Occupational exposures and odds of gastric cancer: a StoP project consortium pooled analysis

Shailja C Shah; Paolo Boffetta; Kenneth C Johnson; Jinfu Hu; Domenico Palli; Monica Ferraroni; Shoichiro Tsugane; Gerson Shigueaki Hamada; Akihisa Hidaka; David Zaridze; Dmitry Maximovich; Jesus Vioque; Eva M Navarrete-Munoz; Zuo-Feng Zhang; Lina Mu; Stefania Boccia; Roberta Pastorino; Robert C Kurtz; Matteo Rota; Rossella Bonzi; Eva Negri; Carlo La Vecchia; Claudio Pelucchi; Dana Hashim

doi:10.1093/ije/dyz263

Occupational exposures and odds of gastric cancer: a StoP project consortium pooled analysis

Int J Epidemiol. 2020 Apr 1;49(2):422-434. doi: 10.1093/ije/dyz263.

Authors

Shailja C Shah¹, Paolo Boffetta², Kenneth C Johnson³, Jinfu Hu⁴, Domenico Palli⁵, Monica Ferraroni⁶, Shoichiro Tsugane⁷, Gerson Shigueaki Hamada⁸, Akihisa Hidaka⁷, David Zaridze⁹, Dmitry Maximovich⁹, Jesus Vioque^{10

11}, Eva M Navarrete-Munoz^{10

11}, Zuo-Feng Zhang¹², Lina Mu¹³, Stefania Boccia^{14

15}, Roberta Pastorino¹⁵, Robert C Kurtz¹⁶, Matteo Rota^{6

17

18}, Rossella Bonzi⁶, Eva Negri¹⁹, Carlo La Vecchia⁶, Claudio Pelucchi⁶, Dana Hashim²

Affiliations

¹ Gastroenterology, Hepatology and Nutrition, Vanderbilt University School of Medicine, Nashville, TN, USA.
² Tisch Cancer Institute, Department of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
³ School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁴ Harbin Medical University, Harbin, China.
⁵ Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy.
⁶ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
⁷ Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan.
⁸ Nikkei Disease Prevention Center, São Paulo, Brazil.
⁹ Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia.
¹⁰ CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
¹¹ Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Campus San Juan, Alicante, Spain.
¹² Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.
¹³ Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA.
¹⁴ Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
¹⁵ Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Roma, Italy.
¹⁶ Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA.
¹⁷ Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
¹⁸ Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
¹⁹ Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.

Abstract

Background: Gastric cancer pathogenesis represents a complex interaction of host genetic determinants, microbial virulence factors and environmental exposures. Our primary aim was to determine the association between occupations/occupational exposures and odds of gastric cancer.

Methods: We conducted a pooled-analysis of individual-level data harmonized from 11 studies in the Stomach cancer Pooling Project. Multivariable logistic regression was used to estimate the odds ratio (OR) of gastric cancer adjusted for relevant confounders.

Results: A total of 5279 gastric cancer cases and 12 297 controls were analysed. There were higher odds of gastric cancer among labour-related occupations, including: agricultural and animal husbandry workers [odds ratio (OR) 1.33, 95% confidence interval (CI): 1.06-1.68]; miners, quarrymen, well-drillers and related workers (OR 1.70, 95% CI: 1.01-2.88); blacksmiths, toolmakers and machine-tool operators (OR 1.41, 95% CI: 1.05-1.89); bricklayers, carpenters and construction workers (OR 1.30, 95% CI: 1.06-1.60); and stationary engine and related equipment operators (OR 6.53, 95% CI: 1.41-30.19). The ORs for wood-dust exposure were 1.51 (95% CI: 1.01-2.26) for intestinal-type and 2.52 (95% CI: 1.46-4.33) for diffuse-type gastric cancer. Corresponding values for aromatic amine exposure were 1.83 (95% CI: 1.09-3.06) and 2.92 (95% CI: 1.36-6.26). Exposure to coal derivatives, pesticides/herbicides, chromium, radiation and magnetic fields were associated with higher odds of diffuse-type, but not intestinal-type gastric cancer.

Conclusions: Based on a large pooled analysis, we identified several occupations and related exposures that are associated with elevated odds of gastric cancer. These findings have potential implications for risk attenuation and could be used to direct investigations evaluating the impact of targeted gastric cancer prevention/early detection programmes based on occupation.

Keywords: Gastric neoplasm; digestive system neoplasm; environment and public health; epidemiology.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Humans
Occupational Diseases* / epidemiology
Occupational Exposure* / adverse effects
Odds Ratio
Stomach Neoplasms* / epidemiology

Grants and funding

K12 HS026395/HS/AHRQ HHS/United States