Cancer risk among patients with coal workers' pneumoconiosis in Taiwan: a nationwide population-based study.
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.
Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Yi-Ping
YP
Hung
Chung-Jen
CJ
Teng
Chia-Jen
CJ
Liu
Yu-Wen
YW
Hu
Man-Hsin
MH
Hung
Cheng-Hwai
CH
Tzeng
Chun-Yu
CY
Liu
Chiu-Mei
CM
Yeh
Tzeng-Ji
TJ
Chen
Tzeon-Jye
TJ
Chiou
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055008:Anthracosis / Q000453:epidemiology*; D003032:Coal Mining; D005260:Female; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
cancer risk; epidemiology; pneumoconiosis; population-based study; risk factors