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Temporal Association of Prostate Cancer Incidence with World Trade Center Rescue/Recovery Work
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10 2021
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Source: Occup Environ Med. 78(10):699-706
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Alternative Title:Occup Environ Med
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Description:Background:
The World Trade Center (WTC) attacks on 9/11/2001 created a hazardous environment with known and suspected carcinogens. Previous studies have identified an increased risk of prostate cancer in responder cohorts compared to the general male population.
Objectives:
To estimate the length of time to prostate cancer among WTC rescue/recovery workers by determining specific time periods during which the risk was significantly elevated.
Methods:
Person-time accruals began six months after enrollment into a WTC cohort and ended at death or 12/31/2015. Cancer data were obtained through linkages with 13 state cancer registries. New York State was the comparison population. We used Poisson regression to estimate hazard ratios and 95% confidence intervals; change points in rate ratios were estimated using profile likelihood.
Results:
The analytic cohort included 54,394 male rescue/recovery workers. We observed 1,120 incident prostate cancer cases. During 2002–2006, no association with WTC exposure was detected. Beginning in 2007, a 24% increased risk (HR: 1.24, 95%CI: 1.16–1.32) was observed among WTC rescue/recovery workers when compared with New York State. Comparing those who arrived earliest at the disaster site on the morning of 9/11/2001 or any time on 9/12/2001 to those who first arrived later, we observed a positive, monotonic, dose-response association in the early (2002–2006) and late (2007–2015) periods.
Conclusions:
Risk of prostate cancer was significantly elevated beginning in 2007 in the WTC Combined Rescue/Recovery Cohort. While unique exposures at the disaster site might have contributed to the observed effect, screening practices including routine prostate specific antigen screening cannot be discounted.
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Pubmed ID:34507966
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Pubmed Central ID:PMC8458078
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