Impact of healthcare services on thyroid cancer incidence among World Trade Center‐exposed rescue and recovery workers

2021 ◽  
Author(s):  
David G. Goldfarb ◽  
Hilary L. Colbeth ◽  
Molly Skerker ◽  
Mayris P. Webber ◽  
David J. Prezant ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Incidence ◽  
World Trade ◽  
World Trade Center ◽  
Healthcare Services ◽  
Trade Center ◽  
Thyroid Cancer Incidence

scholarly journals Molecular Study of Thyroid Cancer in World Trade Center Responders

2019 ◽  
Vol 16 (9) ◽  
pp. 1600 ◽  
Author(s):  
Maaike A. G. van Gerwen ◽  
Stephanie Tuminello ◽  
Gregory J. Riggins ◽  
Thais B. Mendes ◽  
Michael Donovan ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
World Trade ◽  
Diagnostic Yield ◽  
False Positive Rate ◽  
World Trade Center ◽  
Molecular Study ◽  
Positive Rate ◽  
Physician Bias ◽  
Trade Center ◽  
Thyroid Cancer Incidence

Thyroid cancer incidence is higher in World Trade Center (WTC) responders compared with the general population. It is unclear whether this excess in thyroid cancer is associated with WTC-related exposures or if instead there is an over-diagnosis of malignant thyroid cancer among WTC first responders due to enhanced surveillance and physician bias. To maximize diagnostic yield and determine the false positive rate for malignancy, the histological diagnoses of thyroid cancer tumors from WTC responders and age, gender, and histology matched non-WTC thyroid cancer cases were evaluated using biomarkers of malignancy. Using a highly accurate panel of four biomarkers that are able to distinguish benign from malignant thyroid cancer, our results suggest that over-diagnosis by virtue of misdiagnosis of a benign tumor as malignant does not explain the increased incidence of thyroid cancer observed in WTC responders. Therefore, rather than over-diagnosis due to physician bias, the yearly screening visits by the World Trade Center Health Program are identifying true cases of thyroid cancer. Continuing regular screening of this cohort is thus warranted.

scholarly journals Temporal Association of Cancer Incidence with World Trade Center Rescue/Recovery Work

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
David G. Goldfarb ◽  
Paolo Boffetta ◽  
Rachel Zeig-Owens ◽  
Dana Kristjansson ◽  
Jiehui Li ◽  
...  
Keyword(s):  
Cancer Incidence ◽  
World Trade ◽  
World Trade Center ◽  
Temporal Association ◽  
Trade Center

scholarly journals Increased Incidence of Thyroid Cancer among World Trade Center First Responders: A Descriptive Epidemiological Assessment

2019 ◽  
Vol 16 (7) ◽  
pp. 1258 ◽  
Author(s):  
Stephanie Tuminello ◽  
Maaike van Gerwen ◽  
Eric Genden ◽  
Michael Crane ◽  
Wil Lieberman-Cribbin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
World Trade ◽  
Past History ◽  
Demographic Data ◽  
World Trade Center ◽  
Medical Surveillance ◽  
Rescue Workers ◽  
History Of ◽  
Trade Center ◽  
Mount Sinai

An increased incidence of thyroid cancer among 9/11 rescue workers has been reported, the etiology of which remains unclear but which may, at least partly, be the result of the increased medical surveillance this group undergoes. This study aimed to investigate thyroid cancer in World Trade Center (WTC) responders by looking at the demographic data and questionnaire responses of thyroid cancer cases from the Mount Sinai WTC Health Program (WTCHP). WTCHP thyroid cancer tumors were of a similar size (p = 0.4), and were diagnosed at a similar age (p = 0.2) compared to a subset of thyroid cancer cases treated at Mount Sinai without WTC exposure. These results do not support the surveillance bias hypothesis, under which smaller tumors are expected to be diagnosed at earlier ages. WTCHP thyroid cancer cases also reported a past history of radiation exposure and a family history of thyroid conditions at lower rates than expected, with higher than expected rates of previous cancer diagnoses, family histories of other cancers, and high Body Mass Indexes (BMIs). Further research is needed to better understand the underlying risk factors that may play a role in the development of thyroid cancer in this group.

