Occupation and risk of stomach cancer in Poland

Our plain-English summary of Occupation and risk of stomach cancer in Poland, by S. Krstev, M. Dosemeci, J. Lissowska, et al (Occupational and Environmental Medicine, 2005).

The study

• Authors: S. Krstev, M. Dosemeci, J. Lissowska, W.H. Chow, W. Zatonski, M.H. Ward
• Journal: Occupational and Environmental Medicine
• Published: 2005;62(5):318-24
• Cited by: 24 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: In spite of the dramatic decline in the incidence of stomach cancer in the twentieth century, Poland has one of the highest rates in the world.

Aims: To evaluate the risk of stomach cancer by grouped occupations and industries, as well as by some specific occupational exposures.

Methods: Cases (n = 443) were newly diagnosed with stomach adenocarcinomas between 1994 and 1996. Controls (n = 479) were randomly selected from the general population in Warsaw.

Results: Only a few occupations and industries were associated with significantly increased risks of stomach cancer. The most suggestive finding was for work in the leather goods industry. Risk was also significantly increased among men working in fabricated metal production and among women ever employed as managers and governmental officials. Men ever employed as teaching professionals and women employed as technical and science professionals had significantly decreased risks of stomach cancer. Among men, a significant positive trend in risk with duration of employment was observed for work in the leather industry and special trade construction. No significantly increased risks were observed for specific exposures assessed by a job-exposure matrix or by self-reports. However among men there were non-significantly increased risks with 10 or more years exposure to asbestos, metal dust, and nitrosamines assessed by a job-exposure matrix.

Conclusions: Employment in the leather goods industry, special trade construction, and metal fabrication was associated with an increased risk of stomach cancer among men. However, there were only weak associations with specific exposures. Occupational exposures do not contribute substantially to the high rates of stomach cancer in Poland.

In plain English

This population-based case-control study in Warsaw, Poland, looked at whether jobs and workplace exposures were linked to stomach cancer. The analyses included 443 people with stomach adenocarcinoma (285 men, 158 women) and 479 people from the general population (313 men, 166 women). Jobs were grouped, and an exposure chart called a job-exposure matrix assigned exposure to dusts, asbestos, pesticides and nitrosamines. Participants also reported their own exposures. Among men, fabricated metal work was linked to higher risk (odds ratio 2.1, 95% CI 1.1 to 4.2). Also among men, risk rose with years worked in leather goods and in special trade construction. Women managers and governmental officials also had higher risk (odds ratio 2.6, 95% CI 1.1 to 6.1). For asbestos in men, the matrix gave odds ratios of 1.5 (95% CI 0.9 to 2.4) for ever exposure and 1.9 (95% CI 0.9 to 3.8) for 10 or more years. The authors called these of borderline significance. Self-reported exposures showed no significant associations. The authors concluded that occupational exposures do not substantially explain Poland's high stomach cancer rates.

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: population-based case-control study
• Who was studied: Warsaw residents: in the main analyses, 443 newly diagnosed stomach adenocarcinoma cases (285 men, 158 women) and 479 controls randomly selected from the general population of Warsaw (313 men, 166 women)
• Exposure: Lifetime job and industry histories, grouped into occupational and industry categories. A job-exposure matrix assigned exposure (exposed or not) to general, organic, inorganic and metal dust, asbestos, pesticides and nitrosamines. Self-reported exposures were also analysed. The asbestos fiber type is not specified.
• Main results:
  • Men who ever worked in fabricated metal products had a significantly increased risk: OR 2.1 (95% CI 1.1 to 4.2).
  • Men who ever worked in special trade construction had a borderline increased risk: OR 1.9 (95% CI 0.9 to 4.0). Men who ever worked in leather goods also had a borderline increased risk: OR 5.1 (95% CI 1.0 to 25.0).
  • Among men, risk rose significantly with longer employment in the leather goods industry (trend p = 0.03) and in special trade construction (trend p = 0.04). Among women, the only significant duration trend was an inverse one, for scientists or other technical professionals.
  • Women ever employed as managers and governmental officials had a significantly increased risk: OR 2.6 (95% CI 1.1 to 6.1).
  • Risk was significantly reduced among men employed as teaching professionals and among women who were technical and science professionals.
  • Men ever employed in jobs with asbestos exposure, as assessed by the job-exposure matrix, had an increased risk that the authors called of borderline significance: OR 1.5 (95% CI 0.9 to 2.4).
  • For 10 or more years of asbestos exposure assessed by the job-exposure matrix, the authors found a positive association of borderline significance: OR 1.9 (95% CI 0.9 to 3.8). The context of the text and Table 5 indicates this figure is for men.
  • For 10 or more years of exposure assessed by the job-exposure matrix, the authors also found non-significant positive associations for metal dust (OR 1.4, 95% CI 0.8 to 2.5) and nitrosamines (OR 1.3, 95% CI 0.8 to 2.2). The context indicates these figures are for men.
  • Self-reported exposures to specific agents showed no significant associations with stomach cancer risk in men or women.
  • When next-of-kin respondents were excluded, men's self-reported ever exposure to asbestos showed an increased risk of borderline significance: OR 1.7 (95% CI 0.9 to 3.5). There was no trend with longer duration of exposure.
• The authors' conclusion: The authors concluded that their findings for leather goods production, asbestos and metal dust exposure support findings from previous studies. They also concluded that occupational exposures do not substantially explain the high rates of stomach cancer in Poland.
• Limitations the authors state:
  • The analysis relied mainly on job and industry titles, which stand in for actual workplace exposure. This limited the authors' ability to relate exposures directly to stomach cancer.
  • Next-of-kin (proxy) respondents could have introduced bias, because they may know less about the subject's job history.
  • Many comparisons were made, so some findings, increased or reduced, may have been due to chance.
  • Inverse associations, especially in short-term exposure groups, were probably due to a healthy worker effect.
  • Small numbers of exposed people, particularly women, limited the authors' ability to evaluate risk.

Topics

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

Medical terms in this study, explained in our Lexicon: Stomach Cancer, Occupational Exposure, Adenocarcinoma.

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