genetic polymorphisms. The main occupational RF are those related to aromatic amines and polycyclic aromatic hydrocarbons. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

Lung, gastric and colorectal cancer mortality by occupation and industry among working-aged men in Japan.

PubMed

Eguchi, Hisashi; Wada, Koji; Prieto-Merino, David; Smith, Derek R

2017-02-23

We examined occupational and industrial differences in lung, gastric, and colorectal cancer risk among Japanese men of working age (25-64 years) using the 2010 Japanese national survey data for occupation and industry-specific death rates. Poisson regression models were used to estimate the age-adjusted incident rate ratios by lung, gastric, and colorectal cancers, with manufacturing used as the referent occupation or industry. Unemployed Japanese men and those in manufacturing had an 8-11-fold increased risk of lung, gastric and colorectal cancer. The highest mortality rates for lung and colorectal cancer by occupation were "administrative and managerial" (by occupation) and "mining" (by industry). For gastric cancer, the highest mortality rate was "agriculture" (by occupation) and "mining" (by industry). By occupation; Japanese men in service occupations, those in administrative and managerial positions, those in agriculture, forestry and fisheries, and those in professional and engineering categories had higher relative mortality risks for lung, gastric, and colorectal cancers. By industry; mining, electricity and gas, fisheries, and agriculture and forestry had the higher mortality risks for those cancers. Unemployed men had higher mortality rates than men in any occupation and industry for all three cancers. Overall, this study suggests that for Japanese men, occupations and industries may be a key social determinant of health.

Occupational outcomes of adult childhood cancer survivors: A report from the Childhood Cancer Survivor Study

PubMed Central

Kirchhoff, Anne C.; Krull, Kevin R.; Ness, Kirsten K.; Park, Elyse R.; Oeffinger, Kevin C.; Hudson, Melissa M.; Stovall, Marilyn; Robison, Leslie L.; Wickizer, Thomas; Leisenring, Wendy

2010-01-01

Background We examined whether survivors from the Childhood Cancer Survivor Study were less likely to be in higher skill occupations than a sibling comparison and whether certain survivors were at higher risk. Methods We created three mutually-exclusive occupational categories for participants aged ≥25 years: Managerial/Professional and Non-Physical and Physical Service/Blue Collar. We examined currently employed survivors (N=4845) and siblings (N=1727) in multivariable generalized linear models to evaluate the likelihood of being in the three occupational categories. Among all participants, we used multinomial logistic regression to examine the likelihood of these outcomes in comparison to being unemployed (survivors N=6671; siblings N=2129). Multivariable linear models were used to assess survivor occupational differences by cancer and treatment variables. Personal income was compared by occupation. Results Employed survivors were less often in higher skilled Managerial/Professional occupations (Relative Risk=0.93, 95% Confidence Interval 0.89–0.98) than siblings. Survivors who were Black, were diagnosed at a younger age, or had high-dose cranial radiation were less likely to hold Professional occupations than other survivors. In multinomial models, female survivors’ likelihood of being in full-time Professional occupations (27%) was lower than male survivors (42%) and female (41%) and male (50%) siblings. Survivors’ personal income was lower than siblings within each of the three occupational categories in models adjusted for sociodemographic variables. Conclusions Adult childhood cancer survivors are employed in lower skill jobs than siblings. Survivors with certain treatment histories are at higher risk and may require vocational assistance throughout adulthood. PMID:21246530

Functional Deficits and Quality of Life Among Cancer Survivors: Implications for Occupational Therapy in Cancer Survivorship Care.

PubMed

Hwang, Eric J; Lokietz, Nicole C; Lozano, Rachel L; Parke, Megan A

2015-01-01

This study aimed to explore functional deficits and perceived quality of life (QoL) among cancer survivors. Sixty-six participants completed the Post Cancer Outcome Survey developed for the purpose of this study. The results indicated (1) modest to moderate degrees of functional deficits in 28 of the 70 items measuring areas of occupation, performance skills, body functions, and psychosocial well-being within the first year after cancer treatment; (2) significantly lower perceived QoL during the first year of survivorship compared with that before diagnosis, at present, and 5 yr hereafter (p < .001); (3) significant moderate negative correlations between the reported functional deficits and QoL (rs = -.45 to -.57); and (4) a very low percentage of participants (4.5%) receiving occupational therapy during the first year posttreatment. Functional difficulties and compromised QoL identified in this study indicate the need for occupational therapy among cancer survivors. Increasing clients' awareness of occupational therapy for postcancer care is also suggested. Copyright © 2015 by the American Occupational Therapy Association, Inc.

National and Subnational Population-Based Incidence of Cancer in Thailand: Assessing Cancers with the Highest Burdens

PubMed Central

Bilheem, Surichai; Chansaard, Wasan; Khuanchana, Somsak; Leklob, Atit; Rozek, Laura S.; Siriarechakul, Surattaya; Tassanasunthornwong, Sukit

2017-01-01

In Thailand, five cancer types—breast, cervical, colorectal, liver and lung cancer—contribute to over half of the cancer burden. The magnitude of these cancers must be quantified over time to assess previous health policies and highlight future trajectories for targeted prevention efforts. We provide a comprehensive assessment of these five cancers nationally and subnationally, with trend analysis, projections, and number of cases expected for the year 2025 using cancer registry data. We found that breast (average annual percent change (AAPC): 3.1%) and colorectal cancer (female AAPC: 3.3%, male AAPC: 4.1%) are increasing while cervical cancer (AAPC: −4.4%) is decreasing nationwide. However, liver and lung cancers exhibit disproportionately higher burdens in the northeast and north regions, respectively. Lung cancer increased significantly in northeastern and southern women, despite low smoking rates. Liver cancers are expected to increase in the northern males and females. Liver cancer increased in the south, despite the absence of the liver fluke, a known factor, in this region. Our findings are presented in the context of health policy, population dynamics and serve to provide evidence for future prevention strategies. Our subnational estimates provide a basis for understanding variations in region-specific risk factor profiles that contribute to incidence trends over time. PMID:28817104

Burden of HPV-caused cancers in Denmark and the potential effect of HPV-vaccination.

PubMed

Skorstengaard, Malene; Thamsborg, Lise Holst; Lynge, Elsebeth

2017-10-13

Denmark is one of the countries where Human papillomavirus (HPV)-vaccination at present includes only girls. However, the burden of HPV-related cancer in men is increasing, which would argue for gender-neutral vaccination. The aim of this study was to examine the burden of HPV-caused cancers in women and men, and to evaluate the potential of HPV-vaccination in cancer control. Data were retrieved from the literature on population prevalence of high risk (HR) HPV, on HR HPV-prevalence and genotypes in HPV-related cancers, and on number of cytology samples in cervical screening. Data on annual biopsies and conisations were retrieved from the Danish National Health Service Register and the Danish National Patient Register. Incidences of HPV-related cancers in Denmark were extracted from NORDCAN. Number of HPV-caused cancers was calculated from number of HPV-related cancers and the proportion known to be caused by high-risk (HR) HPV. In cross-sectional surveys in Denmark, one fifth of women and almost one third of men were found to be positive for HR HPV. Per year, 548 HPV-caused cancer cases were diagnosed in women and 234 in men, and twice as many cancers in women as in men were preventable with HPV vaccination. However, including screening prevented cervical cancers, the burden of cancers caused by HPV-infection would be 1300-2000 in women as compared to 234 in men. Taking screening prevented cervical cancers into account, the cancer control potential of HPV-vaccination is considerably higher in women than in men. HPV-vaccination could reduce the burden of screening on women and on health care resources. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Lung, gastric and colorectal cancer mortality by occupation and industry among working-aged men in Japan

PubMed Central

Eguchi, Hisashi; Wada, Koji; Prieto-Merino, David; Smith, Derek R.

2017-01-01

We examined occupational and industrial differences in lung, gastric, and colorectal cancer risk among Japanese men of working age (25–64 years) using the 2010 Japanese national survey data for occupation and industry-specific death rates. Poisson regression models were used to estimate the age-adjusted incident rate ratios by lung, gastric, and colorectal cancers, with manufacturing used as the referent occupation or industry. Unemployed Japanese men and those in manufacturing had an 8–11-fold increased risk of lung, gastric and colorectal cancer. The highest mortality rates for lung and colorectal cancer by occupation were “administrative and managerial” (by occupation) and “mining” (by industry). For gastric cancer, the highest mortality rate was “agriculture” (by occupation) and “mining” (by industry). By occupation; Japanese men in service occupations, those in administrative and managerial positions, those in agriculture, forestry and fisheries, and those in professional and engineering categories had higher relative mortality risks for lung, gastric, and colorectal cancers. By industry; mining, electricity and gas, fisheries, and agriculture and forestry had the higher mortality risks for those cancers. Unemployed men had higher mortality rates than men in any occupation and industry for all three cancers. Overall, this study suggests that for Japanese men, occupations and industries may be a key social determinant of health. PMID:28230191

Asbestos-related occupational cancers compensated under the Spanish National Insurance System, 1978–2011

PubMed Central

García-Gómez, Montserrat; Menéndez-Navarro, Alfredo; López, Rosario Castañeda

2015-01-01

Background: In 1978, asbestos-related occupational cancers were added to the Spanish list of occupational diseases. However, there are no full accounts of compensated cases since their inclusion. Objective: To analyze the cases of asbestos-related cancer recognized as occupational in Spain between 1978 and 2011. Methods: Cases were obtained from the Spanish Employment Ministry. Specific incidence rates by year, economic activity, and occupation were obtained. We compared mortality rates of mesothelioma and bronchus and lung cancer mortality in Spain and the European Union. Results: Between 1978 and 2011, 164 asbestos-related occupational cancers were recognized in Spain, with a mean annual rate of 0·08 per 105 employees (0·13 in males, 0·002 in females). Under-recognition rates were an estimated 93·6% (males) and 99·7% (females) for pleural mesothelioma and 98·8% (males) and 100% (females) for bronchus and lung cancer. In Europe for the year 2000, asbestos-related occupational cancer rates ranged from 0·04 per 105 employees in Spain to 7·32 per 105 employees in Norway. Conclusions: These findings provide evidence of gross under-recognition of asbestos-related occupational cancers in Spain. Future work should investigate cases treated in the National Healthcare System to better establish the impact of asbestos on health in Spain. PMID:25335827

Identification of Occupational Cancer Risks in British Columbia, Canada: A Population-Based Case—Control Study of 1,155 Cases of Colon Cancer

PubMed Central

Fang, Raymond; Le, Nhu; Band, Pierre

2011-01-01

Objective Cancer has been recognized to have environmental origin, but occupational cancer risk studies have not been fully documented. The objective of this paper was to identify occupations and industries with elevated colon cancer risk based on lifetime occupational histories collected from 15,463 incident cancer cases. Method A group matched case-control design was used. All cases were diagnosed with histologically proven colon cancers, with cancer controls being all other cancer sites, excluding rectum, lung and unknown primary, diagnosed at the same period of time from the British Columbia Cancer Registry. Data analyses were done on all 597 Canadian standard occupation titles and 1,104 standard industry titles using conditional logistic regression for matched data sets and the likelihood ratio test. Results Excess colon cancer risks was observed in a number of occupations and industries, particularly those with low physical activity and those involving exposure to asbestos, wood dusts, engine exhaust and diesel engine emissions, and ammonia. Discussion The results of our study are in line with those from the literature and further suggest that exposure to wood dusts and to ammonia may carry an increased occupational risk of colon cancer. PMID:22073015

Estimates of cancer burden in Tuscany.

PubMed

Ventura, Leonardo; Miccinesi, Guido; Buzzoni, Carlotta; Crocetti, Emanuele; Paci, Eugenio; Foschi, Roberto; Rossi, Silvia

2013-01-01

The Tuscan cancer registry has been operating since 1985, providing cancer incidence and survival data in Tuscany; it covers about 33% of the regional population. The purpose of this paper is to provide incidence, prevalence and mortality estimates for the major cancers in the whole Tuscany region for the period 1970-2015. The estimated figures were obtained by applying the MIAMOD method. Starting from mortality and survival data, incidence and prevalence were derived using a statistical back-calculation approach. Survival was modeled on the basis of published data from the Italian cancer registries. According to the estimates, the most frequent cancer sites were colon-rectum in both genders, prostate in men and breast in women, with 4,188, 3,082 and 3,092 new diagnoses, respectively, in 2012. The incidence rates were steadily increasing for lung cancer in women and melanoma in both sexes, while they were decreasing for uterine cervix cancer in women, lung cancer in men and stomach cancer in both sexes. For colorectal cancer a small reduction in incidence was estimated for both sexes in recent years. The incidence rates for prostate cancer, after a steep increase and subsequent stabilization, were estimated to increase slightly in the last years. The breast cancer incidence was estimated to stabilize in the last 10 years. The mortality trends were decreasing for all considered cancers except female lung cancer. Prevalence increased for most of the studied cancers except stomach cancer in both sexes, lung cancer in men and cervix cancer in women. The highest prevalence was estimated for breast cancer, with over 42,000 cases in 2012. This paper provides an updated description of the cancer burden in Tuscany until 2015. These trends will have a significant impact on the regional health services and it is therefore important to enhance both primary prevention, for reducing the cancer incidence, and oncological surveillance, for evaluating the care and assistance of

Estimates of cancer burden in Campania.

PubMed

Fusco, Mario; De Angelis, Roberta; Senatore, Gennaro; Zigon, Giulia; Rossi, Silvia

2013-01-01

In Campania two cancer registries have been operating since 1996, covering part of the province of Naples and the province of Salerno, and amounting to 29% of the regional population. The aim of this paper is to provide estimates of the incidence, mortality and prevalence of seven major cancers for the entire Campania region. The estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Survival was modeled on the basis of published data from the Italian cancer registries. In 2012 the most frequent cancers were colorectal, breast and lung cancer with 3,969, 3,675 and 3,629 new diagnosed cases, respectively. The cancers with increasing incidence trends were breast cancer, lung cancer and skin melanoma in women, and colorectal cancer and skin melanoma in men. By contrast, the incidence rates of uterine cervix cancer and stomach cancer were decreasing. In men the lung and prostate cancer incidence rates increased, reaching a peak in different periods, and then decreased and stabilized, respectively. Prevalence was increasing for all considered cancers with the exception of cervical cancer. The highest values in 2012 were estimated for breast and colorectal cancer (34,000 and 22,000 prevalent cases, respectively). In the final period under study there was a decline in mortality for all cancers except female lung cancer. The highest crude mortality rates in 2012 were estimated for lung cancer in men and breast cancer in women: 80 and 31 per 100,000, respectively. This paper provides a description of the burden of the major cancers in Campania until 2015. The estimates highlight the need to reinforce organized screening, especially for breast and colorectal cancer, and to support evidence-based prevention campaigns against female smoking. All these aspects require continuous and updated monitoring of the main epidemiological indicators in

[Causes and prevention of occupational cancer].

PubMed

Kawai, Kazuaki

2013-10-01

Cancer is the leading cause of death in Japan, and is responsible for 30 % of all deaths. Among these deaths, the contributing rate of occupational cancer is only a few percent. However, it is a serious problem for workers exposed to certain carcinogens within the workplace, because they are subjected to high levels of carcinogens throughout their workday. The early adverse health effects exerted by carcinogens are closely related to carcinogenesis. As biomarkers for cancer prevention, 8-hydroxydeoxyguanosine, as an oxidative stress marker, DNA adducts, and cytosine C-5 methylation, as a marker of epigenetic change, may be useful to monitor.

Using the Job Burden-Capital Model of Occupational Stress to Predict Depression and Well-Being among Electronic Manufacturing Service Employees in China.

PubMed

Wang, Chao; Li, Shuang; Li, Tao; Yu, Shanfa; Dai, Junming; Liu, Xiaoman; Zhu, Xiaojun; Ji, Yuqing; Wang, Jin

2016-08-12

This study aimed to identify the association between occupational stress and depression-well-being by proposing a comprehensive and flexible job burden-capital model with its corresponding hypotheses. For this research, 1618 valid samples were gathered from the electronic manufacturing service industry in Hunan Province, China; self-rated questionnaires were administered to participants for data collection after obtaining their written consent. The proposed model was fitted and tested through structural equation model analysis. Single-factor correlation analysis results indicated that coefficients between all items and dimensions had statistical significance. The final model demonstrated satisfactory global goodness of fit (CMIN/DF = 5.37, AGFI = 0.915, NNFI = 0.945, IFI = 0.952, RMSEA = 0.052). Both the measurement and structural models showed acceptable path loadings. Job burden and capital were directly associated with depression and well-being or indirectly related to them through personality. Multi-group structural equation model analyses indicated general applicability of the proposed model to basic features of such a population. Gender, marriage and education led to differences in the relation between occupational stress and health outcomes. The job burden-capital model of occupational stress-depression and well-being was found to be more systematic and comprehensive than previous models.

Using the Job Burden-Capital Model of Occupational Stress to Predict Depression and Well-Being among Electronic Manufacturing Service Employees in China

PubMed Central

Wang, Chao; Li, Shuang; Li, Tao; Yu, Shanfa; Dai, Junming; Liu, Xiaoman; Zhu, Xiaojun; Ji, Yuqing; Wang, Jin

2016-01-01

Background: This study aimed to identify the association between occupational stress and depression-well-being by proposing a comprehensive and flexible job burden-capital model with its corresponding hypotheses. Methods: For this research, 1618 valid samples were gathered from the electronic manufacturing service industry in Hunan Province, China; self-rated questionnaires were administered to participants for data collection after obtaining their written consent. The proposed model was fitted and tested through structural equation model analysis. Results: Single-factor correlation analysis results indicated that coefficients between all items and dimensions had statistical significance. The final model demonstrated satisfactory global goodness of fit (CMIN/DF = 5.37, AGFI = 0.915, NNFI = 0.945, IFI = 0.952, RMSEA = 0.052). Both the measurement and structural models showed acceptable path loadings. Job burden and capital were directly associated with depression and well-being or indirectly related to them through personality. Multi-group structural equation model analyses indicated general applicability of the proposed model to basic features of such a population. Gender, marriage and education led to differences in the relation between occupational stress and health outcomes. Conclusions: The job burden-capital model of occupational stress-depression and well-being was found to be more systematic and comprehensive than previous models. PMID:27529267

Examining lung cancer risks across different industries and occupations in Ontario, Canada: the establishment of the Occupational Disease Surveillance System.

PubMed

Jung, James K H; Feinstein, Saul G; Palma Lazgare, Luis; Macleod, Jill S; Arrandale, Victoria H; McLeod, Christopher B; Peter, Alice; Demers, Paul A

2018-05-07

The Occupational Disease Surveillance System (ODSS) was established in Ontario, Canada by linking a cohort of workers with data created from Workplace Safety and Insurance Board (WSIB) claims to administrative health databases. The aim of this study was to use ODSS to identify high-risk industry and occupation groups for lung cancer in Ontario. Workers in the WSIB lost time claims database were linked to the Ontario Cancer Registry using subjects' health insurance numbers, name, sex, birthdate and death date (if applicable). Several occupations and industries known to be at increased risk were outlined a priori to examine whether ODSS could replicate these associations. Age-adjusted, sex-stratified Cox proportional hazard models compared the risk of lung cancer within one industry/occupation versus all other groups in the cohort. Workers with a lung cancer diagnosis prior to cohort entry were excluded for analysis, leaving 2 187 762 workers for analysis. During the 1983 to 2014 follow-up, 34 661 workers in the cohort were diagnosed with lung cancer. Among expected high-risk industries, elevated risks were observed among workers in quarries/sand pits and construction industries for both sexes, and among males in metal mines, iron foundries, non-metallic mineral products industries and transportation industries. Excess risk was also observed among occupations in drilling/blasting, other mining/quarrying, mineral ore treating, excavating/grading/paving, truck driving, painting, bus driving and construction. This current surveillance system identified several established high-risk groups for lung cancer and could be used for ongoing surveillance of occupational lung cancer in Ontario. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Occupation and oral cancer among women in the South.

PubMed

Winn, D M; Blot, W J; Shy, C M; Fraumeni, J F

1982-01-01

A case-control interview study among 232 North Carolina women with oral or pharyngeal cancer and 410 matched controls evaluated the contribution of occupation to the high risk of this cancer among females in the South. Review of detailed occupational histories found no overall elevated odds ratios for employment in the textile, apparel, or hosiery industry, the major employer of women in the area. Risks also did not increase with years worked in the industry. The findings thus fail to confirm an association reported in surveys in the United States and Great Britain. A new clue to occupational factors was suggested by the excess risk associated with the electronics industry in coastal North Carolina, independent of the participants' tobacco habits.

Multiplicity of skin cancers in Queensland and their cost burden to government and patients.

PubMed

Gordon, Louisa G; Elliott, Thomas M; Olsen, Catherine M; Pandeya, Nirmala; Whiteman, David C

2018-02-01

To determine the cost burden to government and patients for individuals with multiple skin cancers. We used self-reported baseline data on socio-demographics, phenotype and sun exposure behaviours from participants in the QSkin Sun and Health Study with at least one histopathologically confirmed keratinocyte cancer or melanoma (n=5,673). Linkage to Australian Medicare data (2011-2014) provided resource data and government and out-of-pocket patient costs. Generalised linear models examined costs by frequency of skin cancer groups separately for melanoma and keratinocyte cancer. Over three years, 539 participants were diagnosed with melanoma (11% had ≥2 melanomas) and 5,134 participants were treated for keratinocyte cancers (10% had ≥6). Median Medicare costs per person were $1,325 (maximum $6,117) for ≥2 melanomas and $2,126 (maximum $54,618) for ≥6 keratinocyte cancers. Increased costs were associated with private health insurance. Individuals who are multiply affected by skin cancers are relatively common and the accompanying individual and government cost burden can be substantial. These findings support skin cancer being classified as a chronic disease. Implications for public health: Over time, the economic burden for skin cancer for individuals and health providers is high and investment in prevention remains important from an economic viewpoint. © 2017 The Authors.

Occupations with increased risk of pancreatic cancer in the Swedish population

PubMed Central

Alguacil, J; Pollan, M; Gustavsson, P

2003-01-01

Aims: To identify occupations with increased risk of pancreatic cancer in the Swedish population gainfully employed in 1970 over the period 1971–89. Methods: The base population was made up of Swedish men (1 779 646) and Swedish women (1 101 669) gainfully employed at the time of the 1970 census and were still alive and over age 24 on 1 January 1971. Information was drawn from two data sets: the Swedish cancer environment register and a background population register. After 19 years of follow up, 4420 men and 2143 women were diagnosed with histologically confirmed incident pancreatic adenocarcinoma. Log linear Poisson models were fitted, allowing for geographical area and town size. Risk estimators were also calculated for workers reporting the same occupation in 1960 and 1970. Results: Among women, a statistically significant risk excess of pancreatic cancer was observed for "educational methods advisors", "librarian, archivist, curator", "motor vehicle driver", "typographer, lithographer", "purser, steward, stewardess", "other housekeeping and related workers", and the groups of occupations of "electrical, electronic, and related" and "glass, pottery, and tile workers". Men showed a higher incidence of pancreatic cancer among "technical assistants", "travelling agents", "other metal processing workers", "baker and pastry cook", "docker and freight handler", and "waiters". Conclusions: This study does not indicate that occupational factors play an important role in the aetiology of pancreatic cancer in Sweden. Few occupations were at increased risk of pancreatic cancer in both men and women, and the associations observed are in accordance with some previous studies from Western countries. PMID:12883017

Occupational factors and pancreatic cancer.

PubMed Central

Norell, S; Ahlbom, A; Olin, R; Erwald, R; Jacobson, G; Lindberg-Navier, I; Wiechel, K L

1986-01-01

The relation between occupational factors and pancreatic cancer has been studied by two different approaches: a population based case-control study with two series of controls and a retrospective cohort study based on register data. With both approaches, some support was found for an association with occupational exposure to petroleum products. Associations were also indicated with exposure to paint thinner (case-control study) and work in painting and in paint and varnish factories (cohort study), for exposure to detergents, floor cleaning agents, or polish (case-control study) and with floor polishing or window cleaning (cohort study), and for exposure to refuse (case-control study) and work in refuse disposal plants (cohort study). PMID:3790458

Estimates of cancer burden in Veneto.

PubMed

Tognazzo, Sandro; De Angelis, Roberta; Ciampichini, Roberta; Gatta, Gemma

2013-01-01

In Veneto a regional cancer registry has been operating since 1987 which provides incidence and survival data for the region. It currently covers 48% of the regional population. The aim of this paper is to provide estimates of the incidence, mortality and prevalence of the major cancers for the whole Veneto region in the period 1970-2015. The estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Survival was modeled on the basis of published data from the Italian cancer registries. In 2012 the most frequent cancer sites were colon-rectum, prostate and breast with 4,677, 3,760 and 3,729 new diagnosed cases, respectively. The incidence rates were estimated to increase constantly for female lung cancer, prostate cancer, colorectal cancer and melanoma, while they were decreasing for cervical cancer and stomach cancer. For male lung cancer and female breast cancer the rates increased, reaching a peak, and then decreased. In the last years of the period of analysis, mortality declined for all cancers: the highest number of deaths (2,390 in both sexes) was estimated for lung cancer in 2012. Prevalence was increasing for all the considered cancer sites with the exception of lung cancer in men, for which the prevalence was estimated to increase until 2007 and then stabilize. By contrast, the cervical cancer decreased during the whole period. In 2012 breast cancer had the highest prevalence, with about 52,000 cases. This paper provides a description of the burden of the major cancers in Veneto until 2015. The estimates highlight the continuing reduction of cancer mortality. This decline can be related to the improvement of clinical treatments and to multidisciplinary treatment approaches. In order for this positive trend to continue, implementation and reinforcement of the screening programs is needed, especially for breast and colorectal

An epidemiological study on occupation and cancer risk.

PubMed

Kato, I; Tominaga, S; Ikari, A

1990-06-01

The relation between occupation and cancer risk was examined on the basis of 17,164 male and 6,835 female cancer patients aged 30 years or over who were entered in the Aichi Cancer Registry during the period, 1979-1987. Controlling for age, the risk of developing lung cancer was significantly high in sales, transport-and-communications, mental, ceramics and construction workers in men, and service workers in women. The risk of developing liver cancer was significantly high in transport-and-communications and service workers in men. The risk of developing colon cancer was significantly high in professional people of both sexes and in clerical workers in men. The risk of developing female breast cancer was significantly high in professional women, administrative and clerical workers and hairdressers. The risk of developing stomach cancer was significantly high in male and female agricultural workers, while that of developing cancer of the mouth-and-pharynx was significantly high in construction workers in men and filature-and-spinning workers in women. Analysis of smoking and alcohol drinking habits, by occupation, suggested the increased risk of developing lung cancer to be associated with a greater percentage of smokers and the increased risks of developing cancers of the liver and mouth-and-pharynx to be associated with a greater percentage of daily alcohol drinkers. When the analysis was limited to smokers, the risk of developing lung cancer was still significantly high in metal, ceramics and construction workers in men.

Cancer survivorship and return to work: UK occupational physician experience.

PubMed

Amir, Ziv; Wynn, Philip; Whitaker, Stuart; Luker, Karen

2009-09-01

Survivorship following diagnosis of cancer is increasing in prevalence. However, cancer survivors continue to report difficulty re-entering the workplace after diagnosis and treatment. To survey UK occupational health physicians (OHPs) regarding their role in rehabilitation of employed survivors of cancer. Following a pilot study, a questionnaire exploring opinions of OHPs regarding supporting cancer survivors' return to work was posted to all members of the UK Society of Occupational Medicine, with a repeat posting 2 months later. Responses were analyzed for significant correlations with OHP age, sex, qualification level, size of businesses advised and years of experience. There were 797 respondents (response rate 51%). Responses suggested opportunities for developing the knowledge base in relation to prognosis and functional outcomes in patients with a cancer diagnosis; instituting information resources on cancer and work for OHPs and developing communications skills training. Most respondents felt managers treated referral to occupational health (OH) differently for employees with cancer compared with management referral for employees with other diagnoses, with 45% of respondents indicating referral may take place too late to be effective in securing a return to work. A significant lack of understanding of the information requirements of employers and the role of OH by treating doctors was identified. This survey raises several possible significant barriers to return to work by cancer survivors. Recommendations to ameliorate these are made.