scholarly journals Ten-year cancer incidence in rescue/recovery workers and civilians exposed to the September 11, 2001 terrorist attacks on the World Trade Center

2016 ◽  
Vol 59 (9) ◽  
pp. 709-721 ◽  
Author(s):  
Jiehui Li ◽  
Robert M. Brackbill ◽  
Tim S. Liao ◽  
Baozhen Qiao ◽  
James E. Cone ◽  
...  
Keyword(s):  
Cancer Incidence ◽  
World Trade ◽  
World Trade Center ◽  
September 11 ◽  
Terrorist Attacks ◽  
The World ◽  
Trade Center

scholarly journals Cancer Incidence in World Trade Center Rescue and Recovery Workers: 14 Years of Follow-Up

2021 ◽  
Author(s):  
Jiehui Li ◽  
Janette Yung ◽  
Baozhen Qiao ◽  
Erin Takemoto ◽  
David G Goldfarb ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Cancer Incidence ◽  
World Trade ◽  
Cox Regression ◽  
World Trade Center ◽  
Cancer Registries ◽  
Increased Risk ◽  
Long Term Follow Up ◽  
Trade Center

Abstract Background Statistically significantly increased cancer incidence has been reported from 3 cohorts of World Trade Center (WTC) disaster rescue and recovery workers. We pooled data across these cohorts to address ongoing public concerns regarding cancer risk 14 years after WTC exposure. Methods From a combined deduplicated cohort of 69 102 WTC rescue and recovery workers, a sample of 57 402 workers enrolled before 2009 and followed through 2015 was studied. Invasive cancers diagnosed in 2002-2015 were identified from 13 state cancer registries. Standardized incidence ratios (SIRs) were used to assess cancer incidence. Adjusted hazard ratios (aHRs) were estimated from Cox regression to examine associations between WTC exposures and cancer risk. Results Of the 3611 incident cancers identified, 3236 were reported as first-time primary (FP) cancers, with an accumulated 649 724 and 624 620 person-years of follow-up, respectively. Incidence for combined FP cancers was below expectation (SIR = 0.96, 95% confidence interval [CI] = 0.93 to 0.99). Statistically significantly elevated SIRs were observed for melanoma-skin (SIR = 1.43, 95% CI = 1.24 to 1.64), prostate (SIR = 1.19, 95% CI = 1.11 to 1.26), thyroid (SIR = 1.81, 95% CI = 1.57 to 2.09), and tonsil (SIR = 1.40, 95% CI = 1.00 to 1.91) cancer. Those arriving on September 11 had statistically significantly higher aHRs than those arriving after September 17, 2001, for prostate (aHR = 1.61, 95% CI = 1.33 to 1.95) and thyroid (aHR = 1.77, 95% CI = 1.11 to 2.81) cancers, with a statistically significant exposure-response trend for both. Conclusions In the largest cohort of 9/11 rescue and recovery workers ever studied, overall cancer incidence was lower than expected, and intensity of WTC exposure was associated with increased risk for specific cancer sites, demonstrating the value of long-term follow-up studies after environmental disasters.

scholarly journals Cancer incidence in World Trade Center-exposed and non-exposed male firefighters, as compared with the US adult male population: 2001–2016

2021 ◽  
pp. oemed-2021-107570
Author(s):  
Mayris P Webber ◽  
Ankura Singh ◽  
Rachel Zeig-Owens ◽  
Joke Salako ◽  
Molly Skerker ◽  
...  
Keyword(s):  
New York ◽  
Cancer Incidence ◽  
World Trade ◽  
World Trade Center ◽  
Fire Department ◽  
Cancer Registries ◽  
Smoking History ◽  
Health Study ◽  
Male Population ◽  
Trade Center

