Journal
ENVIRONMENT INTERNATIONAL
Volume 147, Issue -, Pages -Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.envint.2020.106320
Keywords
Cancer; Competing risk; Cumulative incidence function; Polychlorinated biphenyls; Yusho
Categories
Funding
- Ministry of Health, Labour and Welfare Research Grant [H30-Shokuhin-Shitei-005]
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The study found that male Yusho patients have a significantly higher risk of cumulative incidence of cancer-specific mortality than female Yusho patients, while there is no gender difference in non-cancer mortality. These results may be useful in providing more accurate information on cancer prognosis and helping determine more appropriate disease management for Yusho patients.
Background: In competing risks settings, the cause-specific cumulative incidence function is of great interest since it quantifies cumulative risk in the presence of other causes. To date, however, long-term cancerand noncancerspecific mortality in Yusho patients exposed to polychlorinated biphenyls (PCBs) and dioxin-related compounds has not been estimated. Methods: We identified vital status and cause of death for Yusho patients between 1968 and 2017. Risk of cancer and noncancer-specific mortality was estimated using a flexible hazards-based regression model, with accounting for competing events. Results: In total, 1664 Yusho patients with 63,566 person-years of follow-up were included in the analysis. 50 year cumulative incidence of cancer mortality was 12.4% (95% confidence interval [CI], 10.5-14.7) in males and 4.7% (95% CI, 3.5-6.4) in females (difference, 7.7 percentage points [95% CI, 5.2-10.2]; adjusted hazard ratio for males, 2.61 [95% CI, 1.93-3.52]). For noncancer, the 50-year cumulative incidence of mortality was 35.4% (95% CI, 32.8-38.3) in males and 35.6% (95% CI, 33.3-38.1) in females (difference, -0.2 percentage points [95% CI,-3.5 to 3.1]; adjusted hazard ratio for males, 1.51 [95% CI, 1.26-1.82]). Conclusions: These findings confirm that male Yusho patients have a significantly higher risk of cumulative incidence of cancer-specific mortality than female Yusho patients. Our findings might be useful in providing Yusho patients with more accurate information on cancer prognosis and survivorship and help determine more appropriate disease management.
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