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Area of Science:

  • Epidemiology
  • Occupational Health
  • Cancer Research

Background:

  • Alcohol and tobacco are significant risk factors for various cancers, including oral, pharyngeal, laryngeal, esophageal, liver, colon, and rectal cancers.
  • Occupational groups exhibit uneven distribution of alcohol and tobacco habits, potentially biasing traditional occupational cancer studies.
  • Lack of confounder information in many occupational cohort studies necessitates adjusted risk assessments.

Purpose of the Study:

  • To calculate Nordic standardized incidence ratios (SIRs) for alcohol and tobacco-related cancers by occupation, adjusted for these habits.
  • To compare adjusted SIRs with unadjusted SIRs to assess the impact of confounder adjustment.

Main Methods:

  • Utilized the Nordic Occupational Cancer (NOCCA) database.
  • Employed confirmatory factor analysis models for simultaneous analysis of alcohol and tobacco-related cancer sites.
  • Calculated adjusted SIRs for specific cancer sites within each occupation.

Main Results:

  • Risk estimates for certain occupations and cancers showed dramatic shifts after adjustment (e.g., farmers' mouth and esophageal cancer risk increased).
  • Wood workers showed an increased risk for pharyngeal cancer after adjustment.
  • Economically inactive individuals exhibited a decreased risk for laryngeal cancer post-adjustment, contrasting with unadjusted higher risk.

Conclusions:

  • Adjustment for alcohol and tobacco consumption significantly altered cancer risk estimates across various occupations.
  • The adjusted risk estimates provide a less confounded description of occupational cancer risks.
  • This adjusted approach aids in identifying genuine occupational risk factors for cancer.