Investigation of occupational and environmental causes of respiratory cancers (ICARE): a multicenter, population-based case-control study in France

Our plain-English summary of Investigation of occupational and environmental causes of respiratory cancers (ICARE): a multicenter, population-based case-control study in France, by D. Luce, I. Stücker, ICARE Study Group (BMC Public Health, 2011).

The study

• Authors: D. Luce, I. Stücker, ICARE Study Group
• Journal: BMC Public Health
• Published: 2011;11:928
• Cited by: 60 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Occupational causes of respiratory cancers need to be further investigated: the role of occupational exposures in the aetiology of head and neck cancers remains largely unknown, and there are still substantial uncertainties for a number of suspected lung carcinogens. The main objective of the study is to examine occupational risk factors for lung and head and neck cancers.

Methods/design: ICARE is a multi-center, population-based case-control study, which included a group of 2926 lung cancer cases, a group of 2415 head and neck cancer cases, and a common control group of 3555 subjects. Incident cases were identified in collaboration with cancer registries, in 10 geographical areas. The control group was a random sample of the population of these areas, with a distribution by sex and age comparable to that of the cases, and a distribution by socioeconomic status comparable to that of the population. Subjects were interviewed face to face, using a standardized questionnaire collecting particularly information on tobacco and alcohol consumption, residential history and a detailed description of occupational history. Biological samples were also collected from study subjects. The main occupational exposures of interest are asbestos, man-made mineral fibers, formaldehyde, polycyclic aromatic hydrocarbons, chromium and nickel compounds, arsenic, wood dust, textile dust, solvents, strong acids, cutting fluids, silica, diesel fumes, welding fumes. The complete list of exposures of interest includes more than 60 substances. Occupational exposure assessment will use several complementary methods: case-by-case evaluation of exposure by experts; development and use of algorithms to assess exposure from the questionnaires; application of job-exposure matrices.

Discussion: The large number of subjects should allow to uncover exposures associated with moderate increase in risks, and to evaluate risks associated with infrequent or widely dispersed exposures. It will be possible to study joint effects of exposure to different occupational risk factors, to examine the interactions between occupational exposures, tobacco smoking, alcohol drinking, and genetic risk factors, and to estimate the proportion of respiratory cancers attributable to occupational exposures in France. In addition, information on many non-occupational risk factors is available, and the study will provide an excellent framework for numerous studies in various fields.

In plain English

This article was a study protocol describing ICARE, a population-based case-control study in France set up to look for job-related causes of lung cancer and head and neck cancers. It did not report any results on whether asbestos or any other workplace exposure was linked to cancer risk. The study included 2926 people with lung cancer, 2415 with head and neck cancer and 3555 comparison subjects from the general population. Between 2001 and 2007, cases were identified with cancer registries in 10 areas of France, and controls were drawn at random from the population of the same areas and recruited by telephone. Among people who could be contacted, 87.1% of lung cancer cases, 82.5% of head and neck cancer cases and 80.6% of controls agreed to take part. Participants were interviewed face to face about tobacco, alcohol, where they had lived and their full work history. Asbestos was listed among the main exposures of interest, along with man-made mineral fibers, silica, welding fumes and others. The authors wrote that assessment of asbestos exposure was still in progress and that analyses were ongoing.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Study protocol describing the design of a multi-center, population-based case-control study. It reports no exposure-risk results.
• Who was studied: 2926 lung cancer cases, 2415 head and neck cancer cases and 3555 population controls in 10 French départements, recruited 2001 to 2007
• Exposure: Occupational exposures of interest, including asbestos (no fiber types specified), man-made mineral fibers, formaldehyde, polycyclic aromatic hydrocarbons, chromium and nickel compounds, arsenic, wood dust, textile dust, solvents, strong acids, cutting fluids, silica, diesel fumes and welding fumes. More than 60 substances in total.
• Main results:
  • Cases were identified through cancer registries in 10 geographical areas of France
  • Controls were a random sample of the population of the same areas
  • Controls were recruited by telephone by a polling institute
  • Recruitment took place from 2001 to 2007
  • Lung cancer cases: 2926 of 3360 contacted (87.1%) agreed to participate
  • Head and neck cancer cases: 2415 of 2927 contacted (82.5%) agreed to participate
  • Controls: 3555 of 4411 contacted (80.6%) agreed and completed the interview
  • Face-to-face interviews collected tobacco and alcohol use, residential history and detailed occupational history
  • Assessment of exposure to asbestos, man-made mineral fibers and solvents was still in progress at the time of writing
  • Epidemiological analyses had not yet been completed
• The authors' conclusion: The authors expected that the study's size would allow it to uncover exposures linked to low to moderate increases in risk, and to assess infrequent or widely dispersed exposures.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Case-Control Study, Occupational Exposure, Lung Cancer, Occupational History, Mineral Fiber.

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