Estimating the asbestos-related lung cancer burden from mesothelioma mortality

PubMed Central

McCormack, V; Peto, J; Byrnes, G; Straif, K; Boffetta, P

2012-01-01

Background: Quantifying the asbestos-related lung cancer burden is difficult in the presence of this disease's multiple causes. We explore two methods to estimate this burden using mesothelioma deaths as a proxy for asbestos exposure. Methods: From the follow-up of 55 asbestos cohorts, we estimated ratios of (i) absolute number of asbestos-related lung cancers to mesothelioma deaths; (ii) excess lung cancer relative risk (%) to mesothelioma mortality per 1000 non-asbestos-related deaths. Results: Ratios varied by asbestos type; there were a mean 0.7 (95% confidence interval 0.5, 1.0) asbestos-related lung cancers per mesothelioma death in crocidolite cohorts (n=6 estimates), 6.1 (3.6, 10.5) in chrysotile (n=16), 4.0 (2.8, 5.9) in amosite (n=4) and 1.9 (1.4, 2.6) in mixed asbestos fibre cohorts (n=31). In a population with 2 mesothelioma deaths per 1000 deaths at ages 40–84 years (e.g., US men), the estimated lung cancer population attributable fraction due to mixed asbestos was estimated to be 4.0%. Conclusion: All types of asbestos fibres kill at least twice as many people through lung cancer than through mesothelioma, except for crocidolite. For chrysotile, widely consumed today, asbestos-related lung cancers cannot be robustly estimated from few mesothelioma deaths and the latter cannot be used to infer no excess risk of lung or other cancers. PMID:22233924

National Estimates of Out-of-Pocket Health Care Expenditure Burdens Among Nonelderly Adults With Cancer: 2001 to 2008

PubMed Central

Bernard, Didem S.M.; Farr, Stacy L.; Fang, Zhengyi

2011-01-01

Purpose To compare the prevalence of high out-of-pocket burdens among patients with cancer with other chronically ill and well patients, and to examine the sociodemographic characteristics associated with high burdens among patients with cancer. Methods The sample included persons 18 to 64 years of age who received treatment for cancer, taken from a nationally representative sample of the US population from the 2001 to 2008 Medical Expenditure Panel Survey. We examined the proportion of persons living in families with high out-of-pocket burdens associated with medical spending, including insurance premiums, relative to income, defining high health care (total) burden as spending more than 20% of income on health care (and premiums). Results The risk of high burdens is significantly greater for patients with cancer compared with other chronically ill and well patients. We find that 13.4% of patients with cancer had high total burdens, in contrast to 9.7% among those with other chronic conditions and 4.4% among those without chronic conditions. Among nonelderly persons with cancer, the following were associated with higher out-of-pocket burdens: private nongroup insurance, age 55 to 64 years, non-Hispanic black, never married or widowed, one child or no children, unemployed, lower income, lower education level, living in nonmetropolitan statistical areas, and having other chronic conditions. Conclusion High burdens may affect treatment choice and deter patients from getting care. Thus, although a detailed patient-physician discussion of costs of care may not be feasible, we believe that an awareness of out-of-pocket burdens among patients with cancer is useful for clinical oncologists. PMID:21632508

Environmental and occupational interventions for primary prevention of cancer: a cross-sectorial policy framework.

PubMed

Espina, Carolina; Porta, Miquel; Schüz, Joachim; Aguado, Ildefonso Hernández; Percival, Robert V; Dora, Carlos; Slevin, Terry; Guzman, Julietta Rodriguez; Meredith, Tim; Landrigan, Philip J; Neira, Maria

2013-04-01

Nearly 13 million new cancer cases and 7.6 million cancer deaths occur worldwide each year; 63% of cancer deaths occur in low- and middle-income countries. A substantial proportion of all cancers are attributable to carcinogenic exposures in the environment and the workplace. We aimed to develop an evidence-based global vision and strategy for the primary prevention of environmental and occupational cancer. We identified relevant studies through PubMed by using combinations of the search terms "environmental," "occupational," "exposure," "cancer," "primary prevention," and "interventions." To supplement the literature review, we convened an international conference titled "Environmental and Occupational Determinants of Cancer: Interventions for Primary Prevention" under the auspices of the World Health Organization, in Asturias, Spain, on 17-18 March 2011. Many cancers of environmental and occupational origin could be prevented. Prevention is most effectively achieved through primary prevention policies that reduce or eliminate involuntary exposures to proven and probable carcinogens. Such strategies can be implemented in a straightforward and cost-effective way based on current knowledge, and they have the added benefit of synergistically reducing risks for other noncommunicable diseases by reducing exposures to shared risk factors. Opportunities exist to revitalize comprehensive global cancer control policies by incorporating primary interventions against environmental and occupational carcinogens.

Estimates of cancer burden in Sardinia.

PubMed

Budroni, Mario; Sechi, Ornelia; Cossu, Antonio; Palmieri, Giuseppe; Tanda, Francesco; Foschi, Roberto; Rossi, Silvia

2013-01-01

Cancer registration in Sardinia covers 43% of the population and started in 1992 in the Sassari province. The aim of this paper is to provide estimates of the incidence, mortality and prevalence of seven major cancers for the entire region in the period 1970-2015. The estimates were obtained by applying the MIAMOD method, a statistical back-calculation approach to derive incidence and prevalence figures starting from mortality and relative survival data. Estimates were compared with the available observed data. In 2012 the lowest incidence was estimated for stomach cancer and melanoma among men, with 140 and 74 new cases, respectively, per 100,000. The mortality rates were highest for lung cancer and were very close to the incidence rates (77 and 95 per 100,000, respectively). In women, breast was by far the most frequent cancer site both in terms of incidence (1,512 new cases) and mortality (295 deaths), followed by colon-rectum (493 cases and 201 deaths), lung (205 cases and 167 deaths), melanoma (106 cases and 15 deaths), stomach (82 cases and 61 deaths), and uterine cervix (36 cases and 19 deaths). The highest prevalence was estimated for breast cancer (15,180 cases), followed by colorectal cancer with about 7,300 prevalent cases in both sexes. This paper provides a description of the burden of the major cancers in Sardinia until 2015. The comparisons between the estimated age-standardized incidence rates and those observed in the Sassari registry indicate good agreement. The estimates show a general decrease in cancer mortality, with the exception of female lung cancer. By contrast, the prevalence is steeply increasing for all considered cancers (with the only exception of cancer of the uterine cervix). This points to the need for more strongly supporting evidence-based prevention campaigns focused on contrasting female smoking, unhealthy nutrition and sun exposure.

The Effect of Cancer Patients' and Their Family Caregivers' Physical and Emotional Symptoms on Caregiver Burden.

PubMed

Johansen, Safora; Cvancarova, Milada; Ruland, Cornelia

Although there is significant evidence that the family caregivers (FCs) of cancer patients can experience significant caregiver burden and symptoms, less is known about the relationships between FCs and patient characteristics that influence caregiver burden. The purpose of this study was to examine the effect of cancer patients' and FCs' symptoms and demographic characteristics on caregiver burden at initiation of the patients' radiation treatment. Two hundred eighty-one dyads of FCs and cancer patients who received a diagnosis of breast, prostate, melanoma, lymphoma, and head and neck cancers were recruited at the beginning of the patients' radiation treatment. Measures of depression, sleep disturbance, fatigue, social support, and self-efficacy were obtained from both FCs and cancer patients. The family caregivers were also assessed for caregiver burden. Associations between patients' and caregivers' symptoms and demographic characteristics and caregiver burden were investigated using multivariate analyses. There were significant associations between caregiver burden and the patient-related variables such as self-efficacy (P = .02), sleep disturbance (P = .03), and social support (P = .04). Among FC-related variables, higher scores of depression (P < .01), fatigue (P < .01), and symptoms (P < .01) were significantly associated with higher caregiver burden. Being a female, either as a patient or FC, increased the likelihood of experiencing fatigue and sleep disturbance. Caregiver burden in FCs is influenced by interplay of patients' and their own symptoms and problems. These interdependencies exist from the beginning of treatment. Nurses should systematically assess the problems and symptoms of the patients and FCs and support them from the time of diagnosis to help prevent symptom development and deterioration.

The burden of HPV associated cancers in two regions in Nigeria 2012-2014.

PubMed

Jedy-Agba, E E; Dareng, E O; Adebamowo, S N; Odutola, M; Oga, E A; Igbinoba, F; Otu, T; Ezeome, E; Bray, F; Hassan, R; Adebamowo, C A

2016-12-01

HPV attributable cancers are the second most common infection-related cancers worldwide, with much higher burden in less developed regions. There are currently no country-specific estimates of the burden of these cancers in Nigeria just like many other low and middle income countries. In this study, we quantified the proportion of the cancer burden in Nigeria that is attributable to HPV infection from 2012 to 2014 using HPV prevalence estimated from previous studies and data from two population based cancer registries (PBCR) in Nigeria. We considered cancer sites for which there is strong evidence of an association with HPV infection based on the International Agency for Research on Cancer (IARC) classification. We obtained age and sex-specific estimates of incident cancers and using the World Standard Population, we derived age standardized incidence (ASR) rates for each cancer type by categories of sex, and estimated the population attributable fractions (PAF). The two PBCR reported 4336 new cancer cases from 2012 to 2014. Of these, 1627 (37.5%) were in males and 2709 (62.5%) in females. Some 11% (488/4336) of these cancers were HPV associated; 2% (38/1627) in men and 17% (450/2709) in women. Of the HPV associated cancers, 7.8% occurred in men and 92.2% in women. The ASRs for HPV associated cancers was 33.5 per 100,000; 2.3 and 31.2 per 100,000 in men and women respectively. The proportion of all cancers attributable to HPV infection ranged from 10.2 to 10.4% (442-453 of 4336) while the proportion of HPV associated cancers attributable to HPV infection ranged from 90.6% to 92.8% (442-453 of the 488 cases). In men, 55.3% to 68.4% of HPV associated cancers were attributable to HPV infection compared to 93.6% to 94.8% in women. The combined ASR for HPV attributable cancers ranged from 31.0 to 31.7 per 100,000. This was 1.4 to 1.7 per 100,000 in men and 29.6 to 30.0 per 100,000 in women. In women, cervical cancer (n=392, ASR 28.3 per 100,000) was the commonest HPV

CHESS improves cancer caregivers' burden and mood: results of an eHealth RCT.

PubMed

DuBenske, Lori L; Gustafson, David H; Namkoong, Kang; Hawkins, Robert P; Atwood, Amy K; Brown, Roger L; Chih, Ming-Yuan; McTavish, Fiona; Carmack, Cindy L; Buss, Mary K; Govindan, Ramaswamy; Cleary, James F

2014-10-01

Informal caregivers (family and friends) of people with cancer are often unprepared for their caregiving role, leading to increased burden or distress. Comprehensive Health Enhancement Support System (CHESS) is a Web-based lung cancer information, communication, and coaching system for caregivers. This randomized trial reports the impact on caregiver burden, disruptiveness, and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites. A total of 285 informal caregivers of patients with advanced nonsmall cell lung cancer were randomly assigned to a comparison group that received Internet or a treatment group that received Internet and CHESS. Caregivers were provided a computer and Internet service if needed. Written surveys were completed at pretest and during the intervention period bimonthly for up to 24 months. Analyses of covariance (ANCOVAs) compared the intervention's effect on caregivers' disruptiveness and burden (CQOLI-C), and negative mood (combined Anxiety, Depression, and Anger scales of the POMS) at 6 months, controlling for blocking variables (site, caregiver's race, and relationship to patient) and the given outcome at pretest. Caregivers randomized to CHESS reported lower burden, t(84) = 2.36, p = .021, d = .39, and negative mood, t(86) = 2.82, p = .006, d = .44, than those in the Internet group. The effect on disruptiveness was not significant. Although caring for someone with a terminal illness will always exact a toll on caregivers, eHealth interventions like CHESS may improve caregivers' understanding and coping skills and, as a result, ease their burden and mood.

CHESS Improves Cancer Caregivers’ Burden and Mood: Results of an eHealth RCT

PubMed Central

DuBenske, Lori L.; Gustafson, David H.; Namkoong, Kang; Hawkins, Robert P.; Atwood, Amy K.; Brown, Roger L.; Chih, Ming-Yuan; McTavish, Fiona; Carmack, Cindy L.; Buss, Mary K.; Govindan, Ramaswamy; Cleary, James F.

2014-01-01

Objective Informal caregivers (family and friends) of people with cancer are often unprepared for their caregiving role, leading to increased burden or distress. CHESS (Comprehensive Health Enhancement Support System) is a web-based lung cancer information, communication and coaching system for caregivers. This randomized trial reports the impact on caregiver burden, disruptiveness and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites. Methods 285 informal caregivers of patients with advanced non-small cell lung cancer were randomly assigned to a comparison group that received Internet or a treatment group that received Internet and CHESS. Caregivers were provided a computer and Internet service if needed. Written surveys were completed at pretest and during the intervention period bimonthly for up to 24 months. ANCOVA analyses compared the intervention’s effect on caregivers’ disruptiveness and burden (CQOLI-C), and negative mood (combined Anxiety, Depression, and Anger scales of the POMS) at six months, controlling for blocking variables (site, caregiver’s race, and relationship to patient) and the given outcome at pretest. Results Caregivers randomized to CHESS reported lower burden [t (84) = 2.36, p = .021, d= .39] and negative mood [t (86) = 2.82, p = .006, d= .44] than those in the Internet group. The effect on disruptiveness was not significant. Conclusions Although caring for someone with a terminal illness will always exact a toll on caregivers, eHealth interventions like CHESS may improve caregivers’ understanding and coping skills and, as a result, ease their burden and mood. PMID:24245838

Occupation and thyroid cancer: a population-based case-control study in Connecticut

PubMed Central

Ba, Yue; Huang, Huang; Lerro, Catherine C.; Li, Shuzhen; Zhao, Nan; Li, Anqi; Ma, Shuangge; Udelsman, Robert; Zhang, Yawei

2016-01-01

Objective The study aims to explore the associations between various occupations and thyroid cancer risk. Methods A population-based case-control study involving 462 histologically confirmed incident cases and 498 controls was conducted in Connecticut in 2010–2011. Results A significantly increased risk of thyroid cancer, particularly papillary microcarcinoma, was observed for those working as the healthcare practitioners and technical workers, health diagnosing and treating practitioners and registered nurses. Those working in building and grounds cleaning, maintenance occupations, pest control, retail sales, and customer service also had increased risk for papillary thyroid cancer. Subjects who worked as cooks, janitors, cleaners, and customer service representatives were at an increased risk of papillary thyroid cancer with tumor size >1 cm. Conclusions Certain occupations were associated with an increased risk of thyroid cancer, with some tumor size and subtype specificity. PMID:26949881

Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors.

PubMed

Kale, Hrishikesh P; Carroll, Norman V

2016-04-15

Cancer-related financial burden has been linked to cancer survivors (CS) forgoing/delaying medical care, skipping follow-up visits, and discontinuing medications. To the authors' knowledge, little is known regarding the effect of financial burden on the health-related quality of life of CS. The authors analyzed 2011 Medical Expenditure Panel Survey data. Financial burden was present if one of the following problems was reported: borrowed money/declared bankruptcy, worried about paying large medical bills, unable to cover the cost of medical care visits, or other financial sacrifices. The following outcomes were evaluated: Physical Component Score (PCS) and Mental Component Score (MCS) of the 12-Item Short-Form Health Survey (SF-12), depressed mood, psychological distress, and worry related to cancer recurrence. The authors also assessed the effect of the number of financial problems on these outcomes. Of the 19.6 million CS analyzed, 28.7% reported financial burden. Among them, the average PCS (42.3 vs 44.9) and MCS (48.1 vs 52.1) were lower for those with financial burden versus those without. In adjusted analyses, CS with financial burden had significantly lower PCS (β = -2.45), and MCS (β = -3.05), had increased odds of depressed mood (odds ratio, 1.95), and were more likely to worry about cancer recurrence (odds ratio, 3.54). Survivors reporting ≥ 3 financial problems reported statistically significant and clinically meaningful differences (≥3 points) in the mean PCS and MCS compared with survivors without financial problems. Cancer-related financial burden was associated with lower health-related quality of life, increased risk of depressed mood, and a higher frequency of worrying about cancer recurrence among CS. © 2015 American Cancer Society.

The burden of chronic ureteral stenting in cervical cancer survivors

PubMed Central

Fan, Yunhua; Jarosek, Stephanie; Elliott, Sean P.

2017-01-01

ABSTRACT Purpose Ureteral obstruction in cervical cancer occurs in up to 11% of patients, many of whom undergo ureteral stenting. Our aim was to describe the patient burden of chronic ureteral stenting in a population-based cohort by detailing two objectives: (1) the frequency of repeat procedures for ureteral obstruction; and, (2) the frequency of urinary adverse effects (UAEs) (e.g., lower urinary tract symptoms, flank pain). Materials and Methods From SEER-Medicare, we identified 202 women who underwent ureteral stent placement prior to or following cervical cancer treatment. The frequency of repeat procedures and rate ratios were compared between treatment modalities. The rates and rate ratios of UAEs were compared between our primary cohort (stent + cervical cancer) and the following groups: no stent + cervical cancer, stent + no cancer, and no stent + no cancer. The “no cancer” group was drawn from the 5% Medicare sample. Results 117/202 women (58%) underwent >1 stent procedure. The frequency of additional procedures was significantly higher in patients who received radiation as part of their treatment. UAEs were very common in women with stent + cancer. The rate of UTI was 190 (per 100 person-years), 67 for LUTS, 42 for stones, and 6 for flank pain. These rates were 3-10 fold higher than in the no stent + no cancer control group; rates were also higher than in the no stent + cancer and the stent + no cancer women. Conclusions The burden of disease associated with ureteral stents is higher than expected and urologists should be actively involved in stent management, screening for associated symptoms and offering definitive reconstruction when appropriate. PMID:27649113

The economic burden of caregiving on families of children and adolescents with cancer: a population-based assessment.

PubMed

Pagano, Eva; Baldi, Ileana; Mosso, Maria Luisa; di Montezemolo, Luca Cordero; Fagioli, Franca; Pastore, Guido; Merletti, Franco

2014-06-01

Childhood cancer represents a relevant economic burden on families. The preferred tool to investigate family expenditure is the retrospective questionnaire, which is subject to recall errors and selection bias. Therefore, in the present study the economic burden of caregiving on families of children and adolescents (0-19 years of age) with cancer was analysed using administrative data as an alternative to retrospective questionnaires. Incident cases of cancer diagnosed in children and adolescents in 2000-2005 (N = 917) were identified from the Piedmont Childhood Cancer Registry and linked to available administrative databases to identify episodes of care during the 3 years after diagnosis (N = 13,433). The opportunity cost of informal caregiving was estimated as the value of the time spent by one of the parents, and was assumed to be equal to the number of days during which the child received inpatient care, day-care or outpatient radiotherapy. Factors affecting the level of economic burden of caregiving on families were analysed in a multivariable model. The economic burden of caregiving increased when care was supplied at the Regional Referral Centre, or when treatment complexity was high. Families with younger children had a higher level of economic burden of caregiving. Leukaemia required a higher family commitment than any other cancer considered. Estimates of the economic burden of caregiving on families of children and adolescents with cancer derived from administrative data should be considered a minimum burden. The estimated effect of the covariates is informative for healthcare decision-makers in planning support programmes. © 2013 Wiley Periodicals, Inc.

Environmental and occupational causes of cancer: new evidence 2005-2007.

PubMed

Clapp, Richard W; Jacobs, Molly M; Loechler, Edward L

2008-01-01

What do we currently know about the occupational and environmental causes of cancer? As of 2007, the International Agency for Research on Cancer (IARC) identified 415 known or suspected carcinogens. Cancer arises through an extremely complicated web of multiple causes, and we will likely never know the full range of agents or combinations of agents. We do know that preventing exposure to individual carcinogens prevents the disease. Declines in cancer rates-such as the drop in male lung cancer cases from the reduction in tobacco smoking or the drop in bladder cancer among cohorts of dye workers from the elimination of exposure to specific aromatic amines-provides evidence that preventing cancer is possible when we act on what we know. Although the overall age-adjusted cancer incidence rates in the United States among both men and women have declined in the last decade, the rates of several types of cancers are on the rise; some of which are linked to environmental and occupational exposures. This report chronicles the most recent epidemiologic evidence linking occupational and environmental exposures with cancer. Peer-reviewed scientific studies published from January 2005 to June 2007 were reviewed, supplementing our state-of-the-evidence report published in September 2005. Despite weaknesses in certain individual studies, we consider the evidence linking the increased risk of several types of cancer with specific exposures somewhat strengthened by recent publications, among them brain cancer from exposure to non-ionizing radiation, particularly radiofrequency fields emitted by mobile telephones; breast cancer from exposure to the pesticide dichlorodiphenyltrichloroethane (DDT) before puberty; leukemia from exposure to 1,3-butadiene; lung cancer from exposure to air pollution; non-Hodgkin's lymphoma (NHL) from exposure to pesticides and solvents; and prostate cancer from exposure to pesticides, polyaromatic hydrocarbons (PAHs), and metal working fluids or mineral

Diversity in the association between occupation and lung cancer among black and white men.

PubMed

Swanson, G M; Lin, C S; Burns, P B

1993-01-01

A population-based case comparison study of incident lung cancer and occupational risk factors was conducted in the tricounty Detroit metropolitan area. Nearly 6000 lung cancer cases and a comparison group of 3600 colon cancer cases were interviewed. This report includes 3792 white and black male lung cancer cases and 1966 black and white colon cancer referents. Cigarette smoking, age at diagnosis, and lifetime work history were assessed to determine the relationship between length of employment in specific occupations and industries and lung cancer. Diverse patterns of association between work history and lung cancer were observed for black and white men. Significant associations were seen between lung cancer and increasing length of employment in the following occupations: for white men, concrete and terrazzo finishers, grinding machine operators, heat treating machine operators, miscellaneous machine operators, truck drivers, driver sales, and laborers; for black men, farm workers, automobile mechanics, painting machine operators, furnace operators, and garbage collectors; for both black and white men, farmers, slicing and cutting machine operators, and garbage collectors. Distinct patterns for black and white men also were observed for length of employment by industry. This study clearly demonstrates the need to include black men in studies of occupational cancer etiology and to evaluate black and white men separately. It also indicates the necessity for cigarette smoking history to accurately assess workplace cancer risks. We propose guidelines for incorporating the use of biomarkers into further studies of occupational cancer epidemiology.

Environmental and Occupational Interventions for Primary Prevention of Cancer: A Cross-Sectorial Policy Framework

PubMed Central

Espina, Carolina; Porta, Miquel; Schüz, Joachim; Aguado, Ildefonso Hernández; Percival, Robert V.; Dora, Carlos; Slevin, Terry; Guzman, Julietta Rodriguez; Meredith, Tim; Landrigan, Philip J.

2013-01-01

Background: Nearly 13 million new cancer cases and 7.6 million cancer deaths occur worldwide each year; 63% of cancer deaths occur in low- and middle-income countries. A substantial proportion of all cancers are attributable to carcinogenic exposures in the environment and the workplace. Objective: We aimed to develop an evidence-based global vision and strategy for the primary prevention of environmental and occupational cancer. Methods: We identified relevant studies through PubMed by using combinations of the search terms “environmental,” “occupational,” “exposure,” “cancer,” “primary prevention,” and “interventions.” To supplement the literature review, we convened an international conference titled “Environmental and Occupational Determinants of Cancer: Interventions for Primary Prevention” under the auspices of the World Health Organization, in Asturias, Spain, on 17–18 March 2011. Discussion: Many cancers of environmental and occupational origin could be prevented. Prevention is most effectively achieved through primary prevention policies that reduce or eliminate involuntary exposures to proven and probable carcinogens. Such strategies can be implemented in a straightforward and cost-effective way based on current knowledge, and they have the added benefit of synergistically reducing risks for other noncommunicable diseases by reducing exposures to shared risk factors. Conclusions: Opportunities exist to revitalize comprehensive global cancer control policies by incorporating primary interventions against environmental and occupational carcinogens. PMID:23384642

Bladder cancer and occupational exposure to leather.

PubMed Central

Marrett, L D; Hartge, P; Meigs, J W

1986-01-01

A large case-control study of bladder cancer (2982 cases; 5782 controls) included information about occupational exposure to leather. Occupational histories of exposed white study subjects were reviewed and 150 were determined to have had "true" on the job exposure to leather. The odds ratio estimate (OR) of bladder cancer associated with such exposure in white subjects (n = 8063) was 1.4 (95% confidence limits = 1.0, 1.9) after adjustment for sex, age, and cigarette smoking. The risk was highest in those first employed in a leather job before 1945, although no dose-response relation with duration of leather employment was found. Subjects employed in "dusty" leather jobs had a slightly higher risk than those with other types of leather jobs. Our results are consistent with reports of an increased risk of bladder cancer associated with exposure to leather. Although the agents responsible have not been identified, our findings of an increased risk associated with exposure in the earlier years of this century and in dusty jobs suggest that leather dusts may be important. PMID:3947575

Occupation and Risk of Bladder Cancer in Nordic Countries.

PubMed

Hadkhale, Kishor; Martinsen, Jan Ivar; Weiderpass, Elisabete; Kjaerheim, Kristina; Lynge, Elsebeth; Sparen, Pär; Tryggvadottir, Laufey; Pukkala, Eero

2016-08-01

The purpose of the study was to describe the variation of bladder cancer incidence according to occupational categories in the Nordic countries. The study cohort comprised 15 million individuals older than 30 years who participated in one or more population censuses in 1960, 1970, 1980/1981, and/or 1990. Standardized incidence ratios (SIRs) were estimated for 53 occupational categories. Significantly increased SIRs were observed among tobacco workers (1.57; 95% confidence interval [CI] 1.24 to 1.96), chimney sweeps (1.48; 95% CI 1.21 to 1.80), waiters (1.43; 95% CI 1.33 to 1.53), hairdressers (1.28; 95% CI 1.18 to 1.40), seamen (1.22; 95% CI 1.16 to 1.30), printers (1.21; 95% CI 1.14 to 1.30), and plumbers (1.20; 95% CI 1.13 to 1.30). A significantly decreased risk of bladder cancer was observed among gardeners (0.78, 0.75 to 0.80), forestry workers (0.74; 95% CI 0.70 to 0.78), and farmers (0.70; 95% CI 0.68 to 0.71). The SIR of bladder cancer was overall similar across the Nordic countries. The study suggests that occupation is evidently associated with bladder cancer risk.

Risk Factors for Breast Cancer, Including Occupational Exposures

PubMed Central

Meo, Margrethe; Vainio, Harri

2011-01-01

The knowledge on the etiology of breast cancer has advanced substantially in recent years, and several etiological factors are now firmly established. However, very few new discoveries have been made in relation to occupational risk factors. The International Agency for Research on Cancer has evaluated over 900 different exposures or agents to-date to determine whether they are carcinogenic to humans. These evaluations are published as a series of Monographs (www.iarc.fr). For breast cancer the following substances have been classified as "carcinogenic to humans" (Group 1): alcoholic beverages, exposure to diethylstilbestrol, estrogen-progestogen contraceptives, estrogen-progestogen hormone replacement therapy and exposure to X-radiation and gamma-radiation (in special populations such as atomic bomb survivors, medical patients, and in-utero exposure). Ethylene oxide is also classified as a Group 1 carcinogen, although the evidence for carcinogenicity in epidemiologic studies, and specifically for the human breast, is limited. The classification "probably carcinogenic to humans" (Group 2A) includes estrogen hormone replacement therapy, tobacco smoking, and shift work involving circadian disruption, including work as a flight attendant. If the association between shift work and breast cancer, the most common female cancer, is confirmed, shift work could become the leading cause of occupational cancer in women. PMID:22953181

Temporal Trend in Lung Cancer Burden Attributed to Ambient Fine Particulate Matter in Guangzhou, China.

