胃癌的发病机制代表了宿主遗传决定因素的复杂相互作用,微生物毒力因子和环境暴露。我们的主要目的是确定职业/职业暴露与胃癌几率之间的关系。
我们对胃癌汇集项目中11项研究的个体水平数据进行了汇总分析。多变量逻辑回归用于估计经相关混杂因素校正的胃癌的比值比(OR)。
共分析了5279例胃癌病例和12.297例对照。在与劳动有关的职业中,患胃癌的几率更高,包括:农牧业工人[优势比(OR)1.33,95%置信区间(CI):1.06-1.68];矿工,采石工,钻井工人和相关工人(OR1.70,95%CI:1.01-2.88);铁匠,工具制造商和机床操作员(OR1.41,95%CI:1.05-1.89);瓦工,木匠和建筑工人(OR1.30,95%CI:1.06-1.60);固定式发动机和相关设备操作员(OR6.53,95%CI:1.41-30.19)。肠型胃癌的木尘暴露OR为1.51(95%CI:1.01-2.26),弥漫型胃癌为2.52(95%CI:1.46-4.33)。芳香胺暴露的相应值分别为1.83(95%CI:1.09-3.06)和2.92(95%CI:1.36-6.26)。接触煤炭衍生物,杀虫剂/除草剂,铬,辐射和磁场与较高的扩散型几率相关,但不是肠型胃癌.
基于大型汇总分析,我们确定了与胃癌发病率升高相关的几种职业和相关暴露.这些发现对降低风险具有潜在意义,可用于直接评估基于职业的靶向胃癌预防/早期检测计划的影响。
Gastric cancer pathogenesis represents a complex interaction of host genetic determinants, microbial virulence factors and environmental exposures. Our primary aim was to determine the association between occupations/occupational exposures and odds of gastric cancer.
We conducted a pooled-analysis of individual-level data harmonized from 11 studies in the Stomach cancer Pooling Project. Multivariable logistic regression was used to estimate the odds ratio (OR) of gastric cancer adjusted for relevant confounders.
A total of 5279 gastric cancer cases and 12 297 controls were analysed. There were higher odds of gastric cancer among labour-related occupations, including: agricultural and animal husbandry workers [odds ratio (OR) 1.33, 95% confidence interval (CI): 1.06-1.68]; miners, quarrymen, well-drillers and related workers (OR 1.70, 95% CI: 1.01-2.88); blacksmiths, toolmakers and machine-tool operators (OR 1.41, 95% CI: 1.05-1.89); bricklayers, carpenters and construction workers (OR 1.30, 95% CI: 1.06-1.60); and stationary engine and related equipment operators (OR 6.53, 95% CI: 1.41-30.19). The ORs for wood-dust exposure were 1.51 (95% CI: 1.01-2.26) for intestinal-type and 2.52 (95% CI: 1.46-4.33) for diffuse-type gastric cancer. Corresponding values for aromatic amine exposure were 1.83 (95% CI: 1.09-3.06) and 2.92 (95% CI: 1.36-6.26). Exposure to coal derivatives, pesticides/herbicides, chromium, radiation and magnetic fields were associated with higher odds of diffuse-type, but not intestinal-type gastric cancer.
Based on a large pooled analysis, we identified several occupations and related exposures that are associated with elevated odds of gastric cancer. These findings have potential implications for risk attenuation and could be used to direct investigations evaluating the impact of targeted gastric cancer prevention/early detection programmes based on occupation.