Browsing by Author "Rahkonen, Ossi"

The trends in incidence of lung cancer in never smokers are unclear as well as the significance of risk factors. We studied time trends in the incidence and risk factors of lung cancer in never smokers in Finland in a large, pooled cohort. We pooled data from seven Finnish health cohorts from the period between 1972 and 2015 with 106 193 never smokers. The harmonized risk factors included education, alcohol consumption, physical activity, height, and BMI. We retrieved incident lung cancers from the nation-wide Finnish Cancer Registry. We estimated average annual percent change (AAPC) and the effects of risk factors on cause-specific hazard ratios (HRs) of lung cancer using Poisson regression. We detected 47 lung cancers in never smoking men (n=31 859) and 155 in never smoking women (n=74 334). The AAPC of lung cancer incidence was -3.30% (95% confidence interval (CI): -5.68% - -0.88%, p=0.009) in never smoking men and 0.00% (95% CI: -1.57%-1.60%, p=0.996) in never smoking women. Of the five studied risk factors only greater height in women had a statistically significant increased risk of lung cancer (multivariate HR=1.84, 95%CI: 1.08-3.12). It is plausible that tobacco control measures focused on working places have reduced passive smoking among men more than among women, which could explain the declining trend in lung cancer incidence in never smoker men but not in never smoker women. As tobacco control measures have not been targeted to domestic environments, it is likely that women’s exposure to passive smoking has continued longer.

Background: Breast cancer is the most common cancer among women in Western countries, invariably worsening ability to work. High occupational class is associated with higher breast cancer incidence but better survival, however, little is known about occupational class differences in breast cancer related sickness absence over time. Therefore, we aimed to examine occupational class differences in the incidence and duration of long-term sickness absence due to breast cancer over time. Methods: A nationally representative 70-per-cent random sample of Finnish women aged 35–64 in 2004–2012 (annual n=499,778–519,318) was linked to register data on over 10-days long medically certified sickness absence due to breast cancer (ICD-10 code C50) in 2005–2013. This study focused on employed women, including upper non-manual employees (n=111,127–128,905), lower non-manual employees (n=270,426–287,016) and manual workers (n=98,067–118,731). The class differences were analysed by calculating age-adjusted cumulative incidence and duration of absence due to breast cancer annually over the period 2005–2013. Results: Throughout the study period, the annual cumulative incidence was highest among upper non-manuals (314–384 per 100,000 persons) and lowest among manual workers (208–268 per 100,000 persons). In contrast, the annual duration of absence was inversely associated with occupational class, with manual workers having the longest (150–173 days) and upper non-manuals the shortest (114–140 days) duration of absence throughout. Occupational class differences in sickness absence due to breast cancer remained broadly stable over time. Conclusions: Employees in lower occupational classes had lower cumulative incidence but longer duration of sickness absence due to breast cancer compared to those in higher occupational classes. Attention should be paid to promotion of work capacity among employees with breast cancer in lower occupational classes.