PubMed

Liao, Yu; Xu, Lin; Lin, Xiao; Hao, Yuan Tao

2017-10-01

To estimate the lung cancer burden that may be attributable to ambient fine particulate matter (PM2.5) pollution in Guangzhou city in China from 2005 to 2013. The data regarding PM2.5 exposure were obtained from the 'Ambient air pollution exposure estimation for the Global Burden of Disease 2013' dataset at 0.1° ×0.1° spatial resolution. Disability-adjusted life years (DALYs) were estimated based on the information of mortality and incidence of lung cancer. Comparative risk analysis and integrated exposure-response function were used to estimate attributed disease burden. The population-weighted average concentration of PM2.5 was increased by 34.6% between 1990 and 2013, from 38.37 μg/m3 to 51.31 μg/m3. The lung cancer DALYs in both men and women were increased by 36.2% from 2005 to 2013. The PM2.5 attributed lung cancer DALYs increased from 12105.0 (8181.0 for males and 3924.0 for females) in 2005 to 16489.3 (11291.7 for males and 5197.6 for females) in 2013. An average of 23.1% lung cancer burden was attributable to PM2.5 pollution in 2013. PM2.5 has caused serious but under-appreciated public health burden in Guangzhou and the trend deteriorates. Effective strategies are needed to tackle this major public health problem. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Cognitive and Occupational Function in Survivors of Adolescent Cancer.

PubMed

Nugent, Bethany D; Bender, Catherine M; Sereika, Susan M; Tersak, Jean M; Rosenzweig, Margaret

2018-02-01

Adolescents with cancer have unique developmental considerations. These include brain development, particularly in the frontal lobe, and a focus on completing education and entering the workforce. Cancer and treatment at this stage may prove to uniquely affect survivors' experience of cognitive and occupational function. An exploratory, cross-sectional, descriptive comparative study was employed to describe cognitive and occupational function in adult survivors of adolescent cancer (diagnosed between the ages of 15 and 21 years) and explore differences in age- and gender-matched controls. In total, 23 survivors and 14 controls participated in the study. While significant differences were not found between the groups on measures of cognitive and occupational function, several small and medium effect sizes were found suggesting that survivors may have greater difficulty than controls. Two small effect sizes were found in measures of neuropsychological performance (the Digit Vigilance test [d = 0.396] and Stroop test [d = 0.226]). Small and medium effect sizes ranging from 0.269 to 0.605 were found for aspects of perceived and total cognitive function. A small effect size was also found in work output (d = 0.367). While we did not find significant differences in cognitive or occupational function between survivors and controls, the effect sizes observed point to the need for future research. Future work using a larger sample size and longitudinal design are needed to further explore cognitive and occupational function in this vulnerable and understudied population and assist in the understanding of patterns of change over time.

Occupational asphalt is not associated with head and neck cancer

PubMed Central

Fogleman, E. V.; Eliot, M.; Michaud, D. S.; Nelson, H. H.; McClean, M. D.

2015-01-01

Background Epidemiologic studies that evaluate the relationship between occupational asphalt exposure and head and neck cancer have had a limited ability to control for known risk factors such as smoking, alcohol and human papillomavirus (HPV). Aims To better elucidate this relationship by including known risk factors in a large case–control study of head and neck squamous cell carcinoma (HNSCC) from the greater Boston area. Methods We analysed the relationship between occupational asphalt exposure and HNSCC among men in the Greater Boston area of Massachusetts. Analyses were conducted using unconditional multivariable logistic regression, performed with adjustments for age, race, education, smoking, alcohol consumption and HPV serology. Results There were 753 cases and 913 controls. No associations between HNSCC and occupational asphalt exposure (neither among ever-exposed nor by occupational duration) were observed for exposures in any occupation or those restricted to the construction industry. We also observed no associations in subgroup analyses of never-smokers and ever-smokers. Adjusting for known risk factors further reduced the estimated effect of asphalt exposure on HNSCC risk. Conclusions We found no evidence for an association between occupational asphalt exposure and HNSCC. The null findings from this well-controlled analysis could suggest that the risk estimates stemming from occupational cohort studies may be overestimated due to uncontrolled confounding and enhance the literature available for weighing cancer risk from occupational exposure to bitumen. PMID:26272381

Travel Burden and Clinical Profile of Cancer Patients Admitted to the Cancer Institute of Iran in 2012.

PubMed

Sadeghi, Fatemeh; Ardestani, Atefeh; Hadji, Maryam; Mohagheghi, Mohammad Ali; Kazemian, Ali; Mirzania, Mehrzad; Mahmoodzadeh, Habibollah; Aghili, Mahdi; Zendehdel, Kazem

2017-03-01

Burden of cancer is increasing in developing countries, where healthcare infrastructures and resources are limited. Evaluating the pattern of care would provide evidence for planning and improvement of the situation. We studied the pattern of residential place and clinical information of cancer patients who were admitted to the Cancer Institute of Iran from January 1, to May 31, 2012. We studied 1,705 consecutive cancer patients admitted to the Cancer Institute in the study period. The most common cancers were breast (29.2%), colorectal (9.0%), stomach (8.3%), head & neck (8.0%) and esophageal (3.8%) cancers. Radiotherapy was the main treatment (52.1%) followed by chemotherapy (43.8%) and surgery (29.1%). We found that 60% of the patients presented in the loco-regional or advanced stages. About 35% of patients travelled from other provinces mainly from Mazandaran (13.4%), Lorestan (10.6%), Zanjan (7.8%) and Ghazvin (6.6%). On average, the cancer patients travelled about 455 kilometers to receive care in the cancer institute. We found more than 38% patients who were referred from other provinces had an early stage tumor. Establishment of comprehensive cancer centers in different geographical regions and implementation of a proper referral system for advanced cancer patients is needed to improve the patient outcomes and mitigate the burden of travel of patients for cancer care.

Asbestos-related occupational cancers compensated under the Industrial Accident Compensation Insurance in Korea.

PubMed

Ahn, Yeon-Soon; Kang, Seong-Kyu

2009-04-01

Compensation for asbestos-related cancers occurring in occupationally-exposed workers is a global issue; this is also an issue in Korea. To provide basic information regarding compensation for workers exposed to asbestos, 60 cases of asbestos-related occupational lung cancer and mesothelioma that were compensated during 15 yr; from 1993 (the year the first case was compensated) to 2007 by the Korea Labor Welfare Corporation (KLWC) are described. The characteristics of the cases were analyzed using the KLWC electronic data and the epidemiologic investigation data conducted by the Occupational Safety and Health Research Institute (OSHRI) of the Korea Occupational Safety and Health Agency (KOSHA). The KLWC approved compensation for 41 cases of lung cancer and 19 cases of mesothelioma. Males accounted for 91.7% (55 cases) of the approved cases. The most common age group was 50-59 yr (45.0%). The mean duration of asbestos exposure for lung cancer and mesothelioma cases was 19.2 and 16.0 yr, respectively. The mean latency period for lung cancer and mesothelioma cases was 22.1 and 22.6 yr, respectively. The major industries associated with mesothelioma cases were shipbuilding and maintenance (4 cases) and manufacture of asbestos textiles (3 cases). The major industries associated with lung cancer cases were shipbuilding and maintenance (7 cases), construction (6 cases), and manufacture of basic metals (4 cases). The statistics pertaining to asbestos-related occupational cancers in Korea differ from other developed countries in that more cases of mesothelioma were compensated than lung cancer cases. Also, the mean latency period for disease onset was shorter than reported by existing epidemiologic studies; this discrepancy may be related to the short history of occupational asbestos use in Korea. Considering the current Korean use of asbestos, the number of compensated cases in Korea is expected to increase in the future but not as much as developed countries.

[Insurance against occupational cancer in Italy and in Europe].

PubMed

Bottazzi, Marco

2009-01-01

European and Italian data show a marked under ascertainment of occupational cancers: only a small proportion is recognized, although for the majority of them the etiological fraction attributable to the workplace is high. Since more than 20 years Patronato INCA is active in order to reduce this gap. Its commitment to spread scientific knowledge has paralleled the action intended to make social security rules more favourable to workers, as well as to improve hygiene and safety in the workplace. Particular attention has been given to updating both the Italian list of occupational diseases for which notification is compulsory (which includes all Group I carcinogens according to IARC) and the Italian tables of occupational diseases. The latter are of particular relevance to the Patronato because, within the Italian norms, causality is approached in different terms according to whether a disease is or is not included in the tables. Together with changing the tables, a theoretical elaboration regarding causality, as required by multifactorial diseases such as occupational cancer, has been carried out. Such a constant commitment to bring to the surface occupational diseases is based on the belief that the right to compensation of workers who turned ill because of the work is important, and even more on the belief that identification of occupational diseases is most important for primary prevention.

Burden of colorectal cancer in Central and South America.

PubMed

Sierra, Monica S; Forman, David

2016-09-01

The colorectal cancer (CRC) burden is increasing in Central and South American due to an ongoing transition towards higher levels of human development. We describe the burden of CRC in the region and review the current status of disease control. We obtained regional- and national-level incidence data from 48 population-based cancer registries in 13 countries, as well as cancer deaths from the WHO mortality database for 18 countries. We estimated world population age-standardized incidence (ASR) and mortality (ASMR) rates per 100,000 person-years for 2003-2007 and the estimated annual percentage change for 1997-2008. The CRC rate in males was 1-2 times higher than that in females. In 2003-2007, the highest ASRs were seen in Uruguayan, Brazilian and Argentinean males (25.2-34.2) and Uruguayan and Brazilian females (21.5-24.7), while El Salvador had the lowest ASR in both sexes (males: 1.5, females: 1.3). ASMRs were<10 for both sexes, except in Uruguay, Cuba and Argentina (10.0-17.7 and 11.3-12.0). CRC incidence is increasing in Chilean males. Most countries have national screening guidelines. Uruguay and Argentina have implemented national screening programs. Geographic variation in CRC and sex gaps may be explained by differences in the prevalence of obesity, physical inactivity, diet, smoking and alcohol consumption, early detection, and cancer registration practices. Establishing optimal CRC screening programs is challenging due to lack of healthcare access and coverage, funding, regional differences and inadequate infrastructure, and may not be feasible. Given the current status of CRC in the region, data generated by population-based cancer registries is crucial for cancer control planning. Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd.. All rights reserved.

Racial disparities in patient survival and tumor mutation burden, and the association between tumor mutation burden and cancer incidence rate.

PubMed

Zhang, Wensheng; Edwards, Andrea; Flemington, Erik K; Zhang, Kun

2017-10-20

The causes underlying racial disparities in cancer are multifactorial. In addition to socioeconomic issues, biological factors may contribute to these inequities, especially in disease incidence and patient survival. To date, there have been few studies that relate the disparities in these aspects to genetic aberrations. In this work, we studied the impacts of race on the patient survival and tumor mutation burden using the data released by the Cancer Genome Atlas (TCGA). The potential relationship between mutation burden and disease incidence is further inferred by an integrative analysis of TCGA data and the data from the Surveillance, Epidemiology, and End Results (SEER) Program. The results show that disparities are present (p < 0.05) in patient survival of five cancers, such as head and neck squamous cell carcinoma. The numbers of tumor driver mutations are differentiated (p < 0.05) over the racial groups in five cancers, such as lung adenocarcinoma. By treating a specific cancer type and a racial group as an "experimental unit", driver mutation numbers demonstrate a significant (r = 0.46, p < 0.002) positive correlation with cancer incidence rates, especially when the five cancers with mutational disparities are exclusively focused (r = 0.88, p < 0.00002). These results enrich our understanding of racial disparities in cancer and carcinogenic process.

Occupational exposure and laryngeal and hypopharyngeal cancer risk in central and eastern Europe

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shangina, O.; Brennan, P.; Szeszenia-Dabrowska, N.

2006-08-15

A multicenter case-control study was conducted during 1999-2002 in four European countries (Poland, Romania, Russia, and Slovakia) to evaluate the role of occupational exposures in risk of laryngeal/hypopharyngeal cancer. Male cancer cases (34 hypopharyngeal, 316 laryngeal) with full data on occupational history and nonoccupational factors were compared with 728 hospital controls for occupational exposure to 73 suspected carcinogens. Occupational history was evaluated by industrial hygienists blinded to case/control status. Elevated risks for over exposure to coal dust were found for both hypopharyngeal (odds ratio (OR) = 4.19, 95% confidence interval (CI): 1.18, 14.89) and laryngeal (OR = 1.81, 95% CI:more » 0.94, 3.47) cancer, with clear dose-response patterns. Inclusion of a 20-year lag in the analysis strengthened these associations. Hypopharyngeal cancer risk was also significantly associated with exposure to mild steel dust (OR = 3.04, 95% CI: 1.39, 6.64) and iron compounds and fumes (OR = 2.74, 95% CI: 1.29, 5.84), without clear dose-response relations. Laryngeal cancer was significantly associated with exposure to hard-alloys dust (OR = 2.23, 95% CI: 1.08, 4.57) and chlorinated solvents (OR = 2.18, 95% CI: 1.03, 4.61), without dose-response relations. A possible link between high formaldehyde exposure and laryngeal cancer was suggested. These data indicate that occupational exposure to coal dust may play a role in laryngeal and hypopharyngeal cancer. Other possible relations need further evaluation.« less

Economic burden of non-cervical cancers attributable to human papillomavirus: a European scoping review.

PubMed

Préaud, Emmanuelle; Largeron, Nathalie

2013-01-01

Human papillomavirus (HPV) has an important role in the aetiology of a range of diseases, including cervical, other anogenital, and head and neck cancers, genital warts and recurrent respiratory papillomatosis. This literature review was conducted to identify the available cost data for non-cervical HPV-related cancers (anal, penile, vulvar, vaginal, head and neck) in Europe and to inform discussion of methodological challenges for future economic research. The literature search was conducted using Medline and key words to identify papers published in English or French between 1 January 2000 and 31 December 2011. Abstracts of major conferences were searched to identify relevant information. Structured methods were used to select references that focused on overall disease management for inclusion in the review. A total of 21 references from seven countries (Denmark, France, Germany, Greece, The Netherlands, Portugal, and the UK) were selected, including 11 references relating to head and neck cancers, five to anogenital cancers, and five to more than one HPV-related disease. Non-cervical cancers accounted for a substantial proportion of the economic burden of HPV-related cancers, and this burden was mainly driven by men (∼70%). A wide range of costs were reported for each disease, particularly head and neck cancers, predominantly due to disease complexity and variation in study design. The main limitation of this study was in the search strategy, which was constrained by the key words, the database searched, and the restriction on language (English/French). Non-cervical cancers attributable to HPV impose a substantial economic burden in Europe, and the burden is greater in men than in women. This review provides useful information for future health-economic studies assessing the impact of HPV vaccination on all HPV-related diseases.

Occupational cancer in Italy: evaluating the extent of compensated cases in the period 1994-2006.

PubMed

Scarselli, Alberto; Scano, Patrizia; Marinaccio, Alessandro; Iavicoli, Sergio

2009-11-01

The aim of this study is to analyze occupational cancer claims compensated in the industrial sector in Italy between 1994 and 2006. A descriptive analysis of compensated occupational cancers based on the Italian Workers' Compensation Authority (INAIL) data was performed. Summary statistics were compiled by sex and age of worker, cancer type, workplace agent and economic sector. The temporal trend in the period 1994-2006 was investigated for the most frequently compensated cancers (mesothelioma and lung cancer from asbestos; nasal cavities cancer from wood and leather dust). Between 1994 and 2006, 6,243 cancer claims were compensated by INAIL due to occupational exposure in the industrial sector. Most (5,288, or 85%) of these compensated claims occurred in the period 2000-2006, when the annual mean of the most compensated cancers increased approximately four times compared to the period 1994-1999. There is an increasing trend in compensation for work-related cancers in Italy in recent years, even if occupational cancers are still widely underreported. (c) 2009 Wiley-Liss, Inc.

Occupational health referrals for advice on cancer-related sickness absence.

PubMed

Wynn, P; Woodcock, K

2011-05-01

Work-related difficulties experienced by employees diagnosed with cancer are widely reported. However, there is limited reliable quantitative evidence that employers treat employees with such diagnoses differently from staff with other chronic disorders. To assess delays to management referral for occupational health advice for employees on long-term sickness absence attributable to cancer, compared with other common causes of long-term health-related absence. An audit of management delays to occupational health referral for all employees with a cancer diagnosis who subsequently applied for ill-health early retirement in a large UK public sector employer. Similar data were collected for two control groups, with musculoskeletal or psychological complaints, matched by age, sex, job title and pension scheme membership. Data were collected for the period 2004-07. Twenty-three cases were identified. Referral to the occupational health services for cases with a cancer diagnosis was delayed on average by 187 days compared with cases with a psychological or musculoskeletal diagnosis (P < 0.001). There is evidence that employers differ in their referral practices for employees with a cancer diagnosis, compared with those with other common disorders leading to long-term absence. This may represent a loss of opportunity for effective vocational rehabilitation or timely support for access to health-related benefits.

Estimating Economic Burden of Cancer Deaths Attributable to Smoking in Iran.

PubMed

Rezaei, Satar; Akbari Sari, Ali; Arab, Mohammad; Majdzadeh, Reza; Mohammadpoorasl, Asghar

2015-01-01

There is a broad consensus among health policy-makers that smoking has a significant impact on both heath system and society. The purpose of this study was to estimate the economic burden of major cancer deaths caused by smoking in Iran in 2012. Number of major cancer deaths due to smoking by sex and age groups in 2012 was obtained from GLOBCAN database. The life expectancy and retirement age were used to estimate years of potential life lost (YPLL) and cost of productive lost attributable to smoking, respectively. Data on prevalence of smoking, relative risk of smoking, life expectancy table, annual wage and employment rate were extracted from the various resources such as previous studies, WHO database and Iranian statistic centers. The data analysis was conducted by Excel software. Smoking was responsible for 4,623 cancer deaths, 80808 YPLL and $US 83,019,583 cost of productivity lost. Lung cancer accounts for largest proportion of total cancer deaths, YPLL and cost of productivity lost attributable to smoking. Males account for 86.6% of cancer deaths, 82.6% of YPLL and 85.3% of cost of productivity lost caused by smoking. Smoking places a high economic burden on health system and society as a whole. In addition, if no one had been smokers in Iran, approximately two out of ten cancer deaths could be prevented.

Risk of laryngeal cancer by occupational chemical exposure in Turkey.

PubMed

Elci, Omur Cinar; Akpinar-Elci, Muge; Blair, Aaron; Dosemeci, Mustafa

2003-10-01

Laryngeal cancer is the second most common cancer among men in Turkey. In this hospital based case-control study, we evaluated laryngeal cancer risks from occupational chemical exposures. We analyzed 940 laryngeal cancer cases and 1519 controls. Occupational history, tobacco, and alcohol use and demographic information were obtained by a questionnaire. The job and industries were classified by special seven-digit codes. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) based on a developed exposure matrix for chemicals, including diesel exhaust, gasoline exhaust, polycyclic aromatic hydrocarbons (PAHs), formaldehyde, and solvents. An excess of laryngeal cancer occurred with diesel exhaust (OR=1.5, 95% CI=1.3-1.9), gasoline exhaust (OR=1.6, 95% CI=1.3-2.0), and PAHs (OR=1.3, 95% CI=1.1-1.6). There was a dose-response relationship for these substances with supraglottic cancers (P<0.000). The PAH association only occurred among those who also had exposure to diesel exhaust.

Emerging proteomics biomarkers and prostate cancer burden in Africa

PubMed Central

Adeola, Henry A.; Blackburn, Jonathan M.; Rebbeck, Timothy R.; Zerbini, Luiz F.

2017-01-01

Various biomarkers have emerged via high throughput omics-based approaches for use in diagnosis, treatment, and monitoring of prostate cancer. Many of these have yet to be demonstrated as having value in routine clinical practice. Moreover, there is a dearth of information on validation of these emerging prostate biomarkers within African cohorts, despite the huge burden and aggressiveness of prostate cancer in men of African descent. This review focusses of the global landmark achievements in prostate cancer proteomics biomarker discovery and the potential for clinical implementation of these biomarkers in Africa. Biomarker validation processes at the preclinical, translational and clinical research level are discussed here, as are the challenges and prospects for the evaluation and use of novel proteomic prostate cancer biomarkers. PMID:28388542

Emerging proteomics biomarkers and prostate cancer burden in Africa.

PubMed

Adeola, Henry A; Blackburn, Jonathan M; Rebbeck, Timothy R; Zerbini, Luiz F

2017-06-06

Various biomarkers have emerged via high throughput omics-based approaches for use in diagnosis, treatment, and monitoring of prostate cancer. Many of these have yet to be demonstrated as having value in routine clinical practice. Moreover, there is a dearth of information on validation of these emerging prostate biomarkers within African cohorts, despite the huge burden and aggressiveness of prostate cancer in men of African descent. This review focusses of the global landmark achievements in prostate cancer proteomics biomarker discovery and the potential for clinical implementation of these biomarkers in Africa. Biomarker validation processes at the preclinical, translational and clinical research level are discussed here, as are the challenges and prospects for the evaluation and use of novel proteomic prostate cancer biomarkers.

Association Between Kidney Cancer and Occupational Exposure to Trichloroethylene.

PubMed

Buhagen, Morten; Grønskag, Anna; Ragde, Siri Fenstad; Hilt, Bjørn

2016-09-01

This study investigates the association between occupational exposure to trichloroethylene (TCE) and kidney cancer, as this correlation has been questioned. The incidence of cancers was studied in a dynamic cohort of 997 male workers who for many years had been occupationally exposed to TCE. During a 50-year observation period, 13 cases of kidney cancer were observed (7.5 expected) with a standardized incidence ratio of 1.7 and a 95% confidence interval of 1.0 to 3.0. Four other cases, not included in the SIR analysis, were also observed. Long-term TCE exposure was positively confirmed for 14 of the 17 incident cases. There is reason to assume that the remaining cases also had been exposed to TCE. The present study supports the view that TCE is a kidney carcinogen.

The economic burden of advanced gastric cancer in Taiwan.

PubMed

Hong, Jihyung; Tsai, Yiling; Novick, Diego; Hsiao, Frank Chi-Huang; Cheng, Rebecca; Chen, Jen-Shi

2017-09-16

Gastric cancer is one of the leading causes of cancer-related deaths in both sexes worldwide, especially in Eastern Asia. This study aimed to estimate the economic burden of advanced gastric cancer (AGC) in Taiwan. The costs of AGC in 2013 were estimated using resource use data from a chart review study (n = 122 with AGC) and national statistics. Annual per-patient costs, where patients' follow-up periods were adjusted for, were estimated with 82 patients who had complete resource use data. The costs were composed of direct medical costs, direct non-medical costs (healthcare travel and caregiver costs), morbidity costs, and mortality costs. Relevant unit costs were retrieved mainly from literature and national statistics, and applied to the resource use data. A broad definition of morbidity and mortality costs was employed to value the productivity loss in patients with unpaid employment, economically inactive and unemployed as well as the life years after the age of retirement. Their narrow definitions were also used in sensitivity analyses, using age- and/or sex-specific employment rates. Forgone future earnings/productivity loss were discounted at 3%. Annual per-patient costs were projected to estimate the total costs of AGC at the national level with an estimated number of patients with AGC (N = 2611) in Taiwan in 2013. The mean age of the 82 patients was 59.3 (SD: 11.9) years, and 67.1% were male. Per-patient costs were US$26,431 for direct medical costs, US$4669 for direct non-medical costs, US$5758 for morbidity costs, and US$145,990 for mortality costs (per death). These per-patient costs were projected to incur total AGC costs of US$423 million at the national-level. Mortality costs accounted for 77.3% of the total costs, followed by direct medical costs (16.3%), morbidity costs (3.6%), and direct non-medical costs (2.9%). AGC was found to exert a significant economic burden in Taiwan, incurring US$423 million in 2013. This represents about 0.08% of

Bladder cancer and occupation: a case-control study in northern Italy.

PubMed Central

Porru, S; Aulenti, V; Donato, F; Boffetta, P; Fazioli, R; Cosciani Cunico, S; Alessio, L

1996-01-01

OBJECTIVES--A hospital based case-control study was conducted between 1992 and 1993 in the province of Brescia, a highly industrialised area in northern Italy, to evaluate occupational risk factors of bladder cancer. METHODS--The study evaluated 355 histologically confirmed cases of bladder cancer (275 men, 80 women) and 579 controls affected by urological non-neoplastic diseases (397 men, 182 women). Lifetime occupational history, smoking and drinking habits, and sociodemographic characteristics were recorded by means of a structured questionnaire. Odds ratios (ORs) were computed with adjustment for age, smoking, alcohol and coffee consumption, education, and place of residence. RESULTS--A significant (P < 0.05) increase of risk of bladder cancer were found in men for labourers in the construction industry (OR 2.1, 95% confidence interval (95% CI) 1.1-3.9) and for recreational and cultural services (OR 5.0, 95% CI 1.3-18.9). Increased risks, although not significant, were found for various other occupations and industries such as machinery mechanics, metal processers and polishers, blacksmiths, gunsmiths, painters; for transport workers, an increased risk with increasing duration of employment was found. CONCLUSIONS--Occupational exposures seem to contribute to bladder cancer risk in the area under study. PMID:8563860

Effect of occupational exposures on lung cancer susceptibility: a study of gene-environment interaction analysis.

PubMed

Malhotra, Jyoti; Sartori, Samantha; Brennan, Paul; Zaridze, David; Szeszenia-Dabrowska, Neonila; Świątkowska, Beata; Rudnai, Peter; Lissowska, Jolanta; Fabianova, Eleonora; Mates, Dana; Bencko, Vladimir; Gaborieau, Valerie; Stücker, Isabelle; Foretova, Lenka; Janout, Vladimir; Boffetta, Paolo

2015-03-01

Occupational exposures are known risk factors for lung cancer. Role of genetically determined host factors in occupational exposure-related lung cancer is unclear. We used genome-wide association (GWA) data from a case-control study conducted in 6 European countries from 1998 to 2002 to identify gene-occupation interactions and related pathways for lung cancer risk. GWA analysis was performed for each exposure using logistic regression and interaction term for genotypes, and exposure was included in this model. Both SNP-based and gene-based interaction P values were calculated. Pathway analysis was performed using three complementary methods, and analyses were adjusted for multiple comparisons. We analyzed 312,605 SNPs and occupational exposure to 70 agents from 1,802 lung cancer cases and 1,725 cancer-free controls. Mean age of study participants was 60.1 ± 9.1 years and 75% were male. Largest number of significant associations (P ≤ 1 × 10(-5)) at SNP level was demonstrated for nickel, brick dust, concrete dust, and cement dust, and for brick dust and cement dust at the gene-level (P ≤ 1 × 10(-4)). Approximately 14 occupational exposures showed significant gene-occupation interactions with pathways related to response to environmental information processing via signal transduction (P < 0.001 and FDR < 0.05). Other pathways that showed significant enrichment were related to immune processes and xenobiotic metabolism. Our findings suggest that pathways related to signal transduction, immune process, and xenobiotic metabolism may be involved in occupational exposure-related lung carcinogenesis. Our study exemplifies an integrative approach using pathway-based analysis to demonstrate the role of genetic variants in occupational exposure-related lung cancer susceptibility. Cancer Epidemiol Biomarkers Prev; 24(3); 570-9. ©2015 AACR. ©2015 American Association for Cancer Research.

Occupational Therapy for the Head and Neck Cancer Patient.

PubMed

Park, Priscilla; Hashmi, Mahjabeen

2018-01-01

Occupational therapy is a health profession concerned with promoting health and well-being through occupation. A diagnosis of head and neck cancer (HNC) often invokes fear and anxiety because of the potential negative impact of the diagnosis and/or treatment on lifestyle and well-being. Occupational therapists perform a unique and important role in addressing quality of life concerns for HNC patients through applied expertise in lifestyle management, facilitating the use of positive coping strategies and daily routine management. Occupational therapy concurrently assists HNC patients to effectively manage the debilitating stress and anxiety associated with HNC diagnosis, treatment, and recovery while facilitating a return to prior or adapted daily routines.

Incidence of testicular cancer and occupation among Swedish men gainfully employed in 1970.

