Occupational cancer among women: Research status and methodologic considerations
ABSTRACT Occupational causes of cancer have not been well-evaluated among women. An increase in the number of women in the work force in jobs with potentially hazardous exposures during the past few decades raises the question as to whether there is a need to enhance our efforts in this area. The inability to evaluate occupational causes of female gynecologic tumors in studies of men, plus the potential for variation in outcome responses between men and women because of gender-based exposure and susceptibility differences, underscore the need for investigations specifically focused on women. Investigations of occupational exposures and cancer risk among women may require design considerations that differ somewhat from studies of men. Issues to consider include the impact of studying outcomes with high survival (e.g., breast cancer), gender-specific exposure patterns and toxicokinetic processing of some chemicals, special limitations in the use of the general population as the referent, and the need to control for established risk factors for gynecologic tumors.
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- "This could be because of smaller numbers of women in the study, but may also indicate that including sufficient numbers of women for analysis was not a high priority in the study design. As discussed above methodological adjustments may need to be made when studying women, such as: increasing the sample sizes due to lower exposure rates, utilizing gender-specific exposure assessment techniques, and considering sex-and gender-specific confounders [Blair et al., 1999; Kennedy and Koehoorn, 2003; Arbuckle, 2006]. "
ABSTRACT: Since the early 1990s, researchers have been concerned with the low rate at which women are included in epidemiologic studies of occupational cancer. A previous evaluation determined that one-third of articles published between 1970 and 1990 included women. To assess whether there has been an improvement in recent years, papers on occupational cancer between 1991 and 2009 were reviewed in fifteen journals. The proportion of articles that included men remained stable around 90%, while the proportion of articles that included women increased substantially, from 39% in 1991-1995 to 62% in 2006-2009. Articles that assessed risk among men only or men and women presented a higher number of risk estimates and were more likely to evaluate dose-response relationships than studies including women. Despite advances in the inclusion of women in studies of occupational cancer, disparities remain in the number of studies of occupational cancer and depth of analysis in studies that included women. Am. J. Ind. Med. 58:276-281, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.American Journal of Industrial Medicine 03/2015; 58(3):276-81. DOI:10.1002/ajim.22424 · 1.59 Impact Factor
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- "Whilst this restriction enabled us to use individual occupation as a surrogate measure for socio-economic class for both sexes, it also implied that the cohort had a higher proportion of men, since only half of the female population in the selected age-groups was occupied, in contrast with Swedish men, who were active in almost all cases . Within their respective populations, working females, who differ from home workers in many lifestyle-related factors , could constitute a more homogeneous subgroup than do working men. "
ABSTRACT: Cutaneous melanoma (CM) is a cancer usually associated with high socio-economic level in the literature. Few studies have, however, assessed this relationship by gender and site or the association between CM and rurality. A major-sized historical occupational Swedish cohort comprising 2,992,166 workers was used to estimate relative risk of cutaneous melanoma, broken down by gender and anatomical site, for occupational sectors (as a proxy of socio-economic class) and rurality. To this end, Poisson models were fitted for each site in men and women, including occupational sector and town size, with adjustment for age, period of diagnosis and geographical area as possible confounding factors. White collar workers presented a marked increased of risk in men in all melanoma cases, as well as in trunk, upper and lower limbs. This pattern was less clear for women, in which some heterogeneity appeared, as low risks in lower socioeconomic sectors in trunk, or risk excesses in white collar workers in lower limbs did not achieve statistical significance. Males also showed significant differences in risk by rural/urban distribution, but in women this association was limited to CM of lower limb. Risk of CM of head/neck did not vary by occupational sector or town size, thus depicting a specific epidemiological profile, which proved common to both sexes. While differences in risk between men and women could suggest greater homogeneity in UV-exposure behaviour among women, the uniform risk pattern in head and neck melanoma, present in both sexes, might support the coexistence of different aetiological pathways, related to anatomical site.BMC Public Health 02/2008; 8:33. DOI:10.1186/1471-2458-8-33 · 2.32 Impact Factor
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- "Furthermore, there is a well-known relationship between socioeconomic class and melanoma risk [Pion et al., 1995], which is also thought to reflect lifestyle differences. It has been pointed out that women working outside the home can differ from homeworkers in many lifestyle-related factors [Blair et al., 1999], such as tobacco, drug or alcohol use, or reproductive history, all of which have been studied as possible modifiers of melanoma risk [Westerdahl et al., 1996]. Dietary fat and coffee consumption have also been associated with melanoma in women [Veierod et al., 1997]. "
ABSTRACT: Background Few occupational studies have addressed melanoma in women. Accordingly, our aim was to identify occupations with higher risk of cutaneous melanoma, overall and by site, in Swedish female workers.Methods All gainfully employed Swedish women were followed-up from 1971 to 1989, using Death/Cancer Registers. Occupational risk ratios adjusted for age, period, town size, and geographic zone were computed for each site. Risk patterns for different sites were then compared.ResultsHigh risks were observed among educators, bank tellers, dental nurses, librarians/archivists/curators, horticultural workers, and hatmakers/milliners. Telephone operators and textile workers had increased risk, mainly in the leg. Other occupation-specific site excesses were also found. Upper-limb risks were correlated with head/neck and thorax, though these two sites were not associated. Legs registered a special pattern, with a moderate correlation with upper limbs or thorax, and no correlation with head/neck.Conclusions Some occupations with possible exposure to arsenic/mercury displayed increased risk. The generalized excess risk among hatmakers/milliners warrants further attention. The weak correlation between legs and other sites suggests site specificity in melanoma risk factors. Am. J. Ind. Med. 2005. © 2005 Wiley-Liss, Inc.American Journal of Industrial Medicine 10/2005; 48(4):270 - 281. DOI:10.1002/ajim.20212 · 1.59 Impact Factor