Dataset Information

Occupational disparities in survival in Korean women with cancer: a nationwide registry linkage study.

ABSTRACT: OBJECTIVES:We sought to examine occupational disparities in survival among Korean women diagnosed with cancer. DESIGN:Population-based, registry-linkage study. SETTING:South Korea. PARTICIPANTS:Our study population comprised female workers registered in the Korean national employment insurance programme during 1995-2000 and diagnosed with cancer between 1995 and 2008. A total of 61?110 women with cancer diagnoses was included in analysis. The occupation was categorised into four groups: (1) managers, professionals and technical workers, (2) clerks, (3) service/sales workers and (4) blue-collar workers. PRIMARY AND SECONDARY OUTCOME MEASURE:Study population were linked to the national death registry until 2009. HRs for mortality adjusting for age and year of diagnosis were calculated in the study sample and subgroups with 10 specific cancer sites including thyroid, breast, stomach, cervix, colon or lung cancer using managers, professionals and technical workers as the reference. RESULTS:Women in service/sales (HR 1.25, 95%?CI 1.15 to 1.35) and blue-collar occupations (HR 1.34, 95%?CI 1.25 to 1.44) had poorer survival for all cancer sites combined, while blue-collar workers showed poorer survival for lung (HR 1.41, 95%?CI 1.14 to 1.77), breast (HR 1.28, 95%?CI 1.06 to 1.54), cervical cancer (HR 1.42, 95%?CI 1.02 to 2.06) and non-Hodgkin's lymphoma (HR 1.69, 95%?CI 1.09 to 2.77) compared with women in professional and managerial positions. CONCLUSION:We found substantial and significant inequalities in overall survival by the occupational group among Korean women with cancer, even in the context of universal access to cancer screening and treatment.

SUBMITTER: Lee HE

PROVIDER: S-EPMC7485248 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Occupational disparities in survival in Korean women with cancer: a nationwide registry linkage study.

Lee Hye-Eun HE Kim Eun-A EA Zaitsu Masayoshi M Kawachi Ichiro I

BMJ open 20200910 9

<h4>Objectives</h4>We sought to examine occupational disparities in survival among Korean women diagnosed with cancer.<h4>Design</h4>Population-based, registry-linkage study.<h4>Setting</h4>South Korea.<h4>Participants</h4>Our study population comprised female workers registered in the Korean national employment insurance programme during 1995-2000 and diagnosed with cancer between 1995 and 2008. A total of 61 110 women with cancer diagnoses was included in analysis. The occupation was categoris ...[more]

PMID: 32912993

Similar Datasets

Project description:ObjectivesWhile colon cancer (CC) risk is associated with several lifestyle-related factors, including physical inactivity, smoking and diet, the contribution of occupation to CC morbidity remains largely unclear. Growing evidence indicates that gastrointestinal infections like salmonellosis could contribute to CC development. We performed a nationwide registry study to assess potential associations between occupation (history) and CC, including also those occupations with known increased exposure to gastrointestinal pathogens like Salmonella. METHODS: Person-level occupational data for all residents in The Netherlands were linked to CC diagnosis data. Differences in the incidence of (overall, proximal and distal) CC among occupational sectors and risk groups were tested for significance by calculating standardised incidence ratios (SIRs) with 95% CIs using the general population as reference group. Effects of gender, age, exposure duration and latency were also assessed.ResultsSignificant differences in CC incidence were observed only for a few occupational sectors, including the manufacturing of rubber and plastics, machinery and leather, the printing sector and the information service sector (SIRs 1.06-1.88). No elevated risk of CC was observed among people with increased salmonellosis risk through occupational exposure to live animals, manure or among those working in the sale of animal-derived food products (SIRs 0.93-0.95, 0.81-0.95 and 0.93-1.09 for overall, proximal and distal CC, respectively).ConclusionsThe results of this study suggest that occupation in itself provides a relatively small contribution to CC incidence. This is consistent with previous studies where a similar degree of variation in risk estimates was observed. The lack of an association with the high-risk occupations for salmonellosis might be due to higher levels of physical activity, a known protective factor for CC and other diseases, of people working in the agricultural sector, which might outweigh the potential Salmonella-associated risk of CC.

