TY - JOUR
T1 - Cancer risk among patients with coal workers' pneumoconiosis in Taiwan
T2 - A nationwide population-based study
AU - Hung, Yi Ping
AU - Teng, Chung Jen
AU - Liu, Chia Jen
AU - Hu, Yu Wen
AU - Hung, Man Hsin
AU - Tzeng, Cheng Hwai
AU - Liu, Chun Yu
AU - Yeh, Chiu Mei
AU - Chen, Tzeng Ji
AU - Chiou, Tzeon Jye
PY - 2014/6/15
Y1 - 2014/6/15
N2 - This study is aimed to evaluate the cancer risk among patients with coal workers' pneumoconiosis (CWP) using a nationwide population-based dataset. Patients without previous cancer who had been diagnosed with CWP and followed-up for more than 1 year between 1997 and 2006 were recruited from the Taiwan National Health Insurance database. Standardized incidence ratios (SIRs) of cancers in CWP patients were calculated and compared to the cancer incidence in the general population. Risk factors for cancer development were also analyzed. After a median follow-up of 9.68 years, 954 cancers developed among 8,051 recruited CWP patients, with a follow-up of 69,398 person-years. The SIR for all cancers was 1.12 [95% confidence interval (CI) 1.04-1.18]. Males older than 80 years had a SIR of 1.27 (95% CI: 1.06-1.51). The SIRs of esophageal (1.76, 95% CI: 1.24-2.44), gastric (1.42, 95% CI: 1.13-1.76), liver and biliary tract (1.18, 95% CI: 1.01-1.37) and lung and mediastinal (1.45, 95% CI: 1.26-1.66) cancers were significantly higher in the CWP group than in the general population. Multivariate analysis showed that age ≥ 60 years [hazard ratio (HR) 1.70, 95% CI: 1.41-2.05), male gender (HR = 1.79, 95% CI: 1.44-2.23) and liver cirrhosis (HR = 3.99, 95% CI: 2.89-5.51) were significant predictors of cancer development in patients with CWP. We concluded that patients with CWP, especially elderly males, were at increased risk of cancer. Age, male gender and liver cirrhosis were independent risk factors for cancer development. What's new? Inhalation of coal dust causes pneumoconiosis, a group of lung diseases including fibrosis and emphysema. Using a nationwide population-based dataset with large patient numbers, this study revealed an increased cancer risk among patients with coal workers' pneumoconiosis in Asia. Male gender, advanced age, and liver cirrhosis were independent risk factors for cancer development that included esophagus, stomach, liver and lung tumors. The authors recommend intensified cancer surveillance in patients with coal workers' pneumoconiosis to accelerate cancer detection and optimize treatment.
AB - This study is aimed to evaluate the cancer risk among patients with coal workers' pneumoconiosis (CWP) using a nationwide population-based dataset. Patients without previous cancer who had been diagnosed with CWP and followed-up for more than 1 year between 1997 and 2006 were recruited from the Taiwan National Health Insurance database. Standardized incidence ratios (SIRs) of cancers in CWP patients were calculated and compared to the cancer incidence in the general population. Risk factors for cancer development were also analyzed. After a median follow-up of 9.68 years, 954 cancers developed among 8,051 recruited CWP patients, with a follow-up of 69,398 person-years. The SIR for all cancers was 1.12 [95% confidence interval (CI) 1.04-1.18]. Males older than 80 years had a SIR of 1.27 (95% CI: 1.06-1.51). The SIRs of esophageal (1.76, 95% CI: 1.24-2.44), gastric (1.42, 95% CI: 1.13-1.76), liver and biliary tract (1.18, 95% CI: 1.01-1.37) and lung and mediastinal (1.45, 95% CI: 1.26-1.66) cancers were significantly higher in the CWP group than in the general population. Multivariate analysis showed that age ≥ 60 years [hazard ratio (HR) 1.70, 95% CI: 1.41-2.05), male gender (HR = 1.79, 95% CI: 1.44-2.23) and liver cirrhosis (HR = 3.99, 95% CI: 2.89-5.51) were significant predictors of cancer development in patients with CWP. We concluded that patients with CWP, especially elderly males, were at increased risk of cancer. Age, male gender and liver cirrhosis were independent risk factors for cancer development. What's new? Inhalation of coal dust causes pneumoconiosis, a group of lung diseases including fibrosis and emphysema. Using a nationwide population-based dataset with large patient numbers, this study revealed an increased cancer risk among patients with coal workers' pneumoconiosis in Asia. Male gender, advanced age, and liver cirrhosis were independent risk factors for cancer development that included esophagus, stomach, liver and lung tumors. The authors recommend intensified cancer surveillance in patients with coal workers' pneumoconiosis to accelerate cancer detection and optimize treatment.
KW - cancer risk
KW - epidemiology
KW - pneumoconiosis
KW - population-based study
KW - risk factors
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U2 - 10.1002/ijc.28611
DO - 10.1002/ijc.28611
M3 - Article
C2 - 24242366
AN - SCOPUS:84897971057
SN - 0020-7136
VL - 134
SP - 2910
EP - 2916
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 12
ER -
