A Collaborative Cohort Study

Details

• Alternative Title:
  Am J Ind Med
• Personal Author:
  Goldfarb, David G. ; Zeig-Owens, Rachel ; Kristjansson, Dana ; Li, Jiehui ; Brackbill, Robert M. ; Farfel, Mark R. ; Cone, James E. ; Kahn, Amy R. ; Qiao, Baozhen ; Schymura, Maria J. ; Webber, Mayris P. ; Dasaro, Christopher R. ; Lucchini, Roberto G. ; Todd, Andrew C. ; Prezant, David J. ; Hall, Charles B. ; Boffetta, Paolo
• Description:
  Background
  
  World Trade Center (WTC)-exposed responders may be eligible to receive no-cost medical monitoring and treatment for certified conditions, including cancer. The survival of responders with cancer has not previously been investigated.
  
  Methods
  
  This study compared the estimated relative survival of WTC-exposed responders who developed cancer while enrolled in two WTC medical monitoring and treatment programs in New York City (WTC-MMTP responders) and WTC-exposed responders not enrolled (WTC-non-MMTP responders) to non-responders from New York State (NYS-non-responders), all restricted to the 11-southernmost NYS counties, where most responders resided. Parametric survival models estimated cancer-specific and all-cause mortality. Follow-up ended at death or 12/31/2016.
  
  Results
  
  From 1/1/2005–12/31/2016, there were: 2,037 cancer cases and 303 deaths (248 cancer-related deaths) among WTC-MMTP responders; 564 cancer cases and 143 deaths (106 cancer-related deaths) among WTC-non-MMTP responders; and, 574,075 cancer cases and 224,040 deaths (158,645 cancer-related deaths) among the NYS-non-responder population. Comparing WTC-MMTP responders with NYS-non-responders, the cancer-specific mortality hazard ratio (HR) was 0.72 (95% CI=0.64–0.82), and all-cause mortality HR was 0.64 (95% CI=0.58–0.72). The cancer-specific HR was 0.94 (95% CI=0.78–1.14), and all-cause mortality HR was 0.93 (95% CI=0.79–1.10) comparing WTC-non-MMTP responders to the NYS-non-responder population.
  
  Conclusions
  
  WTC-MMTP responders had lower mortality compared with NYS-non-responders, after controlling for demographic factors and temporal trends. There may be survival benefits from no-out-of-pocket-cost medical care which could have important implications for healthcare policy, however, other occupational and socioeconomic factors could have contributed to some of the observed survival advantage.
  
  
• Subjects:
  Article Cancer Cohort Studies Emergency Responders Humans Medical Monitoring And Treatment Mortality Neoplasms New York City Proportional Hazards Models Rescue/recovery Work September 11 Terrorist Attacks World Trade Center

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• Source:
  Am J Ind Med. 64(10):815-826
• Pubmed ID:
  34288025
• Pubmed Central ID:
  PMC8515734
• Document Type:
  Journal Article
• Funding:
  U01OH011681/ACL/ACL HHSUnited States/ ; U01 OH011931/OH/NIOSH CDC HHSUnited States/ ; U01OH011315/OH/NIOSH CDC HHSUnited States/ ; 200-2017-93326/OH/NIOSH CDC HHSUnited States/ ; U50/ATU272750/TS/ATSDR CDC HHSUnited States/ ; 200-2011-39378/OH/NIOSH CDC HHSUnited States/ ; P30 CA013330/CA/NCI NIH HHSUnited States/ ; U01 OH011315/OH/NIOSH CDC HHSUnited States/ ; 75N91018D00005 (Task Order 75N91018F00001)/CA/NCI NIH HHSUnited States/ ; U01 OH011480/OH/NIOSH CDC HHSUnited States/ ; U50OH009739/ACL/ACL HHSUnited States/ ; U01 OH011932/OH/NIOSH CDC HHSUnited States/ ; U50 TS272750/TS/ATSDR CDC HHSUnited States/ ; U50/OH009739/OH/NIOSH CDC HHSUnited States/ ; U01OH011315/ACL/ACL HHSUnited States/ ; U50 OH009739/OH/NIOSH CDC HHSUnited States/ ; 200-2011-39383, 200-2017-93325/OH/NIOSH CDC HHSUnited States/ ; U01 OH011681/OH/NIOSH CDC HHSUnited States/ ; 6NU58DP006309/CC/CDC HHSUnited States/
• Volume:
  64
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7571230a765e94d96a3418393e7f82e03e608892ae534dbf92f38e41e07ab9b3
• Download URL:
  https://stacks.cdc.gov/view/cdc/110746/cdc_110746_DS1.pdf
• File Type:
  [PDF - 1.10 MB ]