Usual adult occupation and risk of prostate cancer in West African men: the Ghana Prostate Study

• Published in: Occupational and environmental medicine (London, England) Vol. 76; no. 2; pp. 71 - 77
• Main Authors: Adler, Colin, Friesen, Melissa C, Yeboah, Edward D, Tettey, Yao, Biritwum, Richard B, Adjei, Andrew A, Tay, Evelyn, Okyne, Victoria, Mensah, James E, Truelove, Ann, Yang, Baiyu, Kelly, Scott P, Zhou, Cindy Ke, McCullough, Lauren E, Pardo, Larissa, Hoover, Robert N, Hsing, Ann W, Cook, Michael B, Koutros, Stella
• Format: Journal Article
• Language: English
• Published: England BMJ 01-02-2019; BMJ Publishing Group LTD
• Subjects: Aged; Case-Control Studies; Epidemiology; Genetics; Ghana - epidemiology; Health risk assessment; Humans; Logistic Models; Male; Management; Men; Middle Aged; Military; Military Personnel; Mortality; Occupations; Occupations - statistics & numerical data; ORIGINAL ARTICLE; Personnel Management; Prostate cancer; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - etiology; Regression analysis; Risk analysis; Risk Factors; Sensitivity analysis; Socioeconomic factors; Ghana; United States > US; North America; Europe; epidemiology; international occupational health; cancer
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oemed-2018-105391

ObjectivesEstablished prostate cancer (PCa) risk factors include age, family history of PCa and African ancestry. Studies, mostly among highly screened, predominantly European ancestral populations, suggest that employment in certain occupations (eg, farming, military) may also have an increased risk for PCa. Here, we evaluated the association between usual adult occupation and PCa risk in Ghanaian men, a population with historically low rates of PCa screening.MethodsThe Ghana Prostate Study is a case-control study of PCa that was conducted from 2004 to 2012 in 749 cases and 964 controls. In-person interviews were conducted to collect information from participants, including longest held job. Industrial hygienists classified job titles into occupational categories. Unconditional logistic regression was used to calculate ORs and 95% CIs for the association between longest held job and PCa risk (overall, aggressive (Gleason≥7)), controlling for potential confounders.ResultsRisk was increased among men in management (overall PCa OR=2.2, 95% CI 1.4 to 3.2; aggressive PCa OR=2.2, 95% CI 1.3 to 3.5) and military occupations (overall PCa OR=3.4, 95% CI 1.7 to 7.0; aggressive PCa OR=3.5, 95% CI 1.5 to 8.3). Risks were also elevated for management and military-specific jobs based on 3-digit level Standard Occupational Classification definitions. Sensitivity analyses accounting for access to medical care did not show significant differences.ConclusionsOur study provides some evidence for increased risk of PCa among men in management and military occupations, which is consistent with the published literature. Additional research is needed to clarify the drivers of the associations between these occupations and PCa.