Cancer
Longest held occupation, pesticide occupation employment and prostate cancer aggressiveness among Black and White men in the North Carolina-Louisiana Prostate Cancer Project (PCaP) Carolyn Eberle* Carolyn Eberle Laura Farnan Jeannette T. Bensen James L. Mohler, Eboneé N. Butler
Background: Black US men experience higher incidence of aggressive prostate cancer (PCa) compared with White US men; modifiable risk factors for the PCa are largely unknown. We examine overall and race-specific associations between longest held occupation, employment in a pesticide occupation, and PCa aggressiveness. Methods: We used data from PCaP, a population-based study of Black and White men diagnosed with PCa. We classified longest held occupation using International Standard Classification of Occupations; ever employment was reported for five pesticide occupations. We defined PCa aggressiveness as low, intermediate, or high, based on clinical characteristics linked to risk of progression (Gleason grade, clinical stage, and prostate-specific antigen value). To describe the association between occupation and aggressive PCa, we used logistic regression models to calculate ORs and 95% CIs and examined potential effect-measure modification (EMM) by race. Results: Among 2,111 men, “Managing Directors and Chief Executives” (OR=1.85, 95%CI 1.03-3.35), “Plant and Machine Operators and Assemblers” (OR=1.31, 95%CI 1.00-1.71), and “Agricultural, Forestry, and Fishery Laborers” (OR=3.87, 0.85-17.6) had higher odds of high/intermediate aggressive PCa. Pesticide occupations, landscaping (OR=1.44, 95%CI 1.01-2.04), and garden shop work (OR=1.95, 95%CI 1.16-3.28) had higher odds of high-aggressive PCa. Employment ≥ 30 years among “Plant and Machine Operators and Assemblers”, “Heavy Truck and Lorry Drivers”, and “Agricultural, Forestry, and Fishery Laborers” was positively associated with high-aggressive PCa. We observed substantial heterogeneity of occupation by race (see figure), but not consistent evidence of EMM. Conclusions: Employment as plant/machine operators, agricultural laborers, and in pesticide occupations may increase odds of aggressive PCa; disproportionate employment of Black men in these jobs may contribute to Black-White disparities in PCa aggressiveness.