ObjectiveTo compare cancer incidence in Fire Department of the City of New York (FDNY) firefighters who worked at the World Trade Center (WTC) site to incidence in a population of non-WTC-exposed firefighters, the Career Firefighter Health Study (CFHS) cohort, and to compare rates from each firefighter cohort to rates in demographically similar US males.MethodsFDNY (N=10 786) and CFHS (N=8813) cohorts included male firefighters who were active on 11 September 2001 (9/11) and were followed until death or 31 December 2016. Cases were identified from 15 state cancer registries. Poisson regression models assessed cancers in each group (FDNY and CFHS) versus US males, and associations between group and cancer rates; these models estimated standardised incidence ratios (SIRs) and adjusted relative rates (RRs), respectively. Secondary analyses assessed surveillance bias and smoking history.ResultsWe identified 915 cancer cases in 841 FDNY firefighters and 1002 cases in 909 CFHS firefighters. FDNY had: higher rates for all cancers (RR=1.13; 95% CI 1.02 to 1.25), prostate (RR=1.39; 95% CI 1.19 to 1.63) and thyroid cancer (RR=2.53; 95% CI 1.37 to 4.70); younger median ages at diagnosis (55.6 vs 59.4; p<0.001, all cancers); and more cases with localised disease when compared with CFHS. Compared with US males, both firefighter cohorts had elevated SIRs for prostate cancer and melanoma. Control for surveillance bias in FDNY reduced most differences.ConclusionsExcess cancers occurred in WTC-exposed firefighters relative to each comparison group, which may partially be explained by heightened surveillance. Two decades post-9/11, clearer understanding of WTC-related risk requires extended follow-up and modelling studies (laboratory or animal based) to identify workplace exposures in all firefighters.

scholarly journals Cancer Incidence in World Trade Center Rescue and Recovery Workers, 2001–2008

2013 ◽  
Vol 121 (6) ◽  
pp. 699-704 ◽  
Author(s):  
Samara Solan ◽  
Sylvan Wallenstein ◽  
Moshe Shapiro ◽  
Susan L. Teitelbaum ◽  
Lori Stevenson ◽  
...  
Keyword(s):  
Cancer Incidence ◽  
World Trade ◽  
World Trade Center ◽  
Trade Center

scholarly journals Cancer in General Responders Participating in World Trade Center Health Programs, 2003–2013

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Moshe Z Shapiro ◽  
Sylvan R Wallenstein ◽  
Christopher R Dasaro ◽  
Roberto G Lucchini ◽  
Henry S Sacks ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Incidence ◽  
World Trade ◽  
Health Program ◽  
World Trade Center ◽  
September 11 ◽  
Cox Proportional Hazards ◽  
Cancer Case ◽  
Trade Center

Abstract Background Following the September 11, 2001, attacks on the World Trade Center (WTC), thousands of workers were exposed to an array of toxins known to cause adverse health effects, including cancer. This study evaluates cancer incidence in the WTC Health Program General Responder Cohort occurring within 12 years post exposure. Methods The study population consisted of 28 729 members of the General Responder Cohort enrolled from cohort inception, July 2002 to December 31, 2013. Standardized incidence ratios (SIRs) were calculated with cancer case inclusion and follow-up starting post September 11, 2001 (unrestricted) and, alternatively, to account for selection bias, with case inclusion and follow-up starting 6 months after enrollment in the WTC Health Program (restricted). Case ascertainment was based on linkage with six state cancer registries. Under the restricted criterion, hazard ratios were estimated using multivariable Cox proportional hazards models for all cancer sites combined and for prostate cancer. Results Restricted analyses identified 1072 cancers in 999 responders, with elevations in cancer incidence for all cancer sites combined (SIR = 1.09, 95% confidence interval [CI] = 1.02 to 1.16), prostate cancer (SIR = 1.25, 95% CI = 1.11 to 1.40), thyroid cancer (SIR = 2.19, 95% CI = 1.71 to 2.75), and leukemia (SIR = 1.41, 95% CI = 1.01 to 1.92). Cancer incidence was not associated with any WTC exposure index (composite or individual) for all cancer sites combined or for prostate cancer. Conclusion Our analyses show statistically significant elevations in cancer incidence for all cancer sites combined and for prostate and thyroid cancers and leukemia. Multivariable analyses show no association with magnitude or type of exposure.

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