Temporal association of prostate cancer incidence with World Trade Center rescue/recovery work.

The World Trade Center (WTC) attacks on 11 September 2001 created a hazardous environment with known and suspected carcinogens. Previous studies have identified an increased risk of prostate cancer in responder cohorts compared with the general male population.

To estimate the length of time to prostate cancer among WTC rescue/recovery workers by determining specific time periods during which the risk was significantly elevated.

Person-time accruals began 6 months after enrolment into a WTC cohort and ended at death or 12/31/2015. Cancer data were obtained through linkages with 13 state cancer registries. New York State was the comparison population. We used Poisson regression to estimate hazard ratios and 95% CIs; change points in rate ratios were estimated using profile likelihood.

The analytic cohort included 54 394 male rescue/recovery workers. We observed 1120 incident prostate cancer cases. During 2002-2006, no association with WTC exposure was detected. Beginning in 2007, a 24% increased risk (HR: 1.24, 95% CI 1.16 to 1.32) was observed among WTC rescue/recovery workers when compared with New York State. Comparing those who arrived earliest at the disaster site on the morning of 11 September 2001 or any time on 12 September 2001 to those who first arrived later, we observed a positive, monotonic, dose-response association in the early (2002-2006) and late (2007-2015) periods.

Risk of prostate cancer was significantly elevated beginning in 2007 in the WTC combined rescue/recovery cohort. While unique exposures at the disaster site might have contributed to the observed effect, screening practices including routine prostate specific antigen screening cannot be discounted.

Occupational and environmental medicine. 2021 Sep 10 [Epub ahead of print]

David G Goldfarb, Rachel Zeig-Owens, Dana Kristjansson, Jiehui Li, Robert M Brackbill, Mark R Farfel, James E Cone, Janette Yung, Amy R Kahn, Baozhen Qiao, Maria J Schymura, Mayris P Webber, Christopher R Dasaro, Moshe Shapiro, Andrew C Todd, David J Prezant, Paolo Boffetta, Charles B Hall

Department of Medicine, Division of Pulmonary Medicine, Montefiore Medical Center, Bronx, New York, USA., Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway., World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, New York, USA., Bureau of Cancer Epidemiology, New York State Department of Health, Albany, New York, USA., Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York, USA., Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA., Department of Epidemiology & Population Health, Division of Biostatistics, Albert Einstein College of Medicine, Bronx, New York, USA .