Excess HPV-Related Head and Neck Cancer in the World Trade Center Health Program General Responder Cohort

Details

• Personal Author:
  Black K ; Crane MA ; Dasaro CR ; Giuliano AR ; Graber JM ; Harris G ; Harrison DJ ; Lucchini RG ; Luft BJ ; Moline JM ; Shapiro M ; Steinberg MB ; Todd AC ; Udasin IG
• Description:
  The World Trade Center (WTC) attacks exposed rescue and recovery workers to a complex mix of toxicants, including carcinogens. our study compared site-specific cancer incidence of head and neck cancers (HNC) from 2003 through 2012 among 33,809 consented WTC General Responder Cohort (GRC) members to the New Jersey State Cancer Registry, using standardized incidence ratios (SIRs). HNC grouped using SEER ICD-O-3 codes into HPV-related (oropharyngeal) and non-related (other oral-nasal; laryngeal) tumors based on anatomical site. For the 73 GRC members identified with HNC, proportional hazard regression assessed the relationship between WTC exposure and other socio-demographic characteristics. An overall excess of HNC was not observed (SIR = 1.00, 95% CI: 0.78, 1.25) but excess cancer was seen in the latest observation period (2009-2012: SIR = 1.4; 95% CI: 1.01, 1.89). A similar temporal pattern was seen for HPV-related oropharyngeal cancer and laryngeal cancer, but not for non-HPV-related sites (oral-nasal cancer). HNC was significantly associated with increasing age (8% per year, 95% CI: 5%, 12%), non-Hispanic white ethnic group-ethnicity (hazard ratio (HR) = 3.51, 95 CI: 1.49, 8.27); there was a borderline association with the 9/11 occupation of military/protective services vs. others (HR = 1.83 95% CI: 0.99, 3.38; p = 0.0504). Caution is needed in interpreting these results given the small number of cases, potential for surveillance bias, and long latency for most cancers. Our findings highlight the need to examine the potentially carcinogenic effects of WTC exposure in the context of other strong risk factors, and the need for continued medical monitoring of WTC responders. [Description provided by NIOSH]
• Subjects:
  Carcinogens Demography Emergency Responders Hazardous Substances Neoplasms Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: World Trade Center Cancer Demographic Characteristics Emergency Responders Head And Neck Cancer HPV Larynx Cancer Nasal Cancer Oral Cancer Rescue Workers Sociological Factors Statistical Analysis Toxins Tumors World Trade Center WTC

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• ISSN:
  0020-7136
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Florida ; New Jersey ; New York ; OSHA Region 2 ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  145
• Issue:
  6
• NIOSHTIC Number:
  nn:20054735
• Citation:
  Int J Cancer 2019 Sep; 145(6):1504-1509
• Contact Point Address:
  Judith M. Graber, Department of Biostatistics and Epidemiology, Rutgers School of Public Health; 683 Hoes Lane West, rm. 133 Piscataway, NJ 08854
• Email:
  graber@eohsi.rutgers.edu
• Federal Fiscal Year:
  2019
• Performing Organization:
  Rutgers Biomedical and Health Sciences - School of Public Health, Piscataway, New Jersey
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  International Journal of Cancer
• End Date:
  20180831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:908398a834d4d868845844622db8e15a5fd316dbe6336f842254db3cf2b4ee2178d0c665661e3d6e968e716f1005142a850c76a86eac286780365eb0dafcd9c6
• Download URL:
  https://stacks.cdc.gov/view/cdc/217172/cdc_217172_DS1.pdf
• File Type:
  [PDF - 464.88 KB ]