PubMed

Pollán, M; Gustavsson, P; Cano, M I

2001-11-01

To estimate occupation-specific risk of seminomas and nonseminoma subtypes of testicular cancer among Swedish men gainfully employed in 1970 over the period 1971-1989. Age-period standardized incidence ratios were computed in a dataset linking cancer diagnoses from the Swedish national cancer register to occupational and demographical data obtained in the census in 1970. Log-linear Poisson models were fitted, allowing for geographical area and town size. Taking occupational sector as a proxy for socioeconomic status, occupational risks were recalculated using intra-sector analyses, where the reference group comprised other occupations in the same sector only. Risk estimators per occupation were also computed for men reporting the same occupation in 1960 and 1970, a more specifically exposed group. Seminomas and nonseminomas showed a substantial geographical variation. The association between germ-cell testicular tumors and high socioeconomic groups was found mainly for nonseminomas. Positive associations with particular occupations were more evident for seminomas, for which railway stationmasters, metal annealers and temperers, precision toolmakers, watchmakers, construction smiths, and typographers and lithographers exhibited a risk excess. Concrete and construction worker was the only occupation consistently associated with nonseminomas. Among the many occupations studied, our results corroborate the previously reported increased risk among metal workers, specifically related with seminomatous tumors in this study. Our results confirm the geographical and socioeconomical differences in the incidence of testicular tumors. These factors should be accounted for in occupational studies. The different pattern of occupations related with seminomas and nonseminomas support the need to study these tumors separately.

Population-based assessment of cancer survivors' financial burden and quality of life: a prospective cohort study.

PubMed

Zafar, S Yousuf; McNeil, Rebecca B; Thomas, Catherine M; Lathan, Christopher S; Ayanian, John Z; Provenzale, Dawn

2015-03-01

The impact of financial burden among patients with cancer has not yet been measured in a way that accounts for inter-relationships between quality of life, perceived quality of care, disease status, and sociodemographic characteristics. In a national, prospective, observational, population- and health care systems-based cohort study, patients with colorectal or lung cancer were enrolled from 2003 to 2006 within 3 months of diagnosis. For this analysis, surviving patients who were either disease free or had advanced disease were resurveyed a median 7.3 years from diagnosis. Structural equation modeling was used to investigate relationships between financial burden, quality of life, perceived quality of care, and sociodemographic characteristics. Among 1,000 participants enrolled from five geographic regions, five integrated health care systems, or 15 Veterans Administration Hospitals, 89% (n = 889) were cancer free, and 11% (n = 111) had advanced cancer. Overall, 48% (n = 482) reported difficulties living on their household income, and 41% (n = 396) believed their health care to be "excellent." High financial burden was associated with lower household income (adjusted odds ratio [OR] = 0.61 per $20k per year, P < .001) and younger age (adjusted OR = 0.63 per 10 years; P < .001). High financial burden was also associated with poorer quality of life (adjusted beta = -0.06 per burden category; P < .001). Better quality of life was associated with fewer perceptions of poorer quality of care (adjusted OR = 0.85 per 0.10 EuroQol units; P < .001). Financial burden is prevalent among cancer survivors and is related to patients' health-related quality of life. Future studies should consider interventions to improve patient education and engagement with regard to financial burden. Copyright © 2014 by American Society of Clinical Oncology.

Occupational asphalt is not associated with head and neck cancer.

PubMed

Fogleman, E V; Eliot, M; Michaud, D S; Nelson, H H; McClean, M D; Langevin, S M; Kelsey, K T

2015-10-01

Epidemiologic studies that evaluate the relationship between occupational asphalt exposure and head and neck cancer have had a limited ability to control for known risk factors such as smoking, alcohol and human papillomavirus (HPV). To better elucidate this relationship by including known risk factors in a large case-control study of head and neck squamous cell carcinoma (HNSCC) from the greater Boston area. We analysed the relationship between occupational asphalt exposure and HNSCC among men in the Greater Boston area of Massachusetts. Analyses were conducted using unconditional multivariable logistic regression, performed with adjustments for age, race, education, smoking, alcohol consumption and HPV serology. There were 753 cases and 913 controls. No associations between HNSCC and occupational asphalt exposure (neither among ever-exposed nor by occupational duration) were observed for exposures in any occupation or those restricted to the construction industry. We also observed no associations in subgroup analyses of never-smokers and ever-smokers. Adjusting for known risk factors further reduced the estimated effect of asphalt exposure on HNSCC risk. We found no evidence for an association between occupational asphalt exposure and HNSCC. The null findings from this well-controlled analysis could suggest that the risk estimates stemming from occupational cohort studies may be overestimated due to uncontrolled confounding and enhance the literature available for weighing cancer risk from occupational exposure to bitumen. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Economic burden for patients with chronic myelogenous leukemia--healthcare economics and medical governance of cancer].

PubMed

Kodama, Yuko; Kami, Masahiro

2010-04-01

Due to the recent economic downturn, the economic burden of cancer patients has been further worsened. Specifically for chronic myelogenous leukemia patients, their annual income has decreased by 1, 500, 000 yen from 2000 to 2008, while the cost of their medications has increased from 1,000,000 yen to 1,200,000 yen due the advent of the new drug, Glivec, which was approved in 2001. The scores for psychological burden have increased 30% over the past 8 years before Glivec became available. The economic crisis among cancer patients is a consequence of structural problems with many anticancer drugs and cancer treatment. Especially, problems involving the cost of medical care and the system of drug pricing should be resolved by thorough discussion not only with cancer patients but also with the entire population. Discussion on the medical expense burden for CML patients has flourished through patients' spontaneous activities and information disclosure to a wider population through the internet. This methodology will be significant in establishing medical governance in cancer treatment in Japan.

Estimates of alcohol-related oesophageal cancer burden in Japan: systematic review and meta-analyses

PubMed Central

Shield, Kevin D; Higuchi, Susumu; Yoshimura, Atsushi; Larsen, Elisabeth; Rehm, Maximilien X; Rehm, Jürgen

2015-01-01

Abstract Objective To refine estimates of the burden of alcohol-related oesophageal cancer in Japan. Methods We searched PubMed for published reviews and original studies on alcohol intake, aldehyde dehydrogenase polymorphisms, and risk for oesophageal cancer in Japan, published before 2014. We conducted random-effects meta-analyses, including subgroup analyses by aldehyde dehydrogenase variants. We estimated deaths and loss of disability-adjusted life years (DALYs) from oesophageal cancer using exposure distributions for alcohol based on age, sex and relative risks per unit of exposure. Findings We identified 14 relevant studies. Three cohort studies and four case-control studies had dose–response data. Evidence from cohort studies showed that people who consumed the equivalent of 100 g/day of pure alcohol had an 11.71 fold, (95% confidence interval, CI: 2.67–51.32) risk of oesophageal cancer compared to those who never consumed alcohol. Evidence from case-control studies showed that the increase in risk was 33.11 fold (95% CI: 8.15–134.43) in the population at large. The difference by study design is explained by the 159 fold (95% CI: 27.2–938.2) risk among those with an inactive aldehyde dehydrogenase enzyme variant. Applying these dose–response estimates to the national profile of alcohol intake yielded 5279 oesophageal cancer deaths and 102 988 DALYs lost – almost double the estimates produced by the most recent global burden of disease exercise. Conclusion Use of global dose–response data results in an underestimate of the burden of disease from oesophageal cancer in Japan. Where possible, national burden of disease studies should use results from the population concerned. PMID:26229204

Exploring the role of occupational therapy in caring for cancer survivors in Australia: A cross sectional study.

PubMed

Buckland, Nicole; Mackenzie, Lynette

2017-10-01

With increasing rates of cancer survival in Australia, more people are living with long-term side effects of cancer and its treatment, and cancer survivorship is now considered a distinct phase of cancer care. While occupational therapists play an integral role in multidisciplinary care for people with chronic conditions, there is little evidence documenting the occupational therapy role for people living with chronic cancer-related conditions. This study aimed to explore the views of Australian occupational therapists about current practice and what constitutes best practice for cancer survivors. A cross-sectional online survey was developed and distributed via emailed invitations to the Occupational Therapy Australia membership to collect responses from occupational therapists in a range of locations and practice settings around Australia. A total of 204 completed surveys were returned (response rate of 4%). More than 70% (n = 143) of respondents worked with people with cancer at least sometimes and most worked in acute (13.8%, n = 28) or community (11.2%, n = 23) settings. Participants rated equipment provision as the most common intervention (94%, n = 192), followed by energy conservation (91%, n = 185) and pressure care (78%, n = 160). Lack of funding for occupational therapy positions and a lack of recognition of the role of occupational therapy by health professionals and consumers were identified as key barriers to survivorship care. Research is needed to provide evidence supporting the role and practice of occupational therapy with cancer survivors. Collaborative work with multidisciplinary teams is needed to develop long-term routine treatment pathways that include occupational therapy interventions. © 2017 Occupational Therapy Australia.

Consumer credit as a novel marker for economic burden and health after cancer in a diverse population of breast cancer survivors in the USA.

PubMed

Dean, Lorraine T; Schmitz, Kathryn H; Frick, Kevin D; Nicholas, Lauren H; Zhang, Yuehan; Subramanian, S V; Visvanathan, Kala

2018-06-01

Consumer credit may reflect financial hardship that patients face due to cancer treatment, which in turn may impact ability to manage health after cancer; however, credit's relationship to economic burden and health after cancer has not been evaluated. From May to September 2015, 123 women with a history of breast cancer residing in Pennsylvania or New Jersey completed a cross-sectional survey of demographics, socioeconomic position, comorbidities, SF-12 self-rated health, economic burden since cancer diagnosis, psychosocial stress, and self-reported (poor to excellent) credit quality. Ordinal logistic regression evaluated credit's contribution to economic burden and self-rated health. Mean respondent age was 64 years. Mean year from diagnosis was 11.5. Forty percent of respondents were Black or Other and 60% were White. Twenty-four percent self-reported poor credit, and 76% reported good to excellent credit quality. In adjusted models, changing income, using savings, borrowing money, and being unable to purchase a health need since cancer were associated with poorer credit. Better credit was associated with 7.72 ([1.22, 14.20], p = 0.02) higher physical health t-score, and a - 2.00 ([- 3.92, - 0.09], p = 0.04) point change in psychosocial stress. This exploratory analysis establishes the premise for consumer credit as a marker of economic burden and health for breast cancer survivors. Future work should validate these findings in larger samples and for other health conditions. Stabilizing and monitoring consumer credit may be a potential intervention point for mitigating economic burden after breast cancer.

Caregiving burden and the quality of life of family caregivers of cancer patients: the relationship and correlates.

PubMed

Rha, Sun Young; Park, Yeonhee; Song, Su Kyung; Lee, Chung Eun; Lee, Jiyeon

2015-08-01

Family caregivers of cancer patients become responsible for many elements of cancer care, usually without preparation or training in provision of care. Their efforts of care generate caregiving burden, which could deteriorate caregivers' quality of life (QOL). A secondary data analysis of a cross-sectional descriptive study was conducted to describe the influence of caregiving burden on the QOL of family caregivers of cancer patients with consideration of correlates (N = 212). The Korean versions of Zarit Burden Interview and the World Health Organization QOL BREF were used. Multiple regression analyses were applied to analyze the relationship between the caregiving burden and QOL. Caregiving burden explained 30.3% of variance of the QOL (β = -0.534, p < 0.001). Caregivers caring for patients with functional deterioration experienced higher burden. Caregivers providing care for hospitalized patients demonstrated lower QOL. The caregiver's educational level was a positively contributing factor for the QOL. Caregiving burden was the influential, negatively affecting factor for the QOL. Assessment of caregiving burden with special attention being paid to caregivers caring for patients with functional decline would help to identify caregivers in need of support. Supportive care needs to be sought to alleviate caregiving burden and improve the QOL of caregivers, especially for the caregivers of hospitalized patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Occupational skin cancer due to UV-irradiation--Analyses of notified cases as "virtually-certain" occupational disease in Germany between 2005 and 2011.

PubMed

Schmitt, Jochen; Diepgen, Thomas L

2014-06-01

UV-induced skin cancer is not yet included in the German ordinance on occupational diseases and can only be notified and recognized acknowledged as "virtually-certain" occupational disease. The objective of the study was to analyze notified and acknowledged cases of occupational skin cancer due to UV-irradiation in Germany between 2005 and 2011. All notified cases of occupational skin cancer due to UV-irradiation have been analyzed which have been registered by the German Statutory accident insurance as of May 2012 were analyzed. The data analyze was descriptive stratified annually for presenting time trends.Data analysis was descriptive, stratified by year to defect time trends. Notified cases have increased annually with a total of 548 registered cases of occupational skin cancer induced by UV-irradiation between 2005 and 2011, and 74 recognized acknowledged cases. In 56 cases the procedure was not yet finished. Squamous cell carcinoma (SCC) and in-situ squamous cell carcinoma (actinic keratosis, Bowen's disease) were most frequent and have been the most frequentlyobserved in 333 notified cases. and between 15.6 % and 24.9 % have been recognizedof cases with SCC and actinic keratosis were recognized, respectively. 184 patients with basal cell carcinoma were notified but only 6.5 % recognized acknowledged and only 3 cases with exclusive basal cell carcinoma. Out of 50 notified patients with Mmelanoma only one was recognizedacknowledged. The results are in good agreement with the proposal of the German Minister of labor to establish UV-induced skin cancer as a new occupational disease. © 2014 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

[Occupational and non-occupational determinants of work ability].

PubMed

Makowiec-Dabrowska, Teresa; Koszada-Włodarczyk, Wiesława; Bortkiewicz, Alicja; Gadzicka, Elzbieta; Siedlecka, Jadwiga; Jóźwiak, Zbigniew; Pokorski, Janusz

2008-01-01

Measurements of the work ability subjective assessment, using the work ability index (WAI), are widely applied in the examination of workers. The measurement results suggest that the low level of work ability, which is determined by work-burden factors, health condition, and lifestyles of persons under study, can be a predictor of earlier retirement. The aim of the study was to find out whether WAI can be used in Polish conditions and to identify personal traits and/or job characteristics and conditions of its performance that generate the risk of low work ability. The cross-sectional study embraced 669 men and 536 women at the working age, representing different occupations and exposed to various factors. They self-assessed their work ability by completing a questionnaire that allows to determine WAI values. They also characterized their jobs in terms of physical burden, occupational stress, harmful and strenuous factors, work fatigue, chronic fatigue, and lifestyle. Based on the energy expenditure and health condition (number of diseases), the work burden was objectively defined. A model of multivariate logistic regression was used to assess the effect of the analyzed factors on the risk of low or moderate work ability. The level of work ability in the study group was lower than that observed in analogous occupational groups in other European countries. The results of the analysis indicate that job characterizing factors and workers' individual traits exert a stronger effect on the level of WAI components, which reflect a subjective assessment of work abilities, than factors concerning health conditions. Highly stressogenic work and low tolerance of work burden as well as personal traits (age, frequent alcohol consumption among men and non-occupational burdens among women) represented risk factors responsible for low or moderate VAI values. The measurement of work ability index is an indirect assessment of workers' physical state, and it slightly depends on

Surveillance of nasal and bladder cancer to locate sources of exposure to occupational carcinogens.

PubMed Central

Teschke, K; Morgan, M S; Checkoway, H; Franklin, G; Spinelli, J J; van Belle, G; Weiss, N S

1997-01-01

OBJECTIVE: To locate sources of occupational exposure to nasal and bladder carcinogens for surveillance follow up in British Columbia, Canada. METHODS: Incident cases of nasal cancer (n = 48), bladder cancer (n = 105), and population based controls (n = 159) matched for sex and age, were interviewed about their jobs, exposures, and smoking histories. Odds ratios (ORs) were calculated for 57 occupational groups with stratified exact methods to control for age, sex, and smoking. RESULTS: Occupational groups at increased risk of nasal cancer included: textile workers (six cases, OR 7.6); miners, drillers, and blasters (six cases, OR 3.5); welders (two cases, OR 3.5); pulp and paper workers (three cases, OR 3.1); and plumbers and pipefitters (two cases, OR 3.0). Nasal cancer ORs were not increased in occupations exposed to wood dust, possibly due to low exposures in local wood industries. Strongly increased risks of bladder cancer were found for sheet metal workers (four cases, OR 5.3), miners (19 cases, OR 4.5), gardeners (six cases, OR 3.7), and hairdressers (three cases, OR 3.2). Among occupations originally considered at risk, the following had increased risks of bladder cancer: painters (four cases, OR 2.8); laundry workers (five cases, OR 2.3); chemical and petroleum workers (15 cases, OR 1.8); machinists (eight cases, OR 1.6); and textile workers (three cases, OR 1.5). CONCLUSIONS: Occupational groups with increased risks and three or more cases with similar duties were selected for surveillance follow up. For nasal cancer, these included textile workers (five were garment makers) and pulp and paper workers (three performed maintenance tasks likely to entail stainless steel welding). For bladder cancer, these included miners (12 worked underground), machinists (five worked in traditional machining), hairdressers (three had applied hair dyes), and laundry workers (three were drycleaners). PMID:9245952

Economic and disease burden of breast cancer associated with suboptimal breastfeeding practices in Mexico.

PubMed

Unar-Munguía, Mishel; Meza, Rafael; Colchero, M Arantxa; Torres-Mejía, Gabriela; de Cosío, Teresita Gonzalez

2017-12-01

Exclusive breastfeeding and longer breastfeeding reduce women's breast cancer risk but Mexico has one of the lowest breastfeeding rates worldwide. We estimated the lifetime economic and disease burden of breast cancer in Mexico if 95% of parous women breastfeed each child exclusively for 6 months and continue breastfeeding for over a year. We used a static microsimulation model with a cost-of-illness approach to simulate a cohort of Mexican women. We estimated breast cancer incidence, premature mortality, disability-adjusted life years (DALYs), medical costs, and income losses due to breast cancer and extrapolated the results to 1.116 million Mexican women of age 15 in 2012. Costs were expressed in 2015 US dollars and discounted at a 3% annual rate. We estimated that 2,186 premature deaths (95% CI 2,123-2,248), 9,936 breast cancer cases (95% CI 9,651-10,220), 45,109 DALYs (95% CI 43,000-47,217), and $245 million USD (95% CI 234-256) in medical costs and income losses owing to breast cancer could be saved over a cohort's lifetime. Medical costs account for 80% of the economic burden; income losses and opportunity costs for caregivers account for 15 and 5%, respectively. In Mexico, the burden of breast cancer due to suboptimal breastfeeding in women is high in terms of morbidity, premature mortality, and the economic costs for the health sector and society.

Wood-related occupations, wood dust exposure, and sinonasal cancer.

PubMed

Hayes, R B; Gerin, M; Raatgever, J W; de Bruyn, A

1986-10-01

A case-control study was conducted to examine the relations between type of woodworking and the extent of wood dust exposure to the risks for specific histologic types of sinonasal cancer. In cooperation with the major treatment centers in the Netherlands, 116 male patients newly diagnosed between 1978 and 1981 with primary malignancies of epithelial origin of this site were identified for study. Living controls were selected from the municipal registries, and deceased controls were selected from the national death registry. Interviews were completed for 91 (78%) cases and 195 (75%) controls. Job histories were coded by industry and occupation. An index of exposure was developed to classify the extent of occupational exposure to wood dust. When necessary, adjustment was made for age and usual cigarette use. The risk for nasal adenocarcinoma was elevated by industry for the wood and paper industry (odds ratio (OR) = 11.9) and by occupation for those employed in furniture and cabinet making (OR = 139.8), in factory joinery and carpentry work (OR = 16.3), and in association with high-level wood dust exposure (OR = 26.3). Other types of nasal cancer were not found to be associated with wood-related industries or occupations. A moderate excess in risk for squamous cell cancer (OR = 2.5) was associated with low-level wood dust exposure; however, no dose-response relation was evident. The association between wood dust and adenocarcinoma was strongest for those employed in wood dust-related occupations between 1930 and 1941. The risk of adenocarcinoma did not appear to decrease for at least 15 years after termination of exposure to wood dust. No cases of nasal adenocarcinoma were observed in men whose first exposure to wood dust occurred after 1941.

The role of health policy in the burden of breast cancer in Brazil.

PubMed

Figueiredo, Francisco Winter Dos Santos; Almeida, Tábata Cristina do Carmo; Cardial, Débora Terra; Maciel, Érika da Silva; Fonseca, Fernando Luiz Affonso; Adami, Fernando

2017-11-28

Breast cancer affects millions of women worldwide, particularly in Brazil, where public healthcare system is an important model in health organization and the cost of chronic disease has affected the economy in the first decade of the twenty-first century. The aim was to evaluate the role of health policy in the burden of breast cancer in Brazil between 2004 and 2014. Secondary analysis was performed in 2017 with Brazilian Health Ministry official data, extracted from the Department of Informatics of the National Health System. Age-standardized mortality and the age-standardized incidence of hospital admission by breast cancer were calculated per 100,000 people. Public healthcare costs were converted to US dollars. Regression analysis was performed to estimate the trend of breast cancer rates and healthcare costs, and principal component analysis was performed to estimate a cost factor. Stata® 11.0 was utilized. Between 2004 to 2014, the age-standardized rates of breast cancer mortality and the incidence of hospital admission and public healthcare costs increased. There was a positive correlation between breast cancer and healthcare public costs, mainly influenced by governmental strategies. Governmental strategies are effective against the burden of breast cancer in Brazil.

Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy interventions.

PubMed

Silver, Julie K; Gilchrist, Laura S

2011-05-01

Cancer rehabilitation is an important part of survivorship as a distinct phase of treatment. Although cancer rehabilitation may involve many disciplines, this article specifically covers evidence-based treatment in physical and occupational therapy. Patients may need physical and occupational therapy services for a variety of cancer-related or cancer-treatment-related problems, including pain, fatigue, deconditioning, and difficulty with gait. They may also have problems resuming their previous level of function, which can impact on activities of daily living, instrumental activities of daily living, return to previous home and community activity levels, and return to work. This review discusses the role of physical and occupational therapy in helping cancer patients improve pain and musculoskeletal issues, deconditioning and endurance effects, fatigue, balance and falls, and lymphedema and psychosocial problems.

The role of the occupational therapist in the care of people living with lung cancer.

PubMed

White, Kahren M

2016-06-01

This paper aims to explore the vital role occupational therapists play in enabling people living with lung cancer to continue to actively live. Core assessments and interventions employed by occupational therapists are described in a case study. It will demonstrate how people living with lung cancer can continue to participate in meaningful and chosen life roles, even in the face of functional decline. Skilled management by the occupational therapist of the refractory symptoms of advanced lung cancer supports this participation.

Impact of financial burden of cancer on survivors' quality of life.

PubMed

Fenn, Kathleen M; Evans, Suzanne B; McCorkle, Ruth; DiGiovanna, Michael P; Pusztai, Lajos; Sanft, Tara; Hofstatter, Erin W; Killelea, Brigid K; Knobf, M Tish; Lannin, Donald R; Abu-Khalaf, Maysa; Horowitz, Nina R; Chagpar, Anees B

2014-09-01

Little is known about the relationship between the financial burden of cancer and the physical and emotional health of cancer survivors. We examined the association between financial problems caused by cancer and reported quality of life in a population-based sample of patients with cancer. Data from the 2010 National Health Interview Survey (NHIS) were analyzed. A multivariable regression model was used to examine the relationship between the degree to which cancer caused financial problems and the patients' reported quality of life. Of 2,108 patients who answered the survey question, "To what degree has cancer caused financial problems for you and your family?," 8.6% reported "a lot," whereas 69.6% reported "not at all." Patients who reported "a lot" of financial problems as a result of cancer care costs were more likely to rate their physical health (18.6% v 4.3%, P < .001), mental health (8.3% v 1.8%, P < .001), and satisfaction with social activities and relationships (11.8% v 3.6%, P < .001) as poor compared to those with no financial hardship. On multivariable analysis controlling for all of the significant covariates on bivariate analysis, the degree to which cancer caused financial problems was the strongest independent predictor of quality of life. Patients who reported that cancer caused "a lot" of financial problems were four times less likely to rate their quality of life as "excellent," "very good," or "good" (odds ratio = 0.24; 95% CI, 0.14 to 0.40; P < .001). Increased financial burden asa result of cancer care costs is the strongest independent predictor of poor quality of life among cancer survivors. Copyright © 2014 by American Society of Clinical Oncology.

Association between the high risk occupations and bladder cancer in Iran: a case-control study.

PubMed

Khoubi, Jamshid; Pourabdian, Siamak; Mohebbi, Iraj; Tajvidi, Mina; Zaroorian, Omid; Giahi, Omid

2013-04-01

The objective of this work was to identify the high-risk occupations in Iran and to re-inspect occupations that were related to bladder cancer. In the study, 300 patients suffering from bladder cancer and 500 control individuals were interviewed. Demographic information, occupational history, and history of exposure to chemical compounds such as aromatic amines for each participant were collected. ORs and 95% CIs were calculated using unconditional logistic regression for each occupation. There was a significantly increased risk of bladder cancer among truck and bus drivers (OR = 11.3), skilled agricultural, forestry and fishery workers (OR = 6.0), metal industry workers (OR = 6.0), domestic housekeepers (OR = 5.9), and construction workers (OR = 3.8). The study showed a strong correlation between truck and bus drivers, skilled agricultural, forestry and fishery workers, metal industry workers, domestic housekeepers, as well as construction workers and the increased risk of bladder cancer in these occupations.

Environmental and Occupational Causes of Cancer New Evidence, 2005–2007

PubMed Central

Clapp, Richard W.; Jacobs, Molly M.; Loechler, Edward L

2009-01-01

Executive Summary What do we currently know about the occupational and environmental causes of cancer? As of 2007, the International Agency for Research on Cancer has identified 415 known or suspected carcinogens. Cancer arises through an extremely complicated web of multiple causes. We will likely never know the full range of agents or combinations of agents that cause cancer. However, we do know that preventing exposure to individual carcinogens prevents the disease. Declines in cancer rates – such as the drop in male lung cancer cases from the reduction in tobacco smoking or the drop in bladder cancer among cohorts of dye workers from the elimination of exposure to specific aromatic amines – provides evidence that preventing cancer is possible when we act on what we know. Although the overall age-adjusted cancer incidence rates in the U.S. among both men and women have declined in the last decade, rates of several types of cancers are on the rise; some of these cancers are linked to environmental and occupational exposures. This report chronicles the most recent epidemiological evidence linking occupational and environmental exposures with cancer. Peer-reviewed scientific studies published from January 2005-June 2007 were reviewed, supplementing our state-of-the-evidence report published in September 2005. Despite weaknesses in some individual studies, we consider the evidence linking the increased risk of several types of cancer with specific exposures somewhat strengthened by recent publications, among them: brain cancer from exposure to non-ionizing radiation, particularly radiofrequency fields emitted by mobile telephones;breast cancer from exposure to the pesticide dichloro-diphenyl-trichloroethane (DDT) prior to puberty;leukemia from exposure to 1,3-butadiene;lung cancer from exposure to air pollution;non-Hodgkin's lymphoma (NHL) from exposure to pesticides and solvents; andprostate cancer from exposure to pesticides, polyaromatic hydrocarbons (PAHs

Lung asbestos burden in shipyard and construction workers with mesothelioma: Comparison with burdens in subjects with asbestosis of lung cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warnock, M.L.

1989-10-01

Although mesothelioma is generally considered to be caused by asbestos, epidemiologic studies indicate that some cases have another cause. In order to determine whether pulmonary asbestos burden can be used to define asbestos-related mesotheliomas, asbestos burden was quantified in 27 shipyard or construction workers with diffuse malignant mesothelioma of the pleura or peritoneum and a history of asbestos exposure. Their burden was significantly greater than the burden found in 19 unexposed men. The burdens were also compared to those of previously reported subjects with asbestosis or lung cancer. The median concentration for total amphibole fibers (2.7 million/g dry lung) inmore » subjects with mesothelioma did not differ significantly from our previously reported median values for 14 subjects with asbestosis (1.3 million/g dry lung) or for 60 asbestos workers with lung cancer (1.3 million/g dry lung). Fiber size distribution for amosite, the most prevalent fiber type, was similar in all three subject groups. Fifteen of 25 (60%) subjects with mesothelioma had mild asbestosis. Asbestos body (AB) concentrations were {ge} 1900/g dry lung, and total amphibole fiber concentrations were {ge}390,000/g dry lung. Counts of ABs{ge}0.5/cm{sup 2} in histologic sections always signified both of these concentrations in extracts. Thus, histologic sections showing {ge}0.5 ABs/cm{sup 2} or extracts containing asbestos body or amphibole fiber concentrations of at least 1900 or 390,000/g dry lung, respectively, will confirm an asbestos related mesothelioma.« less

The role of occupational participation and environment among Icelandic women with breast cancer: a qualitative study.

