Cancer risk among patients with coal workers' pneumoconiosis in Taiwan: A nationwide population-based study

Authors

  • Yi-Ping Hung,

    1. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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    • Y.-P.H. and C.-J.T. contributed equally to this work.

  • Chung-Jen Teng,

    1. Division of Oncology and Hematology, Department of Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
    2. School of Medicine, National Yang-Ming University, Taipei, Taiwan
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    • Y.-P.H. and C.-J.T. contributed equally to this work.

  • Chia-Jen Liu,

    1. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    3. Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
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  • Yu-Wen Hu,

    1. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Man-Hsin Hung,

    1. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. School of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Cheng-Hwai Tzeng,

    1. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. School of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Chun-Yu Liu,

    1. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    3. Institute of Biopharmaceutical Sciences, National Yang-Ming University, Taipei, Taiwan
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  • Chiu-Mei Yeh,

    1. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Tzeng-Ji Chen,

    1. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Tzeon-Jye Chiou

    Corresponding author
    1. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    3. Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    • Correspondence to: Tzeon-Jye Chiou, MD, Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Taipei 11217, Taiwan, Tel.: +886-2-28757859, Fax: +886-2-28757874, E-mail: tjchiou@vghtpe.gov.tw

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Abstract

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.

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