Project description:With improved survival in patients with cancer, the risk of developing multiple primary malignancies (MPMs) has increased. We aimed to characterize MPMs involving lung cancer and compare these characteristics between patients with single lung cancer and those with lung cancer and subsequent primary cancer (known as lung cancer first [LCF]).MethodsThis retrospective study was conducted based on Taiwan Cancer Database from Taiwan's National Health Insurance Registry Database. Patients with lung cancer (n = 72,219) from 1 January 2011 to 31 December 2015, were included in this study, and their medical records were traced back to 1 January 2002, and followed until 31 December 2019.ResultsMPMs occurred in 10,577 (14.65%) patients with lung cancer, and LCF and other cancer first (OCF) accounted for 35.55% and 64.45% of these patients, with a mean age at lung cancer diagnosis of 65.18 and 68.92 years, respectively. The median interval between primary malignancies in the OCF group was significantly longer than that in the LCF group (3.26 vs. 0.11 years, p < 0.001). Patients in the single lung cancer group were significantly older than those in the LCF group (67.12 vs. 65.18 years, p < 0.001). The mean survival time of patients with LCF was longer than that of patients with single lung cancer. Following initial lung cancer, the three most common second primary malignancies were lung, colon, and breast cancers. For patients with advanced lung cancer, survival in patients with mutant epidermal growth factor receptor (EGFR) was longer than that in patients with undetected EGFR. In stage 3 and 4 patients with EGFR mutations, the LCF group showed better survival than the single lung cancer group. Conversely, in stage 1 patients with mutant EGFR, the LCF group exhibited worse survival than the single lung cancer group.ConclusionsSurvival in patients with MPMs depends on baseline characteristics and treatments. Our findings may contribute to the development of precision medicine for improving personalized treatment and survival as well as the reduction of medical costs.

Project description:BackgroundAlthough landmark studies in the 1990s demonstrated that adolescents and young adults (AYAs, ages 15-39 years) with cancer had lower survival improvement compared to other ages, therapeutic advances warrant reappraisal of those observations. We utilized more recent data to study site-specific AYA survival trends and disparities and gain a more contemporary understanding of this problem.MethodsUsing California Cancer Registry data from 1988 to 2014, we calculated 1) 5-year overall survival improvement for AYAs compared to other age groups; 2) hazard ratios (HRs) of death for AYAs comparing 2001-2014 with 1988-2000 stratified by site, stage, sex, age group, race and ethnicity, and socioeconomic status (SES); and 3) site-specific adjusted HRs (aHRs) for AYA risk groups and interaction analyses by time period.ResultsFor all cancers combined, AYAs demonstrated survival improvement that exceeded all other age groups, largely due to reduced mortality in human immunodeficiency virus and acquired immunodeficiency syndrome-related cancers. The strongest predictor of death was cancer stage (aHR = 6.32 for distant vs localized, 95% confidence interval [CI] = 6.20 to 6.45). The aHR of death was statistically significantly higher for blacks (1.46, 95% CI = 1.42 to 1.50), Asian and Pacific Islanders (1.12, 95% CI = 1.09 to 1.15), and Latino whites (1.06, 95% CI = 1.04 to 1.08) compared to non-Latino whites, and was statistically significantly higher for low SES compared to high (1.31, 95% CI = 1.29 to 1.34). Survival disparities by stage, race and ethnicity, and SES worsened over time.ConclusionsFor AYAs in aggregate, the historical cancer survival improvement gap has been closed. However, the growing survival disparities in AYA subsets reported here, including advanced stage disease, racial and ethnic minorities, and low SES, highlight new priorities in need of increased attention, including inequities in cancer care and delivery within this vulnerable population.

Dataset Information

Occupational disparities in survival in Korean women with cancer: a nationwide registry linkage study.

Publications

Occupational disparities in survival in Korean women with cancer: a nationwide registry linkage study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets