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Cancer survival among World Trade Center rescue and recovery workers: A collaborative cohort study.
- Source :
-
American journal of industrial medicine [Am J Ind Med] 2021 Oct; Vol. 64 (10), pp. 815-826. Date of Electronic Publication: 2021 Jul 19. - Publication Year :
- 2021
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Abstract
- Background: World Trade Center (WTC)-exposed responders may be eligible to receive no-cost medical monitoring and treatment for certified conditions, including cancer. The survival of responders with cancer has not previously been investigated.<br />Methods: This study compared the estimated relative survival of WTC-exposed responders who developed cancer while enrolled in two WTC medical monitoring and treatment programs in New York City (WTC-MMTP responders) and WTC-exposed responders not enrolled (WTC-non-MMTP responders) to non-responders from New York State (NYS-non-responders), all restricted to the 11-southernmost NYS counties, where most responders resided. Parametric survival models estimated cancer-specific and all-cause mortality. Follow-up ended at death or on December 31, 2016.<br />Results: From January 1, 2005 to December 31, 2016, there were 2,037 cancer cases and 303 deaths (248 cancer-related deaths) among WTC-MMTP responders, 564 cancer cases, and 143 deaths (106 cancer-related deaths) among WTC-non-MMTP responders, and 574,075 cancer cases and 224,040 deaths (158,645 cancer-related deaths) among the NYS-non-responder population. Comparing WTC-MMTP responders with NYS-non-responders, the cancer-specific mortality hazard ratio (HR) was 0.72 (95% confidence interval [CI] = 0.64-0.82), and all-cause mortality HR was 0.64 (95% CI = 0.58-0.72). The cancer-specific HR was 0.94 (95% CI = 0.78-1.14), and all-cause mortality HR was 0.93 (95% CI = 0.79-1.10) comparing WTC-non-MMTP responders to the NYS-non-responder population.<br />Conclusions: WTC-MMTP responders had lower mortality compared with NYS-non-responders, after controlling for demographic factors and temporal trends. There may be survival benefits from no-out-of-pocket-cost medical care which could have important implications for healthcare policy, however, other occupational and socioeconomic factors could have contributed to some of the observed survival advantage.<br /> (© 2021 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals LLC.)
Details
- Language :
- English
- ISSN :
- 1097-0274
- Volume :
- 64
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- American journal of industrial medicine
- Publication Type :
- Academic Journal
- Accession number :
- 34288025
- Full Text :
- https://doi.org/10.1002/ajim.23278