Agricultural Workers and Urinary Bladder Cancer Risk in Egypt

ABSTRACT

The authors examined the associations between farming and the risk for squamous cell (SCC) or urothelial cell (UC) carcinoma of the urinary bladder among Egyptians. The authors used data from a multicenter case-control study (1,525 male and 315 female cases, and 2,069 male and 547 female age- and residence-matched, population-based controls) to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Men in farming and who never smoked had increased risk for either SCC or UC (AOR [95% CI]: 4.65 [2.59–8.36] and 6.22 [3.82–10.15], respectively). If they ever smoked, their risks were 2.27 (1.75–2.95) and 1.93 (1.58–2.35), respectively. Women in farmer households were at increased risk for SCC (1.40 [0.93–2.09] and UC [1.25 (0.82–1.89]), although not statistically significant. Occupational and environmental exposures to farming increased the risk for bladder cancer among Egyptians.

KEYWORDS:

• agricultural workers
• bladder cancer
• Egypt
• epidemiology
• tobacco smoke exposure

Acknowledgments

This study was supported by a grant from the National Cancer Institute, National Institutes of Health (R01-CA115618 to C.A.L.). The authors thank the Ministry of Health and Population of Egypt, and the National Cancer Institute of Cairo University, the Minia Oncology Center, and the South Egypt Cancer Institute in Assiut for supporting the study. The authors are also indebted to the many interviewers, translators, drivers, and other support personnel who made the study possible through their dedicated work. The authors thank especially Drs. Sameera Ezzat and Tamer Hifnawy for their early contribution in recruiting participants, Drs. Iman Gouda and Iman Loay for confirming all histopathological cases, Dr. Mohamed Abdel-Hamid for his assistance with the scientific oversight, and Drs. Mohamed S. Zaghloul and Mohamed A. Abdel-Aziz for facilitating access to different recruitment sites.