PubMed

Palmadottir, Gudrun

2010-12-01

Breast cancer diagnosis generally causes a disruption of occupational life. The purpose of this study was to explore the role of occupational participation and environment in the perception of health and well-being of Icelandic women with breast cancer. Eighteen women were interviewed using the main areas from the Occupational Performance History Interview as a guideline. An inductive analysis revealed seven categories that were organized under two main headings: occupational participation and environment. The categories were labelled "maintaining control and stability", "experiencing sense of self-worth", "enhancing self development", "access to information", "support and care", "refuge in community", and "rehabilitative opportunities". Through occupational participation the women were able to regain control of life and a sense of competence and development. Information, emotional support, safety, and stimulating environments were crucial in alleviating distress and facilitate satisfactory coping with the cancer experience. The results support that occupational participation in a safe and supportive environment has powerful restorative properties. Rehabilitative and supportive services should be based on a holistic perspective and emphasize the healthy aspects of a women's life. Furthermore, occupational therapists need to widen their approach when working with women with breast cancer and focus on their needs as occupational beings.

An analysis of discrepancies between United Kingdom cancer research funding and societal burden and a comparison to previous and United States values.

PubMed

Carter, Ashley J R; Delarosa, Beverly; Hur, Hannah

2015-11-02

Ideally, the allocation of research funding for each specific type of cancer should be proportional to its societal burden. This burden can be estimated with the metric 'years of life lost' (YLL), which combines overall mortality and age at death. Using United Kingdom data from 2010, we compared research funding from the National Cancer Research Institute to this YLL burden metric for 26 types of cancers in order to identify the discrepancies between cancer research funding allocation and societal burden. We also compared these values to United States data from 2010 and United Kingdom data published in 2005. Our study revealed a number of discrepancies between cancer research funding and burden. Some cancers are funded at levels far higher than their relative burden suggests (testicular, leukaemia, Hodgkin's lymphoma, breast, cervical, ovarian, prostate) while other cancers appear under-funded (gallbladder, lung, nasopharyngeal, intestine, stomach, pancreatic, thyroid, oesophageal, liver, kidney, bladder, and brain/central nervous system). United Kingdom funding patterns over the past decade have generally moved to increase funding to previously under-funded cancers with one notable exception showing a converse trend (breast cancer). The broad relationship between United Kingdom and United States funding patterns is similar with a few exceptions (e.g. leukaemia, Hodgkin's lymphoma, prostate, testicular cancer). There are discrepancies between cancer research funding allocation and societal burden in the United Kingdom. These discrepancies are broadly similar in both the United Kingdom and the United States and, while they appear to be improving, this is not consistent across all types of cancer.

Occupational risk factors of lung cancer: a hospital based case-control study

PubMed Central

Droste, J. H.; Weyler, J. J.; Van Meerbeeck, J. P.; Vermeire, P. A.; van Sprundel, M. P.

1999-01-01

OBJECTIVES: To investigate the relation between lung cancer and exposure to occupational carcinogens in a highly industrialised region in western Europe. METHODS: In a case-control study 478 cases and 536 controls, recruited from 10 hospitals in the Antwerp region, were interviewed. Cases were male patients with histologically confirmed lung cancer; controls were male patients without cancer or primary lung diseases. Data were collected by questionnaires to obtain information on occupations, exposures, and smoking history. Job titles were coded with the Office of Populations, Censuses and Surveys industrial classification. Exposure was assessed by self report and by job-task exposure matrix. Exposure odds ratios were calculated with logistic regression analysis adjusted for age, smoking history, and marital and socio-economic status. RESULTS: A job history in the categories manufacturing of transport equipment other than automobiles (for example, shipyard workers), transport support services (for example, dockers), and manufacturing of metal goods (for example, welders) was significantly associated with lung cancer (odds ratios (ORs) 2.3, 1.6, and 1.6 respectively). These associations were independent of smoking, education, civil, and economic status. Self reported exposure to potential carcinogens did not show significant associations with lung cancer, probably due to nondifferential misclassification. When assessed by job-task exposure matrix, exposure to molybdenum, mineral oils, and chromium were significantly associated with lung cancer. A strong association existed between smoking and lung cancer: OR of ex- smokers 4.2, OR of current smokers 14.5 v non-smokers. However, smoking did not confound the relation between occupational exposure and lung cancer. CONCLUSIONS: The study has shown a significant excess risk of lung cancer among workers in manufacturing of metal goods, manufacturing of transport equipment (other than automobiles), and transport support

Re-defining one's occupational self 2 years after breast cancer: a case study.

PubMed

Newman, Robin M

2013-01-01

Margaret*, a 56 year-old Caucasian Stage III breast cancer survivor, participated in a 5 week occupational therapy pilot program, called Take Action. This program was designed for breast cancer survivors who self-reported changes in cognitive function following completion of chemotherapy. The goals of the program were to improve participants' knowledge and use of strategies to enhance occupational performance and to improve satisfaction and performance of meaningful daily activities or occupations. Through a client-centered and evidence-based approach, this case study highlights the importance of incorporating the survivors' sense of self into an occupation-based intervention. Occupational therapists play an important role in facilitating exploration of sense of self in the survivorship phase of care to support occupational performance in self care, productivity, work, leisure and social participation. This case study highlights the important work of redefining oneself in the survivorship phase of care. (*denotes name change).

Global cancer control: responding to the growing burden, rising costs and inequalities in access

PubMed Central

Braga, Sofia; Bystricky, Branislav; Qvortrup, Camilla; Criscitiello, Carmen; Esin, Ece; Sonke, Gabe S; Martínez, Guillem Argilés; Frenel, Jean-Sebastian; Karamouzis, Michalis; Strijbos, Michiel; Yazici, Ozan; Bossi, Paolo; Banerjee, Susana; Troiani, Teresa; Eniu, Alexandru; Ciardiello, Fortunato; Tabernero, Josep; Zielinski, Christoph C; Casali, Paolo G; Cardoso, Fatima; Douillard, Jean-Yves; McGregor, Keith; Bricalli, Gracemarie; Vyas, Malvika; Ilbawi, André

2018-01-01

The cancer burden is rising globally, exerting significant strain on populations and health systems at all income levels. In May 2017, world governments made a commitment to further invest in cancer control as a public health priority, passing the World Health Assembly Resolution 70.12 on cancer prevention and control within an integrated approach. In this manuscript, the 2016 European Society for Medical Oncology Leadership Generation Programme participants propose a strategic framework that is in line with the 2017 WHO Cancer Resolution and consistent with the principle of universal health coverage, which ensures access to optimal cancer care for all people because health is a basic human right. The time for action is now to reduce barriers and provide the highest possible quality cancer care to everyone regardless of circumstance, precondition or geographic location. The national actions and the policy recommendations in this paper set forth the vision of its authors for the future of global cancer control at the national level, where the WHO Cancer Resolution must be implemented if we are to reduce the cancer burden, avoid unnecessary suffering and save as many lives as possible. PMID:29464109

Oncology navigators' perceptions of cancer-related financial burden and financial assistance resources.

PubMed

Spencer, Jennifer C; Samuel, Cleo A; Rosenstein, Donald L; Reeder-Hayes, Katherine E; Manning, Michelle L; Sellers, Jean B; Wheeler, Stephanie B

2018-04-01

As the cost of cancer treatment continues to rise, many patients are faced with significant emotional and financial burden. Oncology navigators guide patients through many aspects of care and therefore may be especially aware of patients' financial distress. Our objective was to explore navigators' perception of their patients' financial burden and their role in addressing financial needs. We conducted a real-time online survey of attendees at an oncology navigators' association conference. Participants included lay navigators, oncology nurse navigators, community health workers, and social workers. Questions assessed perceived burden in their patient population and their role in helping navigate patients through financial resources. Answers to open-ended questions are reported using identified themes. Seventy-eight respondents participated in the survey, reporting that on average 75% of their patients experienced some degree of financial toxicity related to their cancer. Only 45% of navigators felt the majority of these patients were able to get some financial assistance, most often through assistance with medical costs (73%), subsidized insurance (36%), or non-medical expenses (31%). Commonly identified barriers for patients obtaining assistance included lack of resources (50%), lack of knowledge about resources (46%), and complex/duplicative paperwork (20%). Oncology navigators reported a high burden of financial toxicity among their patients but insufficient knowledge or resources to address this need. This study underscores the importance of improved training and coordination for addressing financial burden, and the need to address community and system-level barriers.

Occupational exposures to leaded and unleaded gasoline engine emissions and lung cancer risk.

PubMed

Xu, Mengting; Siemiatycki, Jack; Lavoué, Jérôme; Pasquet, Romain; Pintos, Javier; Rousseau, Marie-Claude; Richardson, Lesley; Ho, Vikki

2018-04-01

To determine whether occupational exposure to gasoline engine emissions (GEE) increased the risk of lung cancer and more specifically whether leaded or unleaded GEE increased the risk. Two population-based case-control studies were conducted in Montreal, Canada. The first was conducted in the early 1980s and included many types of cancer including lung cancer. The second was conducted in the late 1990s and focused on lung cancer. Population controls were used in both studies. Altogether, there were 1595 cases and 1432 population controls. A comprehensive expert-based exposure assessment procedure was implemented and exposure was assessed for 294 agents, including unleaded GEE, leaded GEE and diesel engine emissions (DEE). Logistic regression analyses were conducted to estimate ORs between various metrics of GEE exposure and lung cancer, adjusting for smoking, DEE and other potential confounders. About half of all controls were occupationally exposed to GEE. Irrespective of the metrics of exposure (any exposure, duration of exposure and cumulative exposure) and the type of lung cancer, and the covariates included in models, none of the point estimates of the ORs between occupational exposure to leaded or unleaded GEE and lung cancer were above 1.0. Pooling two studies, the OR for any exposure to leaded GEE was 0.82 (0.68-1.00). Our results do not support the hypothesis that occupational exposure to GEE increases the risk of lung cancer. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

MO-FG-BRB-04: Panel discussion [Global burden of cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Van Dyk, J.

2015-06-15

The global burden of cancer is growing rapidly with an estimated 15 million new cases per year worldwide in 2015, growing to 19 million by 2025 and 24 million by 2035. The largest component of this growth will occur in low-to-middle income countries (LMICs). About half of these cases will require radiation treatment. The gap for available cancer treatment, including radiation therapy, between high-income countries (HICs) and LMICs is enormous. Accurate data and quantitative models to project the needs and the benefits of cancer treatment are a critical first step in closing the large cancer divide between LMICs and HICs.more » In this context, the Union for International Cancer Control (UICC) has developed a Global Task Force on Radiotherapy for Cancer Control (GTFRCC) with a charge to answer the question as to what it will take to close the gap between what exists today and reasonable access to radiation therapy globally by 2035 and what the potential clinical and economic benefits are for doing this. The Task Force has determined the projections of cancer incidence and the infrastructure required to provide access to radiation therapy globally. Furthermore it has shown that appropriate investment not only yields improved clinical outcomes for millions of patients but that it also provides an overall economic gain throughout all the income settings where this investment is made. This symposium will summarize the facets associated with this global cancer challenge by reviewing the cancer burden, looking at the requirements for radiation therapy, reviewing the benefits of providing such therapy both from a clinical and economic perspective and finally by looking at what approaches can be used to aid in the alleviation of this global cancer challenge. The speakers are world renowned experts in global public health issues (R. Atun), medical physics (D. Jaffray) and radiation oncology (N. Coleman). Learning Objectives: To describe the global cancer challenge and the

The cost of lost productivity due to premature cancer-related mortality: an economic measure of the cancer burden.

PubMed

Hanly, Paul A; Sharp, Linda

2014-03-26

Most measures of the cancer burden take a public health perspective. Cancer also has a significant economic impact on society. To assess this economic burden, we estimated years of potential productive life lost (YPPLL) and costs of lost productivity due to premature cancer-related mortality in Ireland. All cancers combined and the 10 sites accounting for most deaths in men and in women were considered. To compute YPPLL, deaths in 5-year age-bands between 15 and 64 years were multiplied by average working-life expectancy. Valuation of costs, using the human capital approach, involved multiplying YPPLL by age-and-gender specific gross wages, and adjusting for unemployment and workforce participation. Sensitivity analyses were conducted around retirement age and wage growth, labour force participation, employment and discount rates, and to explore the impact of including household production and caring costs. Costs were expressed in €2009. Total YPPLL was lower in men than women (men = 10,873; women = 12,119). Premature cancer-related mortality costs were higher in men (men: total cost = €332 million, cost/death = €290,172, cost/YPPLL = €30,558; women: total cost = €177 million, cost/death = €159,959, cost/YPPLL = €14,628). Lung cancer had the highest premature mortality cost (€84.0 million; 16.5% of total costs), followed by cancers of the colorectum (€49.6 million; 9.7%), breast (€49.4 million; 9.7%) and brain & CNS (€42.4 million: 8.3%). The total economic cost of premature cancer-related mortality in Ireland amounted to €509.5 million or 0.3% of gross domestic product. An increase of one year in the retirement age increased the total all-cancer premature mortality cost by 9.9% for men and 5.9% for women. The inclusion of household production and caring costs increased the total cost to €945.7 million. Lost productivity costs due to cancer-related premature mortality are significant. The higher premature mortality cost in males than

Multidimensional analysis of the effect of occupational exposure to organic solvents on lung cancer risk: the ICARE study

PubMed Central

Mattei, Francesca; Liverani, Silvia; Guida, Florence; Matrat, Mireille; Cenée, Sylvie; Azizi, Lamiae; Menvielle, Gwenn; Sanchez, Marie; Pilorget, Corinne; Lapôtre-Ledoux, Bénédicte; Luce, Danièle; Richardson, Sylvia; Stücker, Isabelle

2016-01-01

Background The association between lung cancer and occupational exposure to organic solvents is discussed. Since different solvents are often used simultaneously, it is difficult to assess the role of individual substances. Objectives The present study is focused on an in-depth investigation of the potential association between lung cancer risk and occupational exposure to a large group of organic solvents, taking into account the well-known risk factors for lung cancer, tobacco smoking and occupational exposure to asbestos. Methods We analysed data from the Investigation of occupational and environmental causes of respiratory cancers (ICARE) study, a large French population-based case–control study, set up between 2001 and 2007. A total of 2276 male cases and 2780 male controls were interviewed, and long-life occupational history was collected. In order to overcome the analytical difficulties created by multiple correlated exposures, we carried out a novel type of analysis based on Bayesian profile regression. Results After analysis with conventional logistic regression methods, none of the 11 solvents examined were associated with lung cancer risk. Through a profile regression approach, we did not observe any significant association between solvent exposure and lung cancer. However, we identified clusters at high risk that are related to occupations known to be at risk of developing lung cancer, such as painters. Conclusions Organic solvents do not appear to be substantial contributors to the occupational risk of lung cancer for the occupations known to be at risk. PMID:26911986

Occupation and keratinocyte cancer risk: a population-based case-control study.

PubMed

Marehbian, Josh; Colt, Joanne S; Baris, Dalsu; Stewart, Patricia; Stukel, Therese A; Spencer, Steven K; Karagas, Margaret R

2007-10-01

The aim of our study was to identify occupations associated with increased risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). We conducted a population-based case-control study of BCC and SCC in New Hampshire. Cases (n = 599 BCC, n = 290 SCC) and controls (n = 524) completed a self-administered residence and work history questionnaire and personal interview regarding major risk factors for skin cancer. Reported jobs were coded using the Standardized Occupational Classification system (SOC). Odds ratios (ORs) and confidence intervals (CIs) for BCC and SCC were calculated for men and women separately using unconditional logistic regression models taking into account age, education, skin reaction to sun, history of painful sunburns, time spent outdoors, and for SCC, smoking. Among men, we observed elevated risks of both BCC and SCC among groundskeepers and gardeners, except farm (SOC 5622). We also found that garage and service station-related occupations (SOCs 873) and to some extent food/beverage preparation/service occupations (SOC 521) were associated with BCC risk among men. Women in health services occupations (SOC 523) had elevated risks for both tumors, especially for BCC. Additionally, administrative support (SOC 46/47) occupations were related to BCC risk among women. Other occupations were associated with excess risks, but without consistent trends by duration of employment. We observed several occupations associated with elevated BCC and SCC risk. These results resemble reported findings for cutaneous melanoma and are generally consistent with the few available studies on keratinocyte cancers.

The burden of stomach cancer in indigenous populations: a systematic review and global assessment.

PubMed

Arnold, Melina; Moore, Suzanne P; Hassler, Sven; Ellison-Loschmann, Lis; Forman, David; Bray, Freddie

2014-01-01

Stomach cancer is a leading cause of cancer death, especially in developing countries. Incidence has been associated with poverty and is also reported to disproportionately affect indigenous peoples, many of whom live in poor socioeconomic circumstances and experience lower standards of health. In this comprehensive assessment, we explore the burden of stomach cancer among indigenous peoples globally. The literature was searched systematically for studies on stomach cancer incidence, mortality and survival in indigenous populations, including Indigenous Australians, Maori in New Zealand, indigenous peoples from the circumpolar region, native Americans and Alaska natives in the USA, and the Mapuche peoples in Chile. Data from the New Zealand Health Information Service and the Surveillance Epidemiology and End Results (SEER) Program were used to estimate trends in incidence. Elevated rates of stomach cancer incidence and mortality were found in almost all indigenous peoples relative to corresponding non-indigenous populations in the same regions or countries. This was particularly evident among Inuit residing in the circumpolar region (standardised incidence ratios (SIR) males: 3.9, females: 3.6) and in Maori (SIR males: 2.2, females: 3.2). Increasing trends in incidence were found for some groups. We found a higher burden of stomach cancer in indigenous populations globally, and rising incidence in some indigenous groups, in stark contrast to the decreasing global trends. This is of major public health concern requiring close surveillance and further research of potential risk factors. Given evidence that improving nutrition and housing sanitation, and Helicobacter pylori eradication programmes could reduce stomach cancer rates, policies which address these initiatives could reduce inequalities in stomach cancer burden for indigenous peoples.

The cost and burden of cancer in the European Union 1995-2014.

PubMed

Jönsson, Bengt; Hofmarcher, Thomas; Lindgren, Peter; Wilking, Nils

2016-10-01

There is an intense debate about the cost of cancer and the value of new treatments. However, there is limited data on the cost of cancer in the European Union (EU) and how costs relate to the burden of disease. This paper presents new estimates on the development of the cost of cancer in the EU 1995-2014, with a focus on the major cost components: total health expenditure, cancer drugs, and production loss due to premature mortality. Data on overall health expenditure were combined with national disease estimates to derive cancer-specific health expenditure. Data on drug sales were obtained from IMS Health, and epidemiological data were used to calculate life years lost due to cancer. Health expenditure on cancer increased continuously from €35.7 billion in 1995 to €83.2 billion in 2014 in the EU and spending on cancer drugs from €7.6 billion in 2005 to €19.1 billion in 2014 (current prices). Yet the share of total health expenditure devoted to cancer was mostly constant (around 6 per cent). While expenditures on cancer drugs increased in both absolute and relative terms, other expenditures were stable or decreased, despite increases in cancer incidence driven by a growing and ageing population. Reductions in cancer mortality during working age resulted in decreasing production loss due to premature mortality. Health spending on cancer as a share of total health expenditure is rather low and stable despite the growing incidence and relative burden of cancer. Problems to reallocate funding in health care systems under economic pressure may be one explanation and shifting costs from inpatient to ambulatory care another. Copyright © 2016 Elsevier Ltd. All rights reserved.

Occupation and lung cancer in Shanghai: a case-control study.

PubMed Central

Levin, L I; Zheng, W; Blot, W J; Gao, Y T; Fraumeni, J F

1988-01-01

Occupation was evaluated as a potential risk factor for lung cancer as part of a large population based case-control study conducted in the ten urban districts of Shanghai. A total of 733 newly diagnosed cases of male lung cancer and 760 controls selected from the general population was interviewed to obtain lifetime occupational histories and information on smoking and other factors. Of the approximately 25 major industrial titles examined, significantly raised risks, adjusted for smoking, were found for employment in agricultural production (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.0-2.6). A concomitant increase was detected for farmers (OR = 1.6, 95% CI = 1.0-2.5) when 35 major occupational titles were examined. There was a 70% excess among workers in the chemical industry (OR = 1.7, 95% CI = 0.9-3.1) and a significant decrease among textile industry workers (OR = 0.7, 95% CI = 0.5-1.0). Raised risks of 30% to 80% were associated with reported job exposures to wood and coal dusts, smoke from burning fuels, and chemical fumes. Employment categories were also examined for 672 cases and 735 controls among women, but small numbers in many of the industrial and occupational categories precluded detailed analyses. The largest excess risk among women (OR = 5.1, 95% CI 1.3-23.5) was among glass products workers. Although cigarette smoking was the dominant cause of lung cancer among men and a significant risk factor among women in Shanghai, these findings suggest the importance of certain workplace exposures and offer leads to occupational carcinogens. PMID:3395581

77 FR 4048 - Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... occupational safety and health services, and the prevention of work-related injury and illness. It is... the magnitude of the aggregate health burden associated with occupational injuries and illnesses, as... Occupational Health Study Section (SOHSS), National Institute for Occupational Safety and Health, (NIOSH) In...

76 FR 52330 - Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... occupational safety and health services, and the prevention of work-related injury and illness. It is... the magnitude of the aggregate health burden associated with occupational injuries and illnesses, as... Occupational Health Study Section (SOHSS), National Institute for Occupational Safety and Health (NIOSH) In...

77 FR 51810 - Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-27

... occupational safety and health services, and the prevention of work-related injury and illness. It is... the magnitude of the aggregate health burden associated with occupational injuries and illnesses, as... Occupational Health Study Section (SOHSS), National Institute for Occupational Safety and Health (NIOSH) In...

Employment status and occupational level of adult survivors of childhood cancer in Great Britain: The British childhood cancer survivor study.

PubMed

Frobisher, Clare; Lancashire, Emma R; Jenkinson, Helen; Winter, David L; Kelly, Julie; Reulen, Raoul C; Hawkins, Michael M

2017-06-15

The British Childhood Cancer Survivor Study (BCCSS) provides the first detailed investigation of employment and occupation to be undertaken in a large population-based cohort. Previous studies have been limited by design issues such as using small numbers of survivors with specific diagnoses, and involved limited assessment of employment status and occupational level. The BCCSS includes 17,981 5-year survivors of childhood cancer. Employment status and occupational level were ascertained by questionnaire from eligible survivors (n = 14,836). Multivariate logistic regression was used to explore factors associated with employment and occupation, and to compare survivors to their demographic peers in the general population. Employment status was available for 10,257 survivors. Gender, current age, cancer type, radiotherapy, age at diagnosis and epilepsy were consistently associated with being: employed; unable to work; in managerial or non-manual occupations. Overall, survivors were less likely to be working than expected (OR (99% CI): 0.89 (0.81-0.98)), and this deficit was greatest for irradiated CNS neoplasm survivors (0.34 (0.28-0.41)). Compared to the general population, survivors were fivefold more likely to be unable to work due to illness/disability; the excess was 15-fold among CNS neoplasm survivors treated with radiotherapy. Overall survivors were less likely to be in managerial occupations than expected (0.85 (0.77-0.94)). However, bone sarcoma survivors were more likely to be in these occupations than expected (1.37 (1.01-1.85)) and also similarly for non-manual occupations (1.90 (1.37-2.62)). Survivors of retinoblastoma (1.55 (1.20-2.01)) and 'other' neoplasm group (1.62 (1.30-2.03)) were also more likely to be in non-manual occupations than expected. © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

The relative contributions of function, perceived psychological burden and partner support to cognitive distress in bladder cancer.

PubMed

Heyes, Susan M; Bond, Malcolm J; Harrington, Ann; Belan, Ingrid

2016-09-01

Bladder cancer is a genitourinary disease of increasing incidence. Despite improvements in treatment, outcomes remain equivocal with high recurrence rates. It is associated with poor psychosocial outcomes due to reduced functioning of the genitourinary system. The objective of these analyses was to query whether reported loss of function or the perception of psychological burden caused by this functional impedance was the key to understanding psychosocial outcomes. The sample comprised 119 participants with a confirmed diagnosis of bladder cancer. They completed a self-report questionnaire comprising the Bladder Cancer Index, Mini-mental Adjustment to Cancer Scale, Psychosocial Adjustment to Illness Scale and standard sociodemographic details. Simple mediation and serial mediation were used to explore the potential for psychological burden to mediate associations between loss of function and cognitive distress, and the potential additional contribution of positive partner support on these relationships. Age and duration of cancer were considered as covariates. Simple mediation demonstrated that the association between function and cognitive distress was fully mediated by perceived psychological burden. Serial mediation, which allowed for the addition of partner support, again demonstrated full mediation, with partner support being the key predictive variable. These analyses emphasise the importance of an appreciation of individuals' interpretation of the burden occasioned by bladder cancer and the role of a supportive partner. The implications for management discussions and support services in alleviating negative psychological outcomes in bladder cancer are highlighted. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Occupational exposures and colorectal cancers: A quantitative overview of epidemiological evidence

PubMed Central

Oddone, Enrico; Modonesi, Carlo; Gatta, Gemma

2014-01-01

A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer. In more recent times, however, a growing evidence has shown that other determinants can be very important in increasing (or reducing) incidence of this malignancy. The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground, and high risks of colorectal cancer have been reported among workers in some industrial branches. The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities, by means of a scientific literature review and meta-analysis. This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds, such as leather (RR = 1.70, 95%CI: 1.24-2.34), basic metals (RR = 1.32, 95%CI: 1.07-1.65), plastic and rubber manufacturing (RR = 1.30, 95%CI: 0.98-1.71 and RR = 1.27, 95%CI: 0.92-1.76, respectively), besides workers in the sector of repair and installation of machinery exposed to asbestos (RR = 1.40, 95%CI: 1.07-1.84). Based on our results, the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%. However, homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review. PMID:25253943

Occupational mortality and cancer analysis.

PubMed

Lynge, E

The 1970-census populations have been followed up for deaths and emigrations in the ten-year period 1970-80 in all the Nordic countries. The data show more than a 2-fold difference in overall mortality between the low-risk group of men with pedagogical work and the high-risk group of deck and engine crew workers. These data files have also been supplemented with cancer register records. In Denmark this combined data set has been used in four different ways. First, in order to check the validity of the register, classic associations known from in-depth epidemiological studies were tabulated. Examples are cancer of the lip in farmers and fishermen, where the standardized incidence ratio (SIR) values were 1.85 and 3.17, respectively, and cancer of the nasal cavities and sinuses in skilled furniture makers, SIR = 12.25. Second, a social cancer map was produced by tabulating the cancer incidence by 20 socioeconomic groups. The social gradient was steepest for certain rare cancers related to specific etiologic factors. The social gradient also varied across cancer sites. Third, the register was used as a library for elucidation of newly reported associations. An association confirmed in the Danish data is an excess risk of bladder cancer in hairdressers, SIR = 2.05. An unconfirmed example is an excess risk of malignant melanoma in the printing industry, where Danish data show an SIR of 0.95. Fourth, a systematic tabulation of each cancer diagnosis across detailed occupational groups may lead to identification of previously unknown associations. This procedure is illustrated using cancer of the larynx as an example. Smiths, mechanics, foremen, and shop owners of engineering works and workshops all have an excess risk of laryngeal cancer, SIR = 1.63.

Burden of cervical cancer and role of screening in India

PubMed Central

Bobdey, Saurabh; Sathwara, Jignasa; Jain, Aanchal; Balasubramaniam, Ganesh

2016-01-01

Background: Cervical cancer is a major cause of cancer mortality in women and more than a quarter of its global burden is contributed by developing countries. In India, in spite of alarmingly high figures, there is no nationwide government-sponsored screening program. This study was conducted to assess the burden of cervical cancer in India and review the performance characteristics of available cervical cancer screening tools, so as to provide evidence-based recommendations for application of most practically suited screening test to be used in resource-poor field settings. Materials and Methods: MEDLINE and Web of Science electronic database were searched from January 1990 to December 2015, using the keywords such as “cervical cancer”, “screening”, “early detection”, “cervical cytology” and “visual inspection”, and their corresponding MeSH terms in combination with Boolean operators “OR, AND.” Two authors independently selected studies that are published in English and conducted in India. A total of 11 studies were found to be relevant and eligible to be included in the present study. Results: In India, cervical cancer contributes to approximately 6–29% of all cancers in women. The age-adjusted incidence rate of cervical cancer varies widely among registries; highest is 23.07/100,000 in Mizoram state and the lowest is 4.91/100,000 in Dibrugarh district. The pooled estimates of sensitivity and specificity of visual inspection with acetic acid (VIA), magnified VIA, visual inspection with Lugol's iodine (VILI), cytology (Pap smear), and human papillomavirus DNA were found to be 67.65% and 84.32%, 65.36% and 85.76%, 78.27% and 87.10%, 62.11% and 93.51%, and 77.81% and 91.54%, respectively. Conclusions: In developing countries because of lack of necessary infrastructure and quality control, high-quality cytology screening may not be feasible for wide-scale implementation. Hence, cervical cancer screening program based on visual screening test

Burden of cancer associated with type 2 diabetes mellitus in Japan, 2010-2030.

PubMed

Saito, Eiko; Charvat, Hadrien; Goto, Atsushi; Matsuda, Tomohiro; Noda, Mitsuhiko; Sasazuki, Shizuka; Inoue, Manami

2016-04-01

Diabetes mellitus constitutes a major disease burden globally, and the prevalence of diabetes continues to increase worldwide. We aimed to estimate the burden of cancer associated with type 2 diabetes mellitus in Japan between 2010 and 2030. In this study, we estimated the population attributable fraction of cancer risk associated with type 2 diabetes in 2010 and 2030 using the prevalence estimates of type 2 diabetes in Japan from 1990 to 2030, summary hazard ratios of diabetes and cancer risk from a pooled analysis of eight large-scale Japanese cohort studies, observed incidence/mortality of cancer in 2010 and predicted incidence/mortality for 2030 derived from the age-period-cohort model. Our results showed that between 2010 and 2030, the total numbers of cancer incidence and mortality were predicted to increase by 38.9% and 10.5% in adults aged above 20 years, respectively. In the number of excess incident cancer cases associated with type 2 diabetes, an increase of 26.5% in men and 53.2% in women is expected between 2010 and 2030. The age-specific analysis showed that the population attributable fraction of cancer will increase in adults aged >60 years over time, but will not change in adults aged 20-59 years. In conclusion, this study suggests a modest but steady increase in cancers associated with type 2 diabetes. © 2016 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Factors Associated With Higher Caregiver Burden Among Family Caregivers of Elderly Cancer Patients: A Systematic Review.

PubMed

Ge, Lixia; Mordiffi, Siti Zubaidah

Caring for elderly cancer patients may cause multidimensional burden on family caregivers. Recognition of factors associated with caregiver burden is important for providing proactive support to caregivers at risk. The aim of this study was to identify factors associated with high caregiver burden among family caregivers of elderly cancer patients. A systematic search of 7 electronic databases was conducted from database inception to October 2014. The identified studies were screened, and full text was further assessed. The quality of included studies was assessed using a checklist, and relevant data were extracted using a predeveloped data extraction form. Best-evidence synthesis model was used for data synthesis. The search yielded a total of 3339 studies, and 7 studies involving 1233 family caregivers were included after screening and full assessment of 116 studies. Moderate evidence supported that younger caregivers, solid tumors, and assistance with patient's activities of daily living were significantly associated with high caregiver burden. Eighteen factors were supported by limited evidence, and 1 was a conflicting factor. The scientific literature to date proved that caregiver burden was commonly experienced by family caregivers of elderly cancer patients. The evidence indicated that family caregivers who were at younger age, caring for solid tumor patients, and providing assistance with patient's activities of daily living reported high caregiver burden. The data provide evidence in identifying family caregivers at high risk of high caregiver burden. More high-quality studies are needed to clarify and determine the estimates of the effects of individual factors.

Cancer and construction: what occupational histories in a Canadian community reveal.

PubMed

Brophy, James T; Keith, Margaret M; Gorey, Kevin M; Laukkanen, Ethan; Luginaah, Isaac; Abu-Zahra, Hakam; Watterson, Andrew E; Hellyer, Deborah J; Reinhartz, Abraham; Park, Robert M

2007-01-01

From 2000 to 2002, male patients at a Canadian cancer treatment center with new-incident head-and-neck or esophageal cancers were invited to participate in a population-based study. The study population included 87 cases and 172 controls. A lifetime-history questionnaire was administered. Odds ratios (ORs) were calculated for occupational groups with a minimum of five cases, adjusted for duration of employment, age, smoking, alcohol, education, and income. A significantly increased risk was shown for construction workers (OR = 2.20; 95% CI 1.25-3.91). This investigation of a set of rare cancers over a limited time period demonstrates the feasibility of this research approach. The increased risk among construction workers supports the need for more comprehensive study of exposures in this occupational group.

Textile industry and occupational cancer.

PubMed

Singh, Zorawar; Chadha, Pooja

2016-01-01

Thousands of workers are engaged in textile industry worldwide. Textile industry involves the use of different kinds of dyes which are known to possess carcinogenic properties. Solvents used in these industries are also associated with different health related hazards including cancer. In previous studies on textile and iron industries, the authors have reported genotoxicity among them and observed occurrence of cancer deaths among textile industry workers. Thus, an attempt has been made to compile the studies on the prevalence of different types of cancers among textile industry workers. A wide literature search has been done for compiling the present paper. Papers on cancer occurrence among textile industry workers have been taken from 1976 to 2015. A variety of textile dyes and solvents, many of them being carcinogenic, are being used worldwide in the textile industry. The textile industry workers are therefore, in continuous exposure to these dyes, solvents, fibre dusts and various other toxic chemicals. The present study evaluates the potential of different chemicals and physical factors to be carcinogenic agents among occupationally exposed workers by going through various available reports and researches. Papers were collected using different databases and a number of studies report the association of textile industry and different types of cancer including lung, bladder, colorectal and breast cancer. After going through the available reports, it can be concluded that workers under varied job categories in textile industries are at a higher risk of developing cancer as various chemicals used in the textile industry are toxic and can act as potential health risk in inducing cancer among them. Assessing the cancer risk at different job levels in textile industries may be found useful in assessing the overall risk to the workers and formulating the future cancer preventive strategies.

Occupation and lung cancer in two industrialized areas of northern Italy.

PubMed

Ronco, G; Ciccone, G; Mirabelli, D; Troia, B; Vineis, P

1988-03-15

A population-based case-control study on lung cancer was conducted in 2 industrialized areas of northern Italy. Cases (126) were all males who died from lung cancer between 1976 and 1980. Controls (384) were a random sample of males dying from other causes during the same period. Jobs held during working life have been analyzed according to a list of occupations already known to be causally associated with lung cancer (list A) and a list of occupations suspected of being so (list B). Attributable risk percentages in the population for occupations included in either list A or B were about 36% and 12% in the 2 areas. Welders or workers in industries in which welding is common showed elevated odds ratios: 2.9 for welders (95% CI 0.9-9.8); 4.9 (1.1-22.9) for structural metal workers; 11.4 (2.6-49.9) for workers in structural metal production. Other job categories associated with lung cancer included: electricians and workers in electrical machine production, woodworkers (in furniture or cabinet making, but not in carpentry or joinery) and cleaning services. Smoking did not seem to exert a substantial confounding effect. Attributable risk percentages for tobacco smoking were about 78% and 76% in the population of the 2 areas.

Use of state cancer surveillance data to estimate the cancer burden in disaster-affected areas--Hurricane Katrina, 2005.

PubMed

Joseph, Djenaba A; Wingo, Phyllis A; King, Jessica B; Pollack, Lori A; Richardson, Lisa C; Wu, Xiaocheng; Chen, Vivien; Austin, Harland D; Rogers, Deirdre; Cook, Janice

2007-01-01

The objective of this study was to estimate the burden of cancer in counties affected by Hurricane Katrina using population-based cancer registry data, and to discuss issues related to cancer patients who have been displaced by disasters. The cancer burden was assessed in 75 counties in Louisiana, Alabama, and Mississippi that were designated by the Federal Emergency Management Agency as eligible for individual and public assistance. Data from the National Program of Cancer Registries were used to determine three-year average annual age-adjusted incidence rates and case counts during the diagnosis years 2000-2002 for Louisiana and Alabama. Expected rates and counts for the most-affected counties in Mississippi were estimated by direct, age-specific calculation using the 2000-2002 county level populations and the site-, sex-, race-, and age-specific cancer incidence rates for Louisiana. An estimated 23,549 persons with a new diagnosis of cancer in the past year resided in the disaster-affected counties. Fifty-eight percent of the cases were cancers of the lung/bronchus, colon/rectum, female breast, and prostate. Eleven of the top 15 cancer sites by sex and black/white race in disaster counties had >50% of cases diagnosed at the regional or distant stage. Sizable populations of persons with a recent cancer diagnosis were potentially displaced by Hurricane Katrina. Cancer patients required special attention to access records in order to confirm diagnosis and staging, minimize disruption in treatment, and ensure coverage of care. Cancer registry data can be used to provide disaster planners and clinicians with estimates of the number of cancer patients, many of whom may be undergoing active treatment.

The Benefits and Burdens of Cancer: A Prospective Longitudinal Cohort Study of Adolescents and Young Adults.

PubMed

Straehla, Joelle P; Barton, Krysta S; Yi-Frazier, Joyce P; Wharton, Claire; Baker, Kevin Scott; Bona, Kira; Wolfe, Joanne; Rosenberg, Abby R

2017-05-01

Adolescents and early young adults (AYAs) with cancer are at high risk for poor outcomes. Positive psychological responses such as benefit-finding may buffer the negative impacts of cancer but are poorly understood in this population. We aimed to prospectively describe the content and trajectory of benefit- and burden-finding among AYAs to develop potential targets for future intervention. One-on-one semistructured interviews were conducted with English-speaking AYA patients (aged 14-25 years) within 60 days of diagnosis of a noncentral nervous system malignancy requiring chemotherapy, 6-12 and 12-18 months later. Interviews were coded using directed content analyses with a priori schema defined by existing theoretical frameworks, including changed sense of self, relationships, philosophy of life, and physical well-being. We compared the content, raw counts, and ratios of benefit-to-burden by patient and by time point. Seventeen participants at one tertiary academic medical center (mean age 17.1 years, SD = 2.7) with sarcoma (n = 8), acute leukemia (n = 6), and lymphoma (n = 3) completed 44 interviews with >100 hours of transcript-data. Average benefit counts were higher than average burden counts at each time point; 68% of interviews had a benefit-to-burden ratio >1. Positive changed sense-of-self was the most common benefit across all time points (44% of all reported benefits); reports of physical distress were the most common burden (32%). Longitudinal analyses suggested perceptions evolved; participants tended to focus less on physical manifestations and more on personal strengths and life purpose. AYAs with cancer identify more benefits than burdens throughout cancer treatment and demonstrate rapid maturation of perspectives. These findings not only inform communication practices with AYAs but also suggest opportunities for interventions to potentially improve outcomes.

Effects of occupational therapy on quality of life of patients with metastatic prostate cancer

PubMed Central

Huri, Meral; Huri, Emre; Kayihan, Hulya; Altuntas, Onur

2015-01-01

Objectives: To evaluate the efficiency of occupational therapy relative to a home program in improving quality of life (QoL) among men who were treated for metastatic prostate cancer (MPC). Methods: Fifty-five men were assigned randomly to either the 12-week cognitive behavioral therapy based occupational therapy (OT-CBSM) intervention (treatment group) or a home program (control group) between March 2012 and August 2014 in the Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey. The Canadian Occupational Performance Measure (COPM) was used to measure the occupational performance and identify difficulties in daily living activities. The QoL and symptom status were measured by The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire C30 and its Prostate Cancer Module. A 12-week OT-CBSM intervention including client-centered training of daily living activities, recreational group activities, and cognitive behavioral stress management intervention were applied. Results: The COPM performance and satisfaction scores, which indicate occupational participation and QoL increased statistically in the treatment group in relation to men who were included in the home-program (p≤0.05). Conclusion: A 12-week OT-CBSM intervention was effective in improving QoL in men treated for MPC, and these changes were associated significantly with occupational performance. PMID:26219446

Occupational exposure to crystalline silica and the risk of lung cancer in Canadian men.

PubMed

Kachuri, Linda; Villeneuve, Paul J; Parent, Marie-Élise; Johnson, Kenneth C; Harris, Shelley A

2014-07-01

Crystalline silica is a recognized carcinogen, but the association with lung cancer at lower levels of exposure has not been well characterized. This study investigated the relationship between occupational silica exposure and lung cancer and the combined effects of cigarette smoking and silica exposure on lung cancer risk. A population-based case-control study was conducted in eight Canadian provinces between 1994 and 1997. Self-reported questionnaires were used to obtain a lifetime occupational history and information on other risk factors. Occupational hygienists assigned silica exposures to each job based on concentration, frequency and reliability. Data from 1681 incident lung cancer cases and 2053 controls were analyzed using logistic regression to estimate odds ratios (OR) and their 95% confidence intervals (CI). Models included adjustments for cigarette smoking, lifetime residential second-hand smoke and occupational exposure to diesel and gasoline engine emissions. Relative to the unexposed, increasing duration of silica exposure at any concentration was associated with a significant trend in lung cancer risk (OR ≥ 30 years: 1.67, 1.21-2.24; ptrend  = 0.002). The highest tertile of cumulative silica exposure was associated with lung cancer (OR = 1.81, 1.34-2.42; ptrend  = 0.004) relative to the lowest. Men exposed to silica for ≥30 years with ≥40 cigarette pack-years had the highest risk relative to those unexposed with <10 pack-years (OR = 42.53, 23.54-76.83). The joint relationship with smoking was consistent with a multiplicative model. Our findings suggest that occupational exposure to silica is a risk factor for lung cancer, independently from active and passive smoking, as well as from exposure to other lung carcinogens. © 2013 UICC.

[Motivations and obstacles to occupational disease claims in lung cancer patients: an exploratory psychosocial study].

PubMed

Britel, Manon; Pérol, Olivia; Blois Da Conceiçao, Stéphanie; Ficty, Manon; Brunet, Houria; Avrillon, Virginie; Charbotel, Barbara; Fervers, Béatrice

2017-10-02

The proportion of lung cancers with an occupational origin has been estimated to be between 10 and 20%. They are largely under-reported, as 60% are not compensated as occupational disease. Although most patients are not familiar with the process of compensation, other factors could explain this under-reporting. The aim of this study was to identify psychosocial factors that could impact patients with occupational lung cancer to claim for compensation. We conducted a case study involving semi-structured interviews with eight lung cancer patients enrolled in a cohort designed to systematically screen occupational exposures and propose claims for compensation to work-related cancer patients. Seven interviewed patients were familiar with occupational cancers, but most of them did not believe that past exposure could be related to their current disease. Patients associated compensation claims with a long and complex procedure for an abstract purpose. Several patients expressed a certain attachment to their employers. Interviewed patients often considered compensation claims to be a grievance procedure against the employers whom they did not consider to be responsible for their disease. Lung cancer is itself an obstacle to compensation considering the aggressive treatments and related adverse events, the poor medium-term prognosis and the predominant role of smoking in the etiology of the disease. Patients mentioned the financial compensation and the role of healthcare professionals as key elements to motivate them to claim for compensation.

Occupational exposures and cancer of the colon and rectum.

PubMed

Gerhardsson de Verdier, M; Plato, N; Steineck, G; Peters, J M

1992-01-01

The associations between occupational risks and colorectal cancer were examined in a Swedish population-based, case-referent study. The study was performed in Stockholm in 1986-1988 and included 569 cases and 512 referents. Relative risks (RRs) with 95% confidence intervals were calculated for different occupations/chemicals. Elevated risks of colon cancer were found among male petrol station/automobile repair workers (RR = 2.3, 0.8-6.6) and among males exposed to asbestos (RR = 1.8, 0.9-3.6), while elevated risks of rectal cancer were found among males exposed to soot (RR = 2.2, 1.1-4.3), asbestos (RR = 2.2, 1.0-4.7), cutting fluids/oils (RR = 2.1, 1.1-4.0), and combustion gases from coal/coke/wood (RR = 1.9, 1.0-3.7). However, due to a high correlation between the above-mentioned variables and the few exposed subjects, it is difficult to separate their effects properly. These analyses were adjusted for age. Further adjustments for diet, body mass, and physical activity had little or no influence on the results.

Nasal cancer in England and Wales: an occupational survey.

PubMed Central

Acheson, E D; Cowdell, R H; Rang, E H

1981-01-01

A national survey of the incidence of nasal cancer in England and Wales during the period 1963-7 with special reference to occupation confirmed the well-known increases in incidence of nasal cancer in cabinet makers and wood machinists, together with the absence of any significant increase in carpenters and joiners, and the increases in boot and shoe operatives and repairers, and in nickel smelters in South Wales. The significant excesses of cases found among coalminers, furnacemen in the gas, coke, and chemical industry, and furnacemen and labourers in foundries may be associated with exposure to coal and coke dust or may be spurious. No excess of nasal cancer was found among male textile workers. Excesses of uncertain significance were found among tailors and dressmakers, bakers and pastry cooks, and printers. Apart from the well-known relationships between adenocarcinoma and work in the furniture and footwear industries there is no definite indication in this survey of any association between a particular histological type of nasal tumour and occupation in England and Wales. PMID:7272233

Smoking-attributable burden of lung cancer in the Philippines.

PubMed

Bilano, Ver Luanni Feliciano; Borja, Maridel P; Cruz, Eduardo L; Tan, Alvin G; Mortera, Lalaine L; Reganit, Paul Ferdinand M

2015-05-01

In the Philippines, smoking is highly prevalent and tobacco control policies fail to fully implement the WHO Framework Convention on Tobacco Control provisions. To aid in policy change, intervention implementation, monitoring and evaluation, this study aimed to provide the first internally consistent and latest Philippine estimates of the following: disability-adjusted life-years (DALYs) lost due to lung cancer; population-attributable fractions (PAFs) of smoking; and smoking-attributable lung cancer DALYs. This study applied the Global Burden of Disease and Comparative Risk Assessment frameworks to secondary data, supplemented by expert opinion. A comprehensive internally consistent assessment of disease epidemiology was conducted using DISMOD II and disease impact was quantified as DALYs. PAFs were calculated using the smoking impact ratio and Monte Carlo uncertainty analyses were conducted. For 2008, lung cancer incidence and mortality estimates were 10 871 cases and 9871 deaths respectively. Lung cancer accounted for an estimated 267 787 DALYs lost, 99% of which were due to years of life lost. Overall, the PAF of smoking was 65% and a total of 173 103 DALYs were smoking-attributable. There were increasing trends in incidence, mortality and DALY rates with age. The majority of incidence (72%), mortality (71%) and disease burden (72%) occurred among men, who also had higher PAF estimates. Considerable health gains could be achieved if smoking exposure were reduced in the Philippines. Strong enforcement of measures like increasing taxation to the WHO-endorsed rate, expanding smoke-free environments, and requiring large graphic warnings within a comprehensive tobacco control programme is recommended. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Stomach cancer burden in Central and South America.

PubMed

Sierra, Monica S; Cueva, Patricia; Bravo, Luis Eduardo; Forman, David

2016-09-01

Stomach cancer mortality rates in Central and South America (CSA) are among the highest in the world. We describe the current burden of stomach cancer in CSA. We obtained regional and national-level cancer incidence data from 48 population-based registries (13 countries) and nation-wide cancer deaths from WHO's mortality database (18 countries). We estimated world population age-standardized incidence (ASR) and mortality (ASMR) rates per 100,000 and estimated annual percent change to describe time trends. Stomach cancer was among the 5 most frequently diagnosed cancers and a leading cause of cancer mortality. Between CSA countries, incidence varied by 6-fold and mortality by 5-6-fold. Males had up to 3-times higher rates than females. From 2003 to 2007, the highest ASRs were in Chile, Costa Rica, Colombia, Ecuador, Brazil and Peru (males: 19.2-29.1, females: 9.7-15.1). The highest ASMRs were in Chilean, Costa Rican, Colombian and Guatemalan males (17.4-24.6) and in Guatemalan, Ecuadorian and Peruvian females (10.5-17.1). From 1997 to 2008, incidence declined by 4% per year in Brazil, Chile and Costa Rica; mortality declined by 3-4% in Costa Rica and Chile. 60-96% of all the cancer cases were unspecified in relation to gastric sub-site but, among those specified, non-cardia cancers occurred 2-13-times more frequently than cardia cancers. The variation in rates may reflect differences in the prevalence of Helicobacter pylori infection and other risk factors. High mortality may additionally reflect deficiencies in healthcare access. The high proportion of unspecified cases calls for improving cancer registration processes. Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd.. All rights reserved.

National and sub-national burden of breast cancer in Iran; 1990-2013.

PubMed

Naderimagham, Shohreh; Alipour, Sadaf; Djalalinia, Shirin; Kasaeian, Amir; Noori, Atefeh; Rahimzadeh, Shadi; Modirian, Mitra; Khosravi, Ardeshir; Etemad, Kourosh; Jamshidi, Hamid Reza; Farzadfar, Fashad

2014-12-01

Estimating the burden of diseases, injuries and major risk factors is necessary for adopting appropriate health policies in every country, and this paper aims to explain the study protocol of national and sub-national burden of breast cancer in Iran from 1990 to 2013. We will perform a systematic review of the confirmed databases and literature to gather data on breast cancer epidemiology in Iran. The definitions, data sources, organizing the team, methods of data gathering and data generating will be explained in this paper. The methodology of estimating the trend of prevalence, years of life lost due to premature death (YLLs), years of life lost due to disability (YLDs) and disability-adjusted life years lost (DALYs) of breast cancer by age groups, provinces and probable inequalities will be explained. We will tackle possible data problems due to the lack of data points on provinces and years and also geographical misalignment by using two advanced statistical methods, namely Bayesian autoregressive multilevel and Spatio-temporal models. Trend estimation will be reported using these two models together with uncertainty intervals. This study provides a comprehensive assessment of breast cancer and its specific pattern in Iran. The results will help policy makers to know the trend of prevalence, the distribution, and the inequalities of breast cancer in Iran to allocate resources in a better way.

Review of carcinogenicity of hexavalent chrome and proposal of revising approval standards for an occupational cancers in Korea.

PubMed

Kim, Jungwon; Seo, Sangyun; Kim, Yangho; Kim, Dae Hwan

2018-01-01

The objective of this study is to suggest revised recognition standards for occupational disease due to chromium (VI) by reflecting recent domestic and international research works and considering domestic exposure status with respect to target organs, exposure period, and cumulative exposure dose in relation to the chromium (VI)-induced occupational disease compensation. In this study, the reports published by major international institutions such as World Health Organization (WHO) International Agency for Research on Cancer (IARC) (2012), Occupational Safety and Health Administration (OSHA) (2006), National Institute for Occupational Safety and Health (NIOSH) (2013), American Conference of Governmental Industrial Hygienists (ACGIH) (2004), National Toxicology Program (NTP) (2014), and Agency for Toxic Substances and Disease Registry (ASTDR) (2012) were reviewed and the recent research works searched by PubMed were summarized. Considering the recent research works and the domestic situation, only lung cancer is conserved in the legislative bill in relation to chromium (VI), and the exposure period is not included in the bill. Nasal and paranasal sinus cancer was excluded from the list of cancers that are compensated as the chromium (VI)- induced occupational disease, while lung cancer remains in the list. In the view of legislative unity, considering the fact that only the cancers having sufficient evidence are included in the conventional list of cancers compensated as occupational disease, nasal and paranasal sinus cancer having limited evidence were excluded from the list.The exposure period was also removed from the legislative bill due to the insufficient evidence. Recent advices in connection with cumulative exposure dose were proposed, and other considerable points were provided with respect to individual occupational relevance. It is suggested that the current recognition standard which is "Lung cancer or nasal and paranasal sinus cancer caused by exposure

Comprehensive Geriatric Assessment (CGA) based risk factors for increased caregiver burden among elderly Asian patients with cancer.

PubMed

Rajasekaran, Tanujaa; Tan, Tira; Ong, Whee Sze; Koo, Khai Nee; Chan, Lili; Poon, Donald; Roy Chowdhury, Anupama; Krishna, Lalit; Kanesvaran, Ravindran

2016-05-01

This study aims to identify Comprehensive Geriatric Assessment (CGA) based risk factors to help predict caregiver burden among elderly patients with cancer. The study evaluated 249 patients newly diagnosed with cancer, aged 70years and above, who attended the geriatric oncology clinic at the National Cancer Centre Singapore between 2007 and 2010. Out of 249 patients, 244 patients had information available on family caregiver burden and were analysed. On univariate analysis, ADL dependence, lower IADL scores, ECOG performance status of 3-4, higher fall risk, lower scores in dominant hand grip strength test and mini mental state examination, polypharmacy, higher nutritional risk, haemoglobin <12g/dL and presence of geriatric syndromes were significantly associated with mild to severe caregiver burden. On multivariate analysis, only ECOG performance status of 3-4 (odds ratio [OR], 4.47; 95% confidence interval [CI], 2.27-8.80) and haemoglobin <12g/dL (OR, 2.38; 95% CI, 1.14-4.99) were associated with an increased probability of mild to severe caregiver burden. The model achieved a good fit (Hosmer-Lemeshow's p=0.196) and discrimination (area under the curve [AUC]=0.742; bias-corrected AUC=0.737). Based on this, patients were stratified into 3 risk groups with different proportion of patients with increased caregiver burden (low risk: 3.9% vs intermediate risk: 18.8% vs high risk: 39.6%; p<0.001). ECOG performance status and haemoglobin were associated with increased caregiver burden among elderly patients with cancer. Using these two factors in the clinic may help clinicians identify caregivers at risk and take preventive action to mitigate that. Copyright © 2016 Elsevier Inc. All rights reserved.

Complementary and Alternative Medicine Use and Symptom Burden in Women Undergoing Chemotherapy for Breast Cancer in Malaysia.

PubMed

Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah

Complementary and alternative medicine (CAM) is commonly used for cancer- and chemotherapy-related symptoms. Nurses are likely to encounter many CAM users in their practice. The aims of this study were to assess CAM use and examine the symptom burden of CAM and non-CAM users among patients with breast cancer who are undergoing chemotherapy. A CAM use questionnaire and the Side-Effect Burden Scale were administered to 546 patients. Complementary and alternative medicine use was categorized as mind-body practices (MBPs), natural products (NPs), or traditional medicine (TM). We identified 386 CAM users (70.7%) in this study. The CAM users reported a higher marginal mean total symptom burden score (40.39 ± 2.6) than non-CAM users (36.93 ± 3.21), although this difference was not statistically significant (P = .09). Triple-modality (MBP-NP-TM) CAM users had a significantly higher marginal mean total symptom burden score (47.44 ± 4.12) than single-modality (MBP) users (34.09 ± 4.43). The risk of having a high total symptom burden score was 12.9-fold higher among the MBP-NP-TM users than among the MBP users. Complementary and alternative medicine use is common among Malaysian patients who are undergoing chemotherapy for breast cancer. However, CAM and non-CAM users reported similar symptom burdens, although single-modality use of MBP is likely associated with a lower symptom burden. Nurses should keep abreast of current developments and trends in CAM use. Understanding CAM use and the related symptom burden will allow nurses to initiate open discussion and guide their patients in seeking additional information or referrals for a particular therapy.

