Cancer
Risks of subsequent primary cancers among the World Trade Center rescue and recovery workers diagnosed with cancer Charles B. Hall* Charles Hall Hall Hall Hall Hall Hall Hall Hall Hall Hall Hall Hall Department of Epidemiology and Population Health, Albert Einstein College of Medicine
Purpose: We assessed the incidence of subsequent primary cancers (SPCs) among the World Trade Centers (WTC) exposed rescue and recovery workers diagnosed with cancer.
Materials and Method: The incidences of SPCs among WTC-exposed cancer patients with the first primary cancer diagnosed during 2002-2022 in New York state were evaluated using standardized incidence ratios (SIRs), with cancer patients without WTC exposure as the reference population. We calculated SIRs for specific combinations of first and subsequent cancers, also by date of first arrival at WTC site and status of participation in WTC Health Program (WTCHP). Additionally, we conducted multivariate sub-distribution hazard regression analyses to evaluate the association between WTC exposure and SPCs.
Results: 827 (12.8%) SPCs were identified among 6,474 WTC cancer patients. Compared to non-WTC cancer patients, WTC cancer patients showed an increased risk of subsequent cancers for all cancers combined (SIR:1.08; 95% CI: 1.01-1.16), prostate (SIR:1.52; 95% CI: 1.30-1.77), and thyroid (SIR:1.54; 95% CI: 1.08-2.14) cancers. Elevated SIRs were also observed for specific combinations of first and subsequent cancers. Earlier arrival at the WTC site and participation in WTCHP were associated with an elevated risk of subsequent cancers. Multivariate modeling showed similar findings.
Conclusions: Our study found elevated overall SPCs risk among WTC cancer survivors, most prominently for subsequent prostate and thyroid cancers. Even though heightened medical surveillance likely played a major role for these increases, WTC exposure could also be a plausible contributor. Further research is warranted to continuously monitor the impact of WTC exposure on risk of SPCs.