Cancer- and noncancer-specific cumulative incidence of death after exposure to polychlorinated biphenyls and dioxins: A competing risk analysis among Yusho patients

•We estimated the cumulative cancer risk in Yusho patients.•Males have a significantly higher risk of cumulative cancer than females.•The difference in noncancer risk was similar between males and females. In competing risks settings, the cause-specific cumulative incidence function is of great inte...

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Published in:Environment International Vol. 147; p. 106320
Main Authors: Onozuka, Daisuke, Nakamura, Yuko, Tsuji, Gaku, Furue, Masutaka
Format: Journal Article
Language:English
Published: Netherlands Elsevier Ltd 01.02.2021
Elsevier BV
Elsevier
Subjects:
Cancer
Competing risk
confidence interval
Cumulative incidence function
cumulative risk
death
Dibenzofurans, Polychlorinated
Dioxins
Dioxins - toxicity
disease control
environment
Environmental sciences
Female
females
Food Contamination
GE1-350
hazard ratio
Humans
Incidence
Japan
Male
males
Neoplasms
Polychlorinated biphenyls
Polychlorinated Biphenyls - toxicity
prognosis
regression analysis
risk analysis
Risk Assessment
survival rate
Yusho
Japan
Polychlorinated biphenyls
PCBs
Yusho
Cumulative incidence function
Competing risk
Cancer
ISSN:0160-4120, 1873-6750, 1873-6750
Online Access:Get full text
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Summary:•We estimated the cumulative cancer risk in Yusho patients.•Males have a significantly higher risk of cumulative cancer than females.•The difference in noncancer risk was similar between males and females. 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 cancer- and noncancer-specific mortality in Yusho patients exposed to polychlorinated biphenyls (PCBs) and dioxin-related compounds has not been estimated. 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. 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]). 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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ISSN:0160-4120
1873-6750
1873-6750
DOI:10.1016/j.envint.2020.106320