Abstract 1664P
Background
Sarcomas represent a rare, heterogeneous group of over 80 different tumors arising from mesenchymal or connective tissue. In 2019, soft-tissue sarcomas (STS) accounted for approximately 0.8% of all cancers and 0.9% of all cancer deaths in the United States. Due to the complexity and rarity of sarcomas, their etiology remains poorly understood. The objective of the present study was to systematically assess the association between various occupational exposures and risk of sarcomas.
Methods
A systematic literature search using the PubMed, Scopus and EMBASE databeses was performed to identify relevant cohort and case-control studies. A meta-analysis method was applied on the incidence and mortality outcomes, where the estimate with 95% confidence interval (CI) was obtained.
Results
A total of 59 publications were included in our study. For exposures to phenoxy herbicides and chlorophenols the pooled odds ratio (OR) for STS was 1.82 (95% CI: 1.17 – 2.84, p = 0.008), based on 2 128 cases among 15 studies, while the pooled standardized mortality ratio (SMR) was 40.93 (95% CI: 2.19 - 765.90, p = 0.013), based on 4 cohort studies, 59 289 participants. For exposure to vinyl chloride monomers (VCM) the pooled risk ratios (RR) for angiosarcoma of the liver (ASL) and STS were 19.23 and 2.23 respectively, based on 3 cohort studies, 12 816 participants. Exposure to dioxins was associated with STS mortality (pooled SMR = 2.56, 95 % CI: 1.60 - 4.10 p < 0.001), based on 4 cohort studies. Woodworking occupation was associated with an access risk of STS (pooled OR = 2.16, 95% CI: 1.39 - 3.36, p < 0.001).
Conclusions
Our findings suggest a statistically significant positive association between higher exposure to dioxins and increased mortality from STS; between cumulative exposure to VCM and increased mortality from ASL and STS; woodworking occupation and STS incidence. Notwithstanding the high heterogeneity of the studies, workers exposed to phenoxy herbicides and chlorophenols may experience an increased incidence of STS. Conducting new large case-control studies and extending follow-up of previously assembled cohort studies would be effective ways at reducing uncertainties and could provide more evidence on other risk factors reported in our study.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Anne Grand'Maison.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.