Worldwide burden of cancer attributable to HPV by site, country and HPV type

PubMed Central

Plummer, Martyn; Vignat, Jerome; Franceschi, Silvia

2017-01-01

HPV is the cause of almost all cervical cancer and is responsible for a substantial fraction of other anogenital cancers and oropharyngeal cancers. Understanding the HPV‐attributable cancer burden can boost programs of HPV vaccination and HPV‐based cervical screening. Attributable fractions (AFs) and the relative contributions of different HPV types were derived from published studies reporting on the prevalence of transforming HPV infection in cancer tissue. Maps of age‐standardized incidence rates of HPV‐attributable cancers by country from GLOBOCAN 2012 data are shown separately for the cervix, other anogenital tract and head and neck cancers. The relative contribution of HPV16/18 and HPV6/11/16/18/31/33/45/52/58 was also estimated. 4.5% of all cancers worldwide (630,000 new cancer cases per year) are attributable to HPV: 8.6% in women and 0.8% in men. AF in women ranges from <3% in Australia/New Zealand and the USA to >20% in India and sub‐Saharan Africa. Cervix accounts for 83% of HPV‐attributable cancer, two‐thirds of which occur in less developed countries. Other HPV‐attributable anogenital cancer includes 8,500 vulva; 12,000 vagina; 35,000 anus (half occurring in men) and 13,000 penis. In the head and neck, HPV‐attributable cancers represent 38,000 cases of which 21,000 are oropharyngeal cancers occurring in more developed countries. The relative contributions of HPV16/18 and HPV6/11/16/18/31/33/45/52/58 are 73% and 90%, respectively. Universal access to vaccination is the key to avoiding most cases of HPV‐attributable cancer. The preponderant burden of HPV16/18 and the possibility of cross‐protection emphasize the importance of the introduction of more affordable vaccines in less developed countries. PMID:28369882

Occupational factors and the incidence of cancer of the bladder in Canada.

PubMed Central

Risch, H A; Burch, J D; Miller, A B; Hill, G B; Steele, R; Howe, G R

1988-01-01

During 1979-82, a case-control study of occupational factors and urinary bladder cancer was conducted in Edmonton, Calgary, Toronto, and Kingston, Canada. A total of 826 histologically verified cases of cancer were individually matched by sex, age, and area of residence to 792 randomly selected population controls. Subjects were specifically asked about employment in several industries thought relevant to risk of bladder cancer. Information was also obtained on lifelong occupational history, with special attention given regarding exposures to fumes, dusts, smoke, and chemicals. In addition, subjects provided data on past medical and residential history, on intake of certain dietary items, and on exposure to tobacco and other lifestyle factors. Conditional logistic regression methods were used for the analysis. Under adjustment for cumulative lifetime cigarette consumption, it appeared that for both men and women, most of the occupational factors examined were not associated with significant alteration in risk of bladder cancer. For exposures during the period eight to 28 years before diagnosis, however, raised risk was suggested for men employed at least six months in the chemicals industry (odds ratio = 2.37, p = 0.004), in dye manufacturing or the dyeing of cloth (OR = 3.62 and 4.63, p = 0.041 and 0.035, respectively), as tailors (OR = 3.85, p = 0.015), or in jobs in which contact with diesel or traffic fumes occurred (OR = 1.69, p = 0.0008). Increased risk was also seen for men occupationally exposed to tars or asphalt (OR = 3.11, p = 0.019). This study then, at least for men, supports perhaps a few of the suspect industries as related to risk of bladder cancer. PMID:3395572

75 FR 5333 - Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-02

... aggregate health burden associated with occupational injuries and illnesses, as well as to support more... health services, and the prevention of work-related injury and illness. It is anticipated that research... Occupational Health Study Section (SOHSS), National Institute for Occupational Safety and Health (NIOSH) In...

76 FR 3908 - Safety and Occupational Health Study Section (SOHSS); National Institute for Occupational Safety...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-21

... the aggregate health burden associated with occupational injuries and illnesses, as well as to support... and health services, and the prevention of work-related injury and illness. It is anticipated that... Occupational Health Study Section (SOHSS); National Institute for Occupational Safety and Health (NIOSH...

Estimation of lung cancer burden in Australia, the Philippines, and Singapore: an evaluation of disability adjusted life years.

PubMed

Morampudi, Suman; Das, Neha; Gowda, Arun; Patil, Anand

2017-02-01

Lung cancer is one of the leading cancers and major causes of cancer mortality worldwide. The economic burden associated with the high mortality of lung cancer is high, which accounts for nearly $180 billion on a global scale in 2008. This paper aims to understand the economic burden of lung cancer in terms of disability adjusted life years (DALY) in Australia, the Philippines, and Singapore. The years of life lost (YLL) and years lost due to disability (YLD) were calculated using the formula developed by Murray and Lopez in 1996 as part of a comprehensive assessment of mortality and disability for diseases, injuries and risk factors in 1990 and projected to 2020. The same formula is represented in the Global Burden of Disease template provided by the World Health Organization. Appropriate assumptions were made when data were unavailable and projections were performed using regression analysis to obtain data for 2015. The total DALYs due to lung cancer in Australia, the Philippines, and Singapore were 91,695, 38,584, and 12,435, respectively, and the corresponding DALY rates per a population of 1,000 were 4.0, 0.4, and 2.2, respectively, with a discount rate of 3%. When researchers calculated DALYs without the discount rate, the burden of disease increased substantially; the DALYs were 117,438 in Australia, 50,977 in the Philippines, and 16,379 in Singapore. Overall, YLL or premature death accounted for more than 95% of DALYs in these countries. Strategies for prevention, early diagnosis, and prompt treatment must be devised for diseases where the major burden is due to mortality.

Estimation of lung cancer burden in Australia, the Philippines, and Singapore: an evaluation of disability adjusted life years

PubMed Central

Morampudi, Suman; Das, Neha; Gowda, Arun; Patil, Anand

2017-01-01

Objective: Lung cancer is one of the leading cancers and major causes of cancer mortality worldwide. The economic burden associated with the high mortality of lung cancer is high, which accounts for nearly $180 billion on a global scale in 2008. This paper aims to understand the economic burden of lung cancer in terms of disability adjusted life years (DALY) in Australia, the Philippines, and Singapore. Methods: The years of life lost (YLL) and years lost due to disability (YLD) were calculated using the formula developed by Murray and Lopez in 1996 as part of a comprehensive assessment of mortality and disability for diseases, injuries and risk factors in 1990 and projected to 2020. The same formula is represented in the Global Burden of Disease template provided by the World Health Organization. Appropriate assumptions were made when data were unavailable and projections were performed using regression analysis to obtain data for 2015. Results: The total DALYs due to lung cancer in Australia, the Philippines, and Singapore were 91,695, 38,584, and 12,435, respectively, and the corresponding DALY rates per a population of 1,000 were 4.0, 0.4, and 2.2, respectively, with a discount rate of 3%. When researchers calculated DALYs without the discount rate, the burden of disease increased substantially; the DALYs were 117,438 in Australia, 50,977 in the Philippines, and 16,379 in Singapore. Overall, YLL or premature death accounted for more than 95% of DALYs in these countries. Conclusions: Strategies for prevention, early diagnosis, and prompt treatment must be devised for diseases where the major burden is due to mortality. PMID:28443206

The Patient Burden of Bladder Outlet Obstruction after Prostate Cancer Treatment.

PubMed

Liberman, Daniel; Jarosek, Stephanie; Virnig, Beth A; Chu, Haitao; Elliott, Sean P

2016-05-01

Bladder outlet obstruction after prostate cancer therapy imposes a significant burden on health and quality of life in men. Our objective was to describe the burden of bladder outlet obstruction after prostate cancer therapy by detailing the type of procedures performed and how often those procedures were repeated in men with recurrent bladder outlet obstruction. Using SEER (Surveillance, Epidemiology and End Results)-Medicare linked data from 1992 to 2007 with followup through 2009 we identified 12,676 men who underwent at least 1 bladder outlet obstruction procedure after prostate cancer therapy, including external beam radiotherapy in 3,994, brachytherapy in 1,485, brachytherapy plus external beam radiotherapy in 1,847, radical prostatectomy in 4,736, radical prostatectomy plus external beam radiotherapy in 369 and cryotherapy in 245. Histogram, incidence rates and Cox proportional hazards models with repeat events analysis were done to describe the burden of repeat bladder outlet obstruction treatments stratified by prostate cancer therapy type. We describe the type of bladder outlet obstruction surgery grouped by level of invasiveness. At a median followup of 8.8 years 44.6% of men underwent 2 or more bladder outlet obstruction procedures. Compared to men who underwent radical prostatectomy those treated with brachytherapy and brachytherapy plus external beam radiotherapy were at increased adjusted risk for repeat bladder outlet obstruction treatment (HR 1.2 and 1.32, respectively, each p <0.05). After stricture incision the men treated with radical prostatectomy or radical prostatectomy plus external beam radiotherapy were most likely to undergo dilation at a rate of 34.7% to 35.0%. Stricture resection/ablation was more common after brachytherapy, external beam radiotherapy or brachytherapy plus external beam radiotherapy at a rate of 28.9% to 41.2%. Almost half of the men with bladder outlet obstruction after prostate cancer therapy undergo more than 1

[Occupational cancer. The role of the occupational physician in systematic search and aetiological diagnosis of lung cancer. Analysis of a case list].

PubMed

Porru, S; di Carlo, A Scotto; Placidi, Donatella; Arici, Cecilia; Tassi, G; Alessio, L

2006-01-01

About 15% of lung cancers (LC) might be attributable to occupation. However, clinical practice shows that LC percentage for which occupational aetiology is recognized is lower than expected. To address the role of Occupational Physicians (OP) in systematic search and aetiological diagnosis of LC. The search was carried out at a university hospital in Brescia, northern Italy, a highly industrialized area with many workers potentially exposed to occupational lung carcinogens. Through short occupational history forms, physicians of various departments refer all new cases of primary LC to OP When occupational exposure to lung carcinogens is presumed, the OP evaluates the case at the occupational health clinic and sends clinical reports to notifying physicians, containing aetiological diagnosis and indications for medico-legal obligations. Before 1998, few cases were referred to the OP and even less were compensated. The search yielded 1502 LC; after screening, full occupational health evaluation was performed in 693 cases: occupational aetiology was recognized in 182 (26%). Risk factors were silica, asbestos, polycyclic aromatic hydrocarbons, truck driving, painting, road paving; many workers were exposed to multiple carcinogens. 48 cases were compensated, many others are under litigation. A systematic LC search made it possible to: reach an aetiological diagnosis and reduce the gap between expected LC and those reported/compensated; inform health authorities and undertake preventive action in workplaces; detect sentinel events; provide epidemiological data at community level; promote cooperation among health professionals (oncologists, surgeons, pneumologists, general practitioners, plant OP); increase teaching opportunities for medical students, those taking a specialisation course in occupational health; provide counselling and expert opinions for individual subjects, trade unions, employers, law courts.

Fluorescence imaging to study cancer burden on lymph nodes

NASA Astrophysics Data System (ADS)

D'Souza, Alisha V.; Elliott, Jonathan T.; Gunn, Jason R.; Samkoe, Kimberley S.; Tichauer, Kenneth M.; Pogue, Brian W.

2015-03-01

Morbidity and complexity involved in lymph node staging via surgical resection and biopsy calls for staging techniques that are less invasive. While visible blue dyes are commonly used in locating sentinel lymph nodes, since they follow tumor-draining lymphatic vessels, they do not provide a metric to evaluate presence of cancer. An area of active research is to use fluorescent dyes to assess tumor burden of sentinel and secondary lymph nodes. The goal of this work was to successfully deploy and test an intra-nodal cancer-cell injection model to enable planar fluorescence imaging of a clinically relevant blue dye, specifically methylene blue along with a cancer targeting tracer, Affibody labeled with IRDYE800CW and subsequently segregate tumor-bearing from normal lymph nodes. This direct-injection based tumor model was employed in athymic rats (6 normal, 4 controls, 6 cancer-bearing), where luciferase-expressing breast cancer cells were injected into axillary lymph nodes. Tumor presence in nodes was confirmed by bioluminescence imaging before and after fluorescence imaging. Lymphatic uptake from the injection site (intradermal on forepaw) to lymph node was imaged at approximately 2 frames/minute. Large variability was observed within each cohort.

77 FR 27776 - Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... safety and health services, and the prevention of work-related injury and illness. It is anticipated that... magnitude of the aggregate health burden associated with occupational injuries and illnesses, as well as to... Occupational Health Study Section (SOHSS), National Institute for Occupational Safety and Health (NIOSH) In...

76 FR 18220 - Safety and Occupational Health Study Section (SOHSS), National Institute for Occupational Safety...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

... safety and health services, and the prevention of work-related injury and illness. It is anticipated that... magnitude of the aggregate health burden associated with occupational injuries and illnesses, as well as to... Occupational Health Study Section (SOHSS), National Institute for Occupational Safety and Health (NIOSH) In...

Global epidemiological trends and variations in the burden of gallbladder cancer.

PubMed

Are, Chandrakanth; Ahmad, Humera; Ravipati, Advaitaa; Croo, Darren; Clarey, Dillon; Smith, Lynette; Price, Ray R; Butte, Jean M; Gupta, Sameer; Chaturvedi, Arun; Chowdhury, Sanjib

2017-04-01

The aim of this study is to describe the trends and variations in the global burden of gallbladder cancer (GBC) with an emphasis on geographic variations and female gender. Data (2012-2030) relating to GBC was extracted from GLOBOCAN 2012 database and analyzed. The results of our study document a rising global burden of GBC with geographic and gender variations. The highest burden was noted in the WPRO region (based on WHO regions), Asia (based on continents) and India, Chile, and China (based on countries). The less developed regions of the world account for the majority of the global burden of GBC. The geographic variations are also present within individual countries such as in India and Chile. Females are afflicted at a much higher rate with GBC and this predilection is exaggerated in countries with higher incidence such as India and Chile. In females, people of certain ethnic groups and lower socio-economic standing are at a higher risk. Our study demonstrates a rising global burden of GBC with some specific data on geographic and gender-based variations which can be used to develop strategies at the global as well as the high-risk individual country level. © 2017 Wiley Periodicals, Inc.

Cancer burden and control in the Western Pacific region: challenges and opportunities.

PubMed

Varghese, Cherian; Carlos, Marie Clem; Shin, Hai-Rim

2014-01-01

Cancer has become a priority public health challenge in the Member States of the World Health Organization's (WHO) Western Pacific Region (WPR). Rapid and unplanned urbanization, demographic transition, and lifestyle changes are driving the increase in noncommunicable diseases (NCDs), which include cancer. The WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020, targets a reduction in premature mortality from NCDs by 25% by 2025. The aim of this study was to review the epidemiology of cancer including cancer control efforts in the WPR. Information was primarily extracted from Globocan 2012, Cancer Incidence in Five Continents Vol. X, and the NCD country capacity survey carried out by the WHO in 2013. The WPR, with one-fourth of the world's population, has one-third of all cancers globally. Cancer cases in the WPR are expected to increase from 4.5 million new cases in 2012 to 6.4 million in 2025. In most of the low- and middle-income countries (LMICs) in Asia and in Pacific Island countries and areas, coverage of cancer registration is relatively low and they face many challenges in quality of cancer registry data. Eighty-five percent of LMICs have indicated the existence of a cancer control policy strategy and/or action plan. The predominance of lung, stomach, colorectal, breast, and cervical cancers makes control of the disease more amenable in the WPR. A relatively high ratio of mortality to incidence in LMICs reflects health-system limitations, especially in the diagnosis and management of cancer. Strengthening cancer registration, tobacco control, and promotion of a healthy diet, as well as HBV and HPV vaccination, is the priority areas to reduce cancer burden. Health-system strengthening with a defined package of services at different levels, referral care, trained human resources, and appropriate technology is necessary to improve cancer management. Pain relief and palliative care are priorities as well. A well

Racial and ethnic disparities in human papillomavirus-associated cancer burden with first-generation and second-generation human papillomavirus vaccines.

PubMed

Burger, Emily A; Lee, Kyueun; Saraiya, Mona; Thompson, Trevor D; Chesson, Harrell W; Markowitz, Lauri E; Kim, Jane J

2016-07-01

In the United States, the burden of human papillomavirus (HPV)-associated cancers varies by racial/ethnic group. HPV vaccination may provide opportunities for primary prevention of these cancers. Herein, the authors projected changes in HPV-associated cancer burden among racial/ethnic groups under various coverage assumptions with the available first-generation and second-generation HPV vaccines to evaluate changes in racial/ethnic disparities. Cancer-specific mathematical models simulated the burden of 6 HPV-associated cancers. Model parameters, informed using national registries and epidemiological studies, reflected sex-specific, age-specific, and racial/ethnic-specific heterogeneities in HPV type distribution, cancer incidence, stage of disease at detection, and mortality. Model outcomes included the cumulative lifetime risks of developing and dying of 6 HPV-associated cancers. The level of racial/ethnic disparities was evaluated under each alternative HPV vaccine scenario using several metrics of social group disparity. HPV vaccination is expected to reduce the risks of developing and dying of HPV-associated cancers in all racial/ethnic groups as well as reduce the absolute degree of disparities. However, alternative metrics suggested that relative disparities would persist and in some scenarios worsen. For example, when assuming high uptake with the second-generation HPV vaccine, the lifetime risk of dying of an HPV-associated cancer for males decreased by approximately 60%, yet the relative disparity increased from 3.0 to 3.9. HPV vaccines are expected to reduce the overall burden of HPV-associated cancers for all racial/ethnic groups and to reduce the absolute disparity gap. However, even with the second-generation vaccine, relative disparities will likely still exist and may widen if the underlying causes of these disparities remain unaddressed. Cancer 2016;122:2057-66. © 2016 American Cancer Society. © 2016 American Cancer Society.

Occupational exposure to diesel and gasoline emissions and lung cancer in Canadian men.

PubMed

Villeneuve, Paul J; Parent, Marie-Élise; Sahni, Vanita; Johnson, Kenneth C

2011-07-01

The International Agency for Research on Cancer classifies diesel exhaust as a probable human carcinogen; this decision is based largely from lung cancer evidence. Gasoline exhaust is classified as a possible carcinogen. Epidemiological studies are needed that improve upon some of the limitations of previous research with respect to the characterization of exposure, and the control for the potential confounding influence of smoking and other occupational exposures. Our objective was to investigate associations between occupational exposure to diesel and gasoline engine emissions and lung cancer. We used a case-control study design that involved men 40 years of age and older at the time of interview. Analyses are based on 1681 incident cases of lung cancer and 2,053 population controls. A self-reported questionnaire elicited a lifetime occupational history, including general tasks, and information on other potential risk factors. Occupational exposures to diesel and gasoline emissions, crystalline silica, and asbestos were assigned to each job held by study subjects by industrial hygienists who were blind to case-control status. Exposure metrics for diesel and gasoline emissions that were modeled included: ever exposure, cumulative exposure, and concentration of exposure. We found a dose-response relationship between cumulative occupational exposure to diesel engine emissions and lung cancer. This association was more pronounced for the squamous and large cell subtypes with adjusted odds ratios across the three increasing tertiles of cumulative lifetime exposure relative to those with no exposure of 0.99, 1.25, and 1.32 (p=0.04) for squamous cell carcinoma, and 1.06, 1.19, 1.68 (p=0.02) for large cell carcinoma. While the association with cumulative exposure to gasoline was weakly positive, it was not statistically significant. Our findings suggest that exposure to diesel engine emissions increases the risk of lung cancer particularly for squamous and large cell

Cervical cancer burden and prevention strategies: Asia Oceania perspective.

PubMed

Garland, Suzanne M; Bhatla, Neerja; Ngan, Hextan Y S

2012-09-01

The Asia Oceania region contributes to more than 50% of cervical cancer cases worldwide. Yet cervical cancer is one of few cancers that can be prevented through comprehensive screening for precancerous lesions, with their subsequent treatment. Screening with cervical cytology, a very old technology, has reduced cervical cancer mortality and incidence when applied in comprehensive programs with high coverage and high quality assurance. However, of those countries within this region that have set up such programs, many have been opportunistic, had poor coverage, or inadequate treatment facilities for lesions found. Consequently, they have not seen large reductions in cancer incidence or mortality. Some have therefore adopted visual inspection by acetic acid (VIA) and Lugol's iodine (VILI) or human papillomavirus (HPV) DNA assays for screening. With two safe, immunogenic and efficacious prophylactic vaccines licensed, the way forward to reduction of cervical cancer to becoming uncommon is within reach. Where governments have supported high coverage public-health vaccination programs, reductions in disease burden with shortest incubation (genital warts, high-grade abnormalities) are already being reported. One of the biggest impediments is the cost of vaccines that are affordable to resource-poor countries. Other challenges include, infrastructure for delivery of vaccines, plus general acceptance of vaccination by the community. ©2012 AACR

Burden on informal caregivers of elderly cancer survivors: risk versus resilience.

PubMed

Jones, Simeon B W; Whitford, Hayley S; Bond, Melissa J

2015-01-01

This study assessed psychological morbidity and resilience, including the subjective burden of 76 caregivers of elderly cancer survivors utilizing a cross-sectional questionnaire. Participants were mainly elderly female spouses, sole-caregiving > 35 hours per week; 19.1% and 23.6% reported moderate or greater anxiety and depression, respectively. A significant regression model found depression, emotion-focused coping, and greater years since diagnosis as significant predictors of subjective caregiver burden. Thus, caregiving appears a dominant role for this group and the Brief Assessment Scale for Caregivers of the Medically Ill (BASC) appears to be an efficient screening tool for psychological morbidity in this under-supported group.

Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based, multicenter, cross-sectional survey.

PubMed

Huang, Hui-Yao; Shi, Ju-Fang; Guo, Lan-Wei; Bai, Ya-Na; Liao, Xian-Zhen; Liu, Guo-Xiang; Mao, A-Yan; Ren, Jian-Song; Sun, Xiao-Jie; Zhu, Xin-Yu; Wang, Le; Song, Bing-Bing; Du, Ling-Bin; Zhu, Lin; Gong, Ji-Yong; Zhou, Qi; Liu, Yu-Qin; Cao, Rong; Mai, Ling; Lan, Li; Sun, Xiao-Hua; Ren, Ying; Zhou, Jin-Yi; Wang, Yuan-Zheng; Qi, Xiao; Lou, Pei-An; Shi, Dian; Li, Ni; Zhang, Kai; He, Jie; Dai, Min

2017-04-28

The increasing prevalence of colorectal cancer (CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China. We conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan (CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup (hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure. A total of 2356 patients with a mean age of 57.4 years were included, 57.1% of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY. The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage I, II, III, and IV disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3% of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups (P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later

Occupational variation in incidence of bladder cancer: a comparison of population-representative cohorts from Nordic countries and Canada.

PubMed

Hadkhale, Kishor; MacLeod, Jill; Demers, Paul A; Martinsen, Jan Ivar; Weiderpass, Elisabete; Kjaerheim, Kristina; Lynge, Elsebeth; Sparen, Pär; Tryggvadottir, Laufey; Anne Harris, M; Tjepkema, Michael; Peters, Paul A; Pukkala, Eero

2017-08-04

The objective of this study was to compare occupational variation of the risk of bladder cancer in the Nordic countries and Canada. In the Nordic Occupational Cancer study (NOCCA), 73 653 bladder cancer cases were observed during follow-up of 141.6 million person-years. In the Canadian Census Health and Environment Cohort (CanCHEC), 8170 cases were observed during the follow-up of 36.7 million person-years. Standardised incidence ratios with 95% CI were estimated for 53 occupations in the NOCCA cohort and HR with 95% CIs were estimated for 42 occupations in the CanCHEC. Elevated risks of bladder cancer were observed among hairdressers, printers, sales workers, plumbers, painters, miners and laundry workers. Teachers and agricultural workers had reduced risk of bladder cancer in both cohorts. Chimney-sweeps, tobacco workers and waiters had about 1.5-fold risk in the Nordic countries; no risk estimates for these categories were given from the CanCHEC cohort. We observed different occupational patterns in risk of bladder cancer in Nordic countries and Canada. The only occupation with similarly increased risk was observed among sales workers. Differences in smoking across occupational groups may explain some, but not all, of this variation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Listing Occupational Carcinogens

PubMed Central

Siemiatycki, Jack; Richardson, Lesley; Straif, Kurt; Latreille, Benoit; Lakhani, Ramzan; Campbell, Sally; Rousseau, Marie-Claude; Boffetta, Paolo

2004-01-01

The occupational environment has been a most fruitful one for investigating the etiology of human cancer. Many recognized human carcinogens are occupational carcinogens. There is a large volume of epidemiologic and experimental data concerning cancer risks in different work environments. It is important to synthesize this information for both scientific and public health purposes. Various organizations and individuals have published lists of occupational carcinogens. However, such lists have been limited by unclear criteria for which recognized carcinogens should be considered occupational carcinogens, and by inconsistent and incomplete information on the occupations and industries in which the carcinogenic substances may be found and on their target sites of cancer. Based largely on the evaluations published by the International Agency for Research on Cancer, and augmented with additional information, the present article represents an attempt to summarize, in tabular form, current knowledge on occupational carcinogens, the occupations and industries in which they are found, and their target organs. We have considered 28 agents as definite occupational carcinogens, 27 agents as probable occupational carcinogens, and 113 agents as possible occupational carcinogens. These tables should be useful for regulatory or preventive purposes and for scientific purposes in research priority setting and in understanding carcinogenesis. PMID:15531427

Non-melanoma skin cancer: occupational risk from UV light and arsenic exposure.

PubMed

Surdu, Simona

2014-01-01

Non-melanoma skin cancer (NMSC) has a significant impact on public health and health care costs as a result of high morbidity and disfigurement due to the destruction of surrounding tissues. Although the mortality rates of these tumors are low, the high incidence rates determine a considerable number of deaths. NMSC is the most common type of skin cancer, representing about 1/3 of all malignancies diagnosed worldwide each year. The most common NMSC are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Studies on humans and experimental animals indicate that ultraviolet (UV) light and arsenic play important roles in the development of these skin malignancies. Several epidemiological studies have investigated the risk of developing NMSC and the potential link between exposure to sunlight and arsenic in the agricultural and industrial occupational settings. To date, the published literature suggests that there is no apparent skin cancer risk as regards workplace exposure to artificial UV light or arsenic. Concerning UV light from sun exposure at the workplace, most published studies indicated an elevated risk for SCC, but are less conclusive for BCC. Many of these studies are limited by the methodology used in the evaluation of occupational exposure and the lack of adjustment for major confounders. Therefore, further epidemiological studies are required to focus on exposure assessment at the individual level as well as potential interactions with other occupational and non-occupational exposures and individual susceptibility. In doing so, we can better quantify the true risk of skin cancer in exposed workers and inform effective public health prevention programs.

Employment status and occupational level of adult survivors of childhood cancer in Great Britain: The British childhood cancer survivor study

PubMed Central

Frobisher, Clare; Lancashire, Emma R; Jenkinson, Helen; Winter, David L; Kelly, Julie; Reulen, Raoul C

2017-01-01

The British Childhood Cancer Survivor Study (BCCSS) provides the first detailed investigation of employment and occupation to be undertaken in a large population‐based cohort. Previous studies have been limited by design issues such as using small numbers of survivors with specific diagnoses, and involved limited assessment of employment status and occupational level. The BCCSS includes 17,981 5‐year survivors of childhood cancer. Employment status and occupational level were ascertained by questionnaire from eligible survivors (n = 14,836). Multivariate logistic regression was used to explore factors associated with employment and occupation, and to compare survivors to their demographic peers in the general population. Employment status was available for 10,257 survivors. Gender, current age, cancer type, radiotherapy, age at diagnosis and epilepsy were consistently associated with being: employed; unable to work; in managerial or non‐manual occupations. Overall, survivors were less likely to be working than expected (OR (99% CI): 0.89 (0.81–0.98)), and this deficit was greatest for irradiated CNS neoplasm survivors (0.34 (0.28–0.41)). Compared to the general population, survivors were fivefold more likely to be unable to work due to illness/disability; the excess was 15‐fold among CNS neoplasm survivors treated with radiotherapy. Overall survivors were less likely to be in managerial occupations than expected (0.85 (0.77–0.94)). However, bone sarcoma survivors were more likely to be in these occupations than expected (1.37 (1.01–1.85)) and also similarly for non‐manual occupations (1.90 (1.37–2.62)). Survivors of retinoblastoma (1.55 (1.20–2.01)) and ‘other’ neoplasm group (1.62 (1.30–2.03)) were also more likely to be in non‐manual occupations than expected. PMID:28316069

Radio frequency radiation-related cancer: assessing causation in the occupational/military setting.

