Modifiable risk factors and cancer mortality in transport, rescue, and security industries

Purpose: We investigated the risk of mortality from cancers attributable to modifiable risk factors across representative transport, rescue, and security industries. Methods: We used nationwide Danish registries to identify all 307,605 workers from these industries from 2001 through 2015 and 2,278,363 other economically active individuals aged 18–64 years at the baseline for comparison. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) for site-specific cancer deaths were calculated using Cox regression. Site-specific cancers were categorized by using population-attributable fraction (PAF) estimates derived from the previous literature. Results: During an average follow-up of 12.8 years, 5977 cancer deaths were registered in these industries. Cancer mortality with a high proportion of avoidable deaths (i.e., high PAF) was elevated in male seafarers (1.37; 1.16–1.62), in men of land transport (1.44; 1.35–1.52), in women of land transport (1.51; 1.29–1.77), and in women of defense forces (1.43; 1.13–1.81). In contrast, cancer mortality with a high PAF was reduced in men of police force (0.63; 0.51–0.78). The total cancer mortality was higher in seafarers (1.24; 1.12–1.37), workers in land transport (1.31; 1.27–1.36), and workers in defense forces (1.14; 1.07–1.22). Conclusions: We observed considerable cancer mortality disparities associated with modifiable risk factors across transport, rescue, and security industries.