Rare cancers of unknown etiology: lessons learned from a European multi-center case–control study

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DOI

  • Elsebeth Lynge, Københavns Universitet
  • ,
  • Linda Kaerlev, Research Unit of Clinical Epidemiology, Syddansk Universitet, Centre for Clinical Epidemiology
  • ,
  • Jørn Olsen
  • Svend Sabroe
  • ,
  • Noemia Afonso, Centro Hospitalar E Universitário Do Porto
  • ,
  • Wolfgang Ahrens, University of Bremen, Leibniz Institute for Prevention Research and Epidemiology
  • ,
  • Mikael Eriksson, Lund University
  • ,
  • Franco Merletti, University of Turin
  • ,
  • Maria Morales-Suarez-Varelas, University of Valencia, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)
  • ,
  • Aivars Stengrevics
  • ,
  • Pascal Guénel, Universite Paris-Sud

Rare cancers together constitute one fourth of cancers. As some rare cancers are caused by occupational exposures, a systematic search for further associations might contribute to future prevention. We undertook a European, multi-center case–control study of occupational risks for cancers of small intestine, bone sarcoma, uveal melanoma, mycosis fungoides, thymus, male biliary tract and breast. Incident cases aged 35–69 years and sex-and age-matched population/colon cancer controls were interviewed, including a complete list of jobs. Associations between occupational exposure and cancer were assessed with unconditional logistic regression controlled for sex, age, country, and known confounders, and reported as odds ratios (OR) with 95% confidence intervals (CI). Interviewed were 1053 cases, 2062 population, and 1084 colon cancer controls. Male biliary tract cancer was associated with exposure to oils with polychlorinated biphenyls; OR 2.8 (95% CI 1.3–5.9); male breast cancer with exposure to trichloroethylene; OR 1.9 (95% CI 1.1–3.3); bone sarcoma with job as a carpenter/joiner; OR 4.3 (95% CI 1.7–10.5); and uveal melanoma with job as a welder/sheet metal worker; OR 1.95 (95% CI 1.08–3.52); and cook; OR 2.4 (95% CI 1.4–4.3). A confirmatory study of printers enhanced suspicion of 1,2-dichloropropane as a risk for biliary tract cancer. Results contributed to evidence for classification of welding and 1,2-dichloropronane as human carcinogens. However, despite efforts across nine countries, for some cancer sites only about 100 cases were interviewed. The Rare Cancer Study illustrated both the strengths and limitations of explorative studies for identification of etiological leads.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Epidemiology
Vol/bind35
Nummer10
Sider (fra-til)937-948
ISSN0393-2990
DOI
StatusUdgivet - okt. 2020

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