Perceived Physical Strain at Work and Incidence of Prostate Cancer – a Case-Control Study in Sweden and Finland

Document Type: Research Articles

Authors

1 Faculty of Social Sciences, University of Tampere, Tampere, Finland.

2 Tampere University Hospital, Department of Oncology, Tampere, Finland.

3 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

4 Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.

5 Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.

6 Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.

7 Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.

Abstract

The evidence that prostate cancer is associated to physical inactivity is inconsistent. We studied the association of
perceived physical workload (PPWL) at work and incidence of prostate cancer in a case-control setting. We used data
from the Nordic Occupational Cancer study from Finland and Sweden. Five population controls were selected for
each prostate cancer patient, matched on age and country. We had 239,835 cases and 1,199,175 controls in our study.
For each case and control we estimated cumulative PPWL based on probability, level and duration of PPWL using
the NOCCA Job Exposure Matrix. We then stratified individuals as having no exposure (reference category), low
physical activity (below 50th percentile of the exposed), moderate exposure (50th-90th percentile) and high exposure
(90th percentile and higher). The hazard ratios for prostate cancer from the lowest to highest cumulative PPWL levels
were 0.90 (95% confidence interval 0.89-0.91), 0.88 (0.87-0.89) and 0.93 (0.92-0.95). There was no statistically
significant dose response effect of PPWL on prostate cancer incidence. Inclusion of socioeconomic status in the model
did not substantially change the result. The results were similar before Prostate Specific Antigen (PSA) testing and
during the years of PSA testing in these countries. In summary, individuals with physical strain at work had a lower
risk of invasive prostate cancer as compared to individuals without physical strain at work.

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