PubMed

Peleg, Michael; Nativ, Or; Richter, Elihu D

2018-05-01

We reexamine whether radio frequency radiation (RFR) in the occupational and military settings is a human carcinogen. We extended an analysis of an already-reported case series of patients with cancer previously exposed to whole-body prolonged RFR, mainly from communication equipment and radar. We focused on hematolymphatic (HL) cancers. We used analysis by percentage frequency (PF) of a cancer type, which is the proportion of a specific cancer type relative to the total number of cancer cases. We also examined and analyzed the published data on three other cohort studies from similar military settings from different countries. The PF of HL cancers in the case series was very high, at 40% with only 23% expected for the series age and gender profile, confidence interval CI95%: 26-56%, p<0.01, 19 out of 47 patients had HL cancers. We also found high PF for multiple primaries. As for the three other cohort studies: In the Polish military sector, the PF of HL cancers was 36% in the exposed population as compared to 12% in the unexposed population, p<0.001. In a small group of employees exposed to RFR in Israeli defense industry, the PF of HL cancers was 60% versus 17% expected for the group age and gender profile, p<0.05. In Belgian radar battalions the HL PF was 8.3% versus 1.4% in the control battalions as shown in a causes of deaths study and HL cancer mortality rate ratio was 7.2 and statistically significant. Similar findings were reported on radio amateurs and Korean war technicians. Elevated risk ratios were previously reported in most of the above studies. The consistent association of RFR and highly elevated HL cancer risk in the four groups spread over three countries, operating different RFR equipment types and analyzed by different research protocols, suggests a cause-effect relationship between RFR and HL cancers in military/occupational settings. While complete measurements of RFR exposures were not available and rough exposure assessments from patients

The economic burden of human papillomavirus-related precancers and cancers in Sweden

PubMed Central

Silfverschiöld, Maria; Greiff, Lennart; Asciutto, Christine; Wennerberg, Johan; Lydryp, Marie-Louise; Håkansson, Ulf; Sparén, Pär; Borgfeldt, Christer

2017-01-01

Background High-risk (HR) human papillomavirus (HPV) infection is an established cause of malignant disease. We used a societal perspective to estimate the cost of HR HPV-related cervical, vulvar, vaginal, anal, and penile precancer and cancer, and oropharyngeal cancer in Sweden in 2006, 1 year before HPV vaccination became available in the country. Materials and methods This prevalence-based cost-of-illness study used diagnosis-specific data from national registries to determine the number of HR HPV-related precancers and cancers. The HR HPV-attributable fractions of these diseases were derived from a literature review and applied to the total burden to estimate HR HPV-attributable costs. Direct costs were based on health care utilization and indirect costs on loss of productivity due to morbidity (i.e., sick leave and early retirement) and premature mortality. Results The total annual cost of all HR HPV-attributable precancers and cancers was €94 million (€10.3/inhabitant). Direct costs accounted for €31.3 million (€3.4/inhabitant) of the total annual cost, and inpatient care amounted to €20.7 million of direct costs. Indirect costs made up €62.6 million (€6.9/inhabitant) of the total annual cost, and premature mortality amounted to €36 million of indirect costs. Cervical precancer and cancer was most costly (total annual cost €58.4 million). Among cancers affecting both genders, anal precancer and cancer, and oropharyngeal cancer were the most costly (€11.2 million and €11.9 million, respectively). For oropharyngeal cancer, males had the highest health care utilization and represented 71% of the total annual cost. Penile precancer and cancer was least costly (€2.6 million). Conclusion The economic burden of HR HPV-related precancers and cancers is substantial. The disease-related management and treatment costs we report are relevant as a point of reference for future economic evaluations investigating the overall benefits of HPV

Trend Analysis of Betel Nut-associated Oral Cancer 
and Health Burden in China.

PubMed

Hu, Yan Jia; Chen, Jie; Zhong, Wai Sheng; Ling, Tian You; Jian, Xin Chun; Lu, Ruo Huang; Tang, Zhan Gui; Tao, Lin

To forecast the future trend of betel nut-associated oral cancer and the resulting burden on health based on historical oral cancer patient data in Hunan province, China. Oral cancer patient data in five hospitals in Changsha (the capital city of Hunan province) were collected for the past 12 years. Three methods were used to analyse the data; Microsoft Excel Forecast Sheet, Excel Trendline, and the Logistic growth model. A combination of these three methods was used to forecast the future trend of betel nut-associated oral cancer and the resulting burden on health. Betel nut-associated oral cancer cases have been increasing rapidly in the past 12  years in Changsha. As of 2016, betel nuts had caused 8,222 cases of oral cancer in Changsha and close to 25,000 cases in Hunan, resulting in about ¥5 billion in accumulated financial loss. The combined trend analysis predicts that by 2030, betel nuts will cause more than 100,000 cases of oral cancer in Changsha and more than 300,000 cases in Hunan, and more than ¥64 billion in accumulated financial loss in medical expenses. The trend analysis of oral cancer patient data predicts that the growing betel nut industry in Hunan province will cause a humanitarian catastrophe with massive loss of human life and national resources. To prevent this catastrophe, China should ban betel nuts and provide early oral cancer screening for betel nut consumers as soon as possible.

Global burden of cancer attributable to high body-mass index in 2012: a population-based study

PubMed Central

Byrnes, Graham; Renehan, Prof Andrew G; Stevens, Gretchen A; Ezzati, Prof Majid; Ferlay, Jacques; Miranda, J. Jaime; Romieu, Isabelle; Dikshit, Rajesh; Forman, David; Soerjomataram, Isabelle

2015-01-01

Background Excess body mass index (BMI) is associated with increased risk of cancer. To inform public health policyand future research, we estimated the global burden of cancer attributable to excess BMI. Methods Population attributable fractions (PAFs) were derived using relative risks and BMI estimates in adults by age, sex and country. Assuming a10-year lag-period, PAFs were calculated using BMI estimates in 2002. GLOBOCAN2012 was used to compute numbers of new cancer cases attributable to excess BMI. In an alternative scenario, we computed the proportion of potentially avoidable cancers assuming that populations maintained their BMI-level observed in 1982. Secondary analyses were performed to test the model and estimate the impactof hormone replacement therapy (HRT) and smoking. Findings Worldwide, we estimated that 481,000 or 3·6% of all new cancer cases in 2012 were attributable to excess BMI. PAFs were greater in women compared with men (5·4% versus 1·9%). The burden was concentrated in countries with very high and high human development index (HDI, PAF: 5·3% and 4·8%) compared with countries with moderate and low HDI (PAF: 1·6% and 1·0%). Corpus uteri, post-menopausal breast and colon cancers accounted for approximately two-thirds (64%) of excess BMI attributable cancers. One fourth (~118,000) of all cases related to excess BMI in 2012 could be attributed to the rising BMI since 1982. Interpretation These findings further underpin the need for a global effort to abate the rising trends in population-level excess weight. Assuming that the relationship between excess BMI and cancer is causal and the current pattern of population weight gain continues, this will likely augment the future burden of cancer. Funding World Cancer Research Fund, Marie Currie Fellowship, the National Health and Medical Research Council Australia and US NIH. PMID:25467404

'Burden to others' as a public concern in advanced cancer: a comparative survey in seven European countries.

PubMed

Bausewein, Claudia; Calanzani, Natalia; Daveson, Barbara A; Simon, Steffen T; Ferreira, Pedro L; Higginson, Irene J; Bechinger-English, Dorothee; Deliens, Luc; Gysels, Marjolein; Toscani, Franco; Ceulemans, Lucas; Harding, Richard; Gomes, Barbara

2013-03-08

Europe faces an enormous public health challenge with aging populations and rising cancer incidence. Little is known about what concerns the public across European countries regarding cancer care towards the end of life. We aimed to compare the level of public concern with different symptoms and problems in advanced cancer across Europe and examine factors influencing this. Telephone survey with 9,344 individuals aged ≥16 in England, Flanders, Germany, Italy, Netherlands, Portugal and Spain. Participants were asked about nine symptoms and problems, imagining a situation of advanced cancer with less than one year to live. These were ranked and the three top concerns examined in detail. As 'burden to others' showed most variation within and between countries, we determined the relative influence of factors on this concern using GEE and logistic regression. Overall response rate was 21%. Pain was the top concern in all countries, from 34% participants (Italy) to 49% (Flanders). Burden was second in England, Germany, Italy, Portugal, and Spain. Breathlessness was second in Flanders and the Netherlands. Concern with burden was independently associated with age (70+ years, OR 1.50; 95%CI 1.24-1.82), living alone (OR 0.82, 95%CI 0.73-0.93) and preferring quality rather than quantity of life (OR 1.43, 95%CI 1.14-1.80). When imagining a last year of life with cancer, the public is not only concerned about medical problems but also about being a burden. Public education about palliative care and symptom control is needed. Cancer care should include a routine assessment and management of social concerns, particularly for older patients with poor prognosis.

Affordability of cancer treatment for aging cancer patients in Singapore: an analysis of health, lifestyle, and financial burden.

PubMed

Chan, Alexandre; Chiang, Yu Yan; Low, Xiu Hui; Yap, Kevin Yi-Lwern; Ng, Raymond

2013-12-01

With the expected rise in newly diagnosed cancer cases among the elderly in Singapore, the affordability of cancer treatments, particularly of targeted therapies, will be a growing concern for patients. This study examines the perspectives of aging cancer patients on the financial burden of their cancer treatments. A single-center, prospective study was conducted in the largest ambulatory cancer center in Singapore. Older (50 years old and above) cancer patients receiving treatment were recruited. Patients completed three sets of self-reporting tools assessing their (a) demographics and lifestyles, (b) health-related quality of life, and (c) perceptions of cancer treatment costs. The association between targeted therapy utilities and their perceived financial burden was evaluated using a multivariable logistic regression. Five hundred and sixteen patients were included in the study. The majority of the respondents (69.6 %) were between 50 and 64 years old. The majority were Singaporeans (97.7 %), belonged to the ethnic Chinese group (88.4 %), and most were female (59.1 %). The users of targeted therapies were 2.92 times more likely to perceive that the amount of cash that they spent on cancer treatment was more than expected and 2.52 times more likely to have difficulty paying for cancer treatments. Fortunately, the majority of the respondents (70.6 %) found their existing financial schemes helpful in reducing the necessary out-of-pocket expenses. Although aging cancer patients feel that the financial schemes in Singapore have helped them tremendously, the general perception is that they require further help to offset their out-of-pocket expenses. This is especially true for users of targeted therapies and those who have a poorer health status.

Associations between advanced cancer patients' survival and family caregiver presence and burden.

PubMed

Dionne-Odom, J Nicholas; Hull, Jay G; Martin, Michelle Y; Lyons, Kathleen Doyle; Prescott, Anna T; Tosteson, Tor; Li, Zhongze; Akyar, Imatullah; Raju, Dheeraj; Bakitas, Marie A

2016-05-01

We conducted a randomized controlled trial (RCT) of an early palliative care intervention (ENABLE: Educate, Nurture, Advise, Before Life Ends) for persons with advanced cancer and their family caregivers. Not all patient participants had a caregiver coparticipant; hence, we explored whether there were relationships between patient survival, having an enrolled caregiver, and caregiver outcomes prior to death. One hundred and twenty-three patient-caregiver dyads and 84 patients without a caregiver coparticipant participated in the ENABLE early versus delayed (12 weeks later) RCT. We collected caregiver quality-of-life (QOL), depression, and burden (objective, stress, and demand) measures every 6 weeks for 24 weeks and every 3 months thereafter until the patient's death or study completion. We conducted survival analyses using log-rank and Cox proportional hazards models. Patients with a caregiver coparticipant had significantly shorter survival (Wald = 4.31, HR = 1.52, CI: 1.02-2.25, P = 0.04). After including caregiver status, marital status (married/unmarried), their interaction, and relevant covariates, caregiver status (Wald = 6.25, HR = 2.62, CI: 1.23-5.59, P = 0.01), being married (Wald = 8.79, HR = 2.92, CI: 1.44-5.91, P = 0.003), and their interaction (Wald = 5.18, HR = 0.35, CI: 0.14-0.87, P = 0.02) were significant predictors of lower patient survival. Lower survival in patients with a caregiver was significantly related to higher caregiver demand burden (Wald = 4.87, CI: 1.01-1.20, P = 0.03) but not caregiver QOL, depression, and objective and stress burden. Advanced cancer patients with caregivers enrolled in a clinical trial had lower survival than patients without caregivers; however, this mortality risk was mostly attributable to higher survival by unmarried patients without caregivers. Higher caregiver demand burden was also associated with decreased patient survival. © 2016 The Authors. Cancer Medicine published by

[Hazard assessment and occupational safety measures in surgery : Relevant knowledge on occupational medicine].

PubMed

Darius, S; Meyer, F; Böckelmann, I

2016-11-01

Surgeons routinely work in an environment with occupational risks and hazards about which they are often uninformed. Based on the currently available scientific literature this review article describes the various hazards in the operating theater and their effects on personnel, particularly from the surgical perspective. A further aim of this article is to describe the occupational safety measures to reduce the burdens and to maintain the long-term health of personnel. Ultimately, surgeons should be equipped with the necessary knowledge for implementing hazard assessments according to the German Occupational Health and Safety Act. Surgeons are exposed to increased risks and hazards by working in awkward positions with a high risk for musculoskeletal pain and injuries. They are also commonly exposed to inhalational anesthetics, surgical smoke, radiation, noise and infectious agents. Furthermore, the mental and emotional stress associated with these activities is also high. Meaningful occupational safety measures for reduction of burdens are from a technical aspect the installation of effective air extraction systems, measures to reduce exposure to radiation and noise and the use of safer instruments to prevent needle stick injuries. Furthermore, individual occupational safety measures, such as the use of personal protective equipment (e.g. radiation protective clothing and double gloves) must be observed. The consistent implementation and also adherence to these described occupational safety measures and regulations can reduce the burden on operating theater personnel and contribute to maintaining health. Furthermore, periodic preventive healthcare controls and health checks by the company medical officer and individually initiated additional prevention measures can be a sensible augmentation to these safety measures.

Occupational exposure to endotoxins and lung cancer risk: results of the ICARE Study

PubMed Central

Ben Khedher, Soumaya; Neri, Monica; Guida, Florence; Matrat, Mireille; Cenée, Sylvie; Sanchez, Marie; Menvielle, Gwenn; Molinié, Florence; Luce, Danièle; Stücker, Isabelle

2017-01-01

Objectives To investigate the role of occupational exposure to endotoxins in lung cancer in a French population-based case–control study (ICARE (Investigation of occupational and environmental causes of respiratory cancers)). Methods Detailed information was collected on the occupational history and smoking habits from 2926 patients with histologically confirmed lung cancer and 3555 matched controls. We evaluated each subject’s endotoxin exposure after cross referencing International Standard Classification of Occupations (ISCO) codes (for job tasks) and Nomenclature d'Activités Françaises (NAF) codes (for activity sectors). Endotoxin exposure levels were attributed to each work environment based on literature reports. ORs and 95% CIs were estimated using unconditional logistic regression models and controlled for main confounding factors. Results An inverse association between exposure to endotoxins and lung cancer was found (OR=0.80, 95% CI 0.66 to 0.95). Negative trends were shown with duration and cumulative exposure, and the risk was decreased decades after exposure cessation (all statistically significant). Lung cancer risk was particularly reduced among workers highly exposed (eg, in dairy, cattle, poultry, pig farms), but also in those weakly exposed (eg, in waste treatment). Statistically significant interactions were shown with smoking, and never/light smokers were more sensitive to an endotoxin effect than heavy smokers (eg, OR=0.14, 95% CI 0.06 to 0.32 and OR=0.80, 95% CI 0.45 to 1.40, respectively, for the quartiles with the highest cumulative exposure, compared with those never exposed). Pronounced inverse associations were shown with adenocarcinoma histological subtype (OR=0.37, 95% CI 0.25 to 0.55 in the highly exposed). Conclusions Our findings suggest that exposure to endotoxins, even at a low level, reduces the risk of lung cancer. PMID:28490662

Modifiable factors associated with caregiver burden among family caregivers of terminally ill Korean cancer patients.

PubMed

Yoon, Seok-Joon; Kim, Jong-Sung; Jung, Jin-Gyu; Kim, Sung-Soo; Kim, Samyong

2014-05-01

Higher caregiver burden is associated with poor quality of life among family caregivers. However, in Korea, very few studies have examined factors associated with caregiver burden. The present study investigated factors associated with caregiver burden among family caregivers of terminally ill Korean cancer patients, particularly modifiable factors as a potential target of intervention strategies. A cross-sectional study using self-administered questionnaires was performed. Sixty-four family caregivers of terminally ill cancer patients who were admitted to the hospice-palliative care unit of a university hospital in South Korea were included. To identify caregiver burden, the Caregiver Reaction Assessment scale (CRA) was used in this study. Time spent in providing care per day, number of visits per week from other family members, family functioning, and a positive subscale, self-esteem, of the CRA were deemed as modifiable factors. Other sociodemographic, caregiving characteristics of the subjects were non-modifiable factors. Longer time spent providing care per day, fewer weekly visits from other family members, poor family functioning, and low self-esteem were considered as modifiable factors associated with caregiver burden. Low monthly income and the spouse being the family caregiver were non-modifiable factors. Our study has practical significance in that it identifies modifiable factors that can be used to devise intervention strategies. Developing and applying such intervention strategies for alleviating the factors associated with high caregiver burden could be important for improving the quality of life of both patients and their families.

Lung cancer risk in the electroplating industry in Lombardy, Italy, using the Italian occupational cancer monitoring (OCCAM) information system.

PubMed

Panizza, Celestino; Bai, Edoardo; Oddone, Enrico; Scaburri, Alessandra; Massari, Stefania; Modonesi, Carlo; Contiero, Paolo; Marinaccio, Alessandro; Crosignani, Paolo

2012-01-01

Occupational Cancer Monitoring (OCCAM) is an Italian organization that monitors occupational cancers, by area and industrial sector, by retrieving cases and employment history from official databases. OCCAM previously estimated a relative risk (RR) of lung cancer of about 1.32 among "metal treatment" workers in Lombardy, northern Italy, potentially exposed to chrome and nickel. In the present study, lung cancer risk was estimated among electroplating workers only. Lombardy electroplating companies were identified from descriptions in Social Security files. Lung cancer risk was evaluated from 2001 to 2008 incident cases identified from hospital discharge records. The RR for lung cancer among electroplating workers was 2.03 (90% CI 1.33-3.10, 18 cases) for men; 3.00 (90% CI 1.38-9.03, 4 cases) for women. Electroplaters had higher risks than "metal treatment" workers. Although the risks were due to past exposure, case histories and recent acute effects indicate a present carcinogenic hazard in some Lombardy electroplating factories. Copyright © 2011 Wiley Periodicals, Inc.

Occupational risk factors for testicular cancer: a registry-based case-control study in Rhineland Palatinate – Germany

PubMed Central

Yousif, Lamyaa; Hammer, Gaël P.; Emrich, Katharina; Blettner, Maria; Zeeb, Hajo

2013-01-01

Objectives: Testicular cancer affects mainly men below the age of 50. An association with occupation and social status has been suggested but risk factors are not well understood. A registry-based case-control study focusing on occupation was performed in Germany. Methods: All 348 testicular cancer cases with available gainful occupational information registered between 2000 and 2005; as well as 564 suitable controls (from a pool of other cancers) were drawn from the Cancer Registry of Rhineland-Palatinate. Unconditional logistic regression was used to compute odds ratios (OR) and associated 95% confidence intervals (CI). Results: Slightly elevated OR were observed for technicians and related professionals (OR 1.62, 95% CI 1.00–2.63) and for clerical support workers (OR 1.71, 95% CI 1.14–2.56). This increase was highest in the age group 20–50 for technicians (OR 2.02, 95% CI 1.23–3.33) and clerks (OR 2.00, 95% CI 1.30–3.09), respectively. An association with testicular cancer was observed for no other occupation. Conclusion: An increased risk of testicular cancer was observed for technicians and related professionals and clerical support workers. This could be related to socioeconomic status or sedentary life style, two factors that were identified in previous studies. While the feasibility of a purely registry-based study was shown, missing occupational data and the choice of cancer controls represent challenges to the validity of this approach. PMID:24265602

Association between hypogonadism, symptom burden, and survival in male patients with advanced cancer.

PubMed

Dev, Rony; Hui, David; Del Fabbro, Egidio; Delgado-Guay, Marvin O; Sobti, Nikhil; Dalal, Shalini; Bruera, Eduardo

2014-05-15

A high frequency of hypogonadism has been reported in male patients with advanced cancer. The current study was performed to evaluate the association between low testosterone levels, symptom burden, and survival in male patients with cancer. Of 131 consecutive male patients with cancer, 119 (91%) had an endocrine evaluation of total (TT), free (FT), and bioavailable testosterone (BT); high-sensitivity C-reactive protein (CRP); vitamin B12; thyroid-stimulating hormone; 25-hydroxy vitamin D; and cortisol levels when presenting with symptoms of fatigue and/or anorexia-cachexia. Symptoms were evaluated by the Edmonton Symptom Assessment Scale. The authors examined the correlation using the Spearman test and survival with the log-rank test and Cox regression analysis. The median age of the patients was 64 years; the majority of patients were white (85 patients; 71%). The median TT level was 209 ng/dL (normal: ≥ 200 ng/dL), the median FT was 4.4 ng/dL (normal: ≥ 9 ng/dL), and the median BT was 22.0 ng/dL (normal: ≥ 61 ng/dL). Low TT, FT, and BT values were all associated with worse fatigue (P ≤ .04), poor Eastern Cooperative Oncology Group performance status (P ≤ .05), weight loss (P ≤ .01), and opioid use (P ≤ .005). Low TT and FT were associated with increased anxiety (P ≤ .04), a decreased feeling of well-being (P ≤ .04), and increased dyspnea (P ≤ .05), whereas low BT was only found to be associated with anorexia (P = .05). Decreased TT, FT, and BT values were all found to be significantly associated with elevated CRP and low albumin and hemoglobin. On multivariate analysis, decreased survival was associated with low TT (hazards ratio [HR], 1.66; P = .034), declining Eastern Cooperative Oncology Group performance status (HR, 1.55; P = .004), high CRP (HR, 3.28; P < .001), and decreased albumin (HR, 2.52; P < .001). In male patients with cancer, low testosterone levels were associated with systemic inflammation, weight loss, increased

Occupation and bladder cancer: a death-certificate study.

PubMed Central

Dolin, P. J.; Cook-Mozaffari, P.

1992-01-01

Occupational statements on death certificates of 2,457 males aged 25-64 who died from bladder cancer in selected coastal and estaurine regions of England and Wales during 1965-1980 were studied. Excess mortality was found for deck and engine room crew of ships, railway workers, electrical and electronic workers, shoemakers and repairers, and tobacco workers. An excess of cases also occurred among food workers, particularly those employed in the bread and flour confectionary industry or involved in the extraction of animal and vegetable oils and fats. Use of a job-exposure matrix revealed elevated risk for occupations in which most workers were exposed to paints and pigments, benzene and cutting oils. PMID:1520596

Influence of occupation and education level on breast cancer stage at diagnosis, and treatment options in China

PubMed Central

Liu, Yang; Zhang, Jian; Huang, Rong; Feng, Wei-Liang; Kong, Ya-Nan; Xu, Feng; Zhao, Lin; Song, Qing-Kun; Li, Jing; Zhang, Bao-Ning; Fan, Jin-Hu; Qiao, You-Lin; Xie, Xiao-Ming; Zheng, Shan; He, Jian-Jun; Wang, Ke

2017-01-01

Abstract The objective of this study was to evaluate the impact of occupation and education level of Chinese female breast cancer patients on their cancer staging at diagnosis, clinical and pathological features, rate of implementation, and selection of treatment. The medical charts of 4211 confirmed female breast cancer cases diagnosed between 1999 and 2008, from 7 breast cancer centers spread across the whole of China, were reviewed. Data including information on the patient's sociodemographic status, clinical and pathological characteristics, implementation of clinical examination and treatment modalities were analyzed. In parallel, the associations between different occupations and level of educational attainment were analyzed in relation to tumor stage through TNM staging, clinical and pathological characteristics, implementation of clinical examination, and treatment patterns. Multivariate logistic regression was used to identify whether the occupation and education level of patients are independent factors of TNM staging at diagnosis. There were significant differences among different occupation groups and the education level of patients in regards to pathological characteristics and treatment choice. Both the occupation and education level of patients were independent factors of TNM staging at diagnosis. For patients within the lower-income occupation or lower educational attainment group, the tumor stage was later, the rates of implementation of relevant investigations were lower, as were the rates of radiotherapy, chemotherapy, and endocrine therapy. This study suggests that strategies should work toward developing more accurate and effective breast cancer prevention and treatment strategies aimed specifically at patients with lower educational attainment levels and at specific occupation groups. PMID:28403116

Gender differences in caregiver burden and its determinants in family members of terminally ill cancer patients.

PubMed

Schrank, Beate; Ebert-Vogel, Alexandra; Amering, Michaela; Masel, Eva K; Neubauer, Marie; Watzke, Herbert; Zehetmayer, Sonja; Schur, Sophie

2016-07-01

Female family caregivers consistently report higher levels of stress and burden compared to male caregivers. Explanations for the apparently higher psychological vulnerability of female caregivers are largely missing to date. This study assesses the correlates and determinants of caregiver burden in family caregivers of advanced cancer patients with a specific focus on gender differences. Three hundred and eight self-identified main informal caregivers of advanced cancer patients were cross-sectionally assessed using structured questionnaires for caregiver burden and hypothesised determinants of burden, including sociodemographic characteristics, caring arrangements, support needs, hope and coping style. Gender differences and predictors of burden were assessed using t-tests, chi-squared tests and univariate linear regression. Significant univariate predictors were entered in an analysis of covariance separately for men and women. Burden was significantly higher in women. Hope was the most significant protective factor against burden in both genders, together with perceived fulfilment of support needs. Only in women emotion-oriented coping and being in employment while caring were significantly predictive of higher burden in the multivariate analysis. The model explained 36% of the variance in burden in men and 29% in women. Psychological support interventions for family caregivers should take gender-specific risk factors into account. Interventions focusing on keeping up hope while caring for a terminally ill family member may be a valuable addition to palliative services to improve support for family carers. Women may benefit from interventions that address adaptive coping and strategies to deal with the dual demands of employment and caring. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

UK research expenditure on dementia, heart disease, stroke and cancer: are levels of spending related to disease burden?

PubMed

Luengo-Fernandez, R; Leal, J; Gray, A M

2012-01-01

A UK government review recommended that the impact of disease on the population and economy should be assessed to inform health research priorities. This study aims to quantify UK governmental and charity research funding for dementia, cancer, coronary heart disease (CHD) and stroke in 2007/08 and assess whether the levels of research expenditure are aligned with disease and economic burden. We identified UK governmental agencies and charities providing health research funding and determined their levels of funding for dementia, cancer, CHD and stroke. Research funding levels were compared to the number of cases, disability-adjusted life years (DALYs) and economic burden. Economic costs were estimated using data on morbidity, mortality, health and social care use, private costs and other related indicators. Research funding to the four diseases was £833 million, of which £590 million (71%) was devoted to cancer, £169 million (20%) to CHD, £50 million (6%) to dementia and £23 million (4%) to stroke. Cancer received £482 in research funding per 1000 DALYs lost, CHD received £266, dementia received £166, with stroke receiving £71. In terms of economic burden, for every £1 million of health and social care costs attributable to each disease, cancer received £129 269 in research funding, CHD received £73 153, stroke received £8745 and dementia received £4882. Most health research funding in the UK is currently directed towards cancer. When compared to their burden, our analysis suggests that research spending on dementia and stroke is severely underfunded in comparison with cancer and CHD. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.