No doubt you are aware that many toxic substances are associated with higher cancer risk, and when there’s definite evidence of causing cancer, they are called carcinogens. For example, several national and international bodies have linked Agent Orange with prostate cancer (PCa) and numerous other cancers or cancer precursors.

However, there are studies that suggest increased risk for PCa may actually be an occupational hazard of certain occupations or industries. Some of them involve obvious exposure to harmful substances, but in others it’s less clear what it is about a man’s job that places him in the path of PCa.

A large case-controlled study of occupations and PCa was conducted by a team of researchers connected with five Canadian research centers. Their paper, “Occupation and risk of prostate cancer in Canadian men: A case-control study across eight Canadian provinces,” was published in Cancer Epidemiology in 2017.^[i] The scope of their exploration into the role of occupation and PCa risk was impressive.

They utilized data from the National Enhanced Cancer Surveillance System which covered eight Canadian provinces from 1994-97. Included in the 1737 records of those diagnosed with any cancer during that period were their lifetime occupational histories. Also included were 1803 controls (no cancer history) with their work histories as well. The team was able to group individuals by occupation and industry employment. Here is a list of occupations with observed elevated PCa chances:

• Farming/farm management
• Armed forces
• Office work (with 10 or more years of employment)
• Plumbing (with 10 or more years of employment)
• Forestry/logging industry

A second large-scale analysis was published two years later. Titled “Original quantitative research Prostate cancer risk by occupation in the Occupational Disease Surveillance System (ODSS) in Ontario, Canada”, the authors accessed data on over a million male workers in Ontario from 1983-2015.^[ii] The records included workers’ compensation claims that were linked to administrative health databases. Specifically, they identified 34,997 cases of PCa, and again the patients’ occupational histories were available. Increased PCa risk was observed in the following jobs:

• Management/administration
• Teaching
• Transportation
• Construction
• Firefighting
• Police work

Findings for farming and clerical work were not consistent.

Both studies call for further research, but it’s worth noting that the results have PCa screening implications for workers in any of these jobs. According to the authors of the 2019 paper, “Routine prostate cancer screening is not recommended in Canada, but there are screening related factors that may influence screening behaviours in men.”^[iii] I believe that occupational risks are indeed a factor warranting screening. Based on these studies, I recommend that workers in the identified jobs be diligent about screening for PCa on a regular basis. This is especially important because many of these jobs have no evident exposure to carcinogens. While the most commonly known risk factors for PCa (e.g., family history, obesity, unhealthy diet, etc.) are evenly distributed across all occupations, the authors point out that some occupations involve particular exposure to factors that have been inconsistently linked to cancer: sedentary behaviour, psychological stress, and shift work.

Early PCa detection offers the highest probability of successful treatment. Today’s minimal-to-noninvasive treatment options not only greatly minimize side effects but also offer cancer control results competitive with standard whole gland treatments like radical prostatectomy and radiation.

PSA screening should not be avoided due to fear that a suspicious result will automatically lead to a conventional biopsy. The overwhelming body of current literature affirms that an abnormally high or rising PSA blood test should be followed by a 3T multiparametric MRI of the prostate before rushing to biopsy. To paraphrase age-old wisdom, an ounce of early detection is worth a pound of treatment.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

References

[i] Sritharan J, Demers PA, Harris SA, Cole DC, Peters CE; Canadian Cancer Registries Epidemiology Research Group;
Villeneuve PJ. Occupation and risk of prostate cancer in Canadian men: A case-control study across eight Canadian provinces. Cancer Epidemiol. 2017 Jun;48:96-103.
[ii] Sritharan J, MacLeod JS, McLeod CB, Peter A, Demers PA. Prostate cancer risk by occupation in the Occupational Disease Surveillance System (ODSS) in Ontario, Canada. Health Promot Chronic Dis Prev Can. 2019 May;39(5):178-
186.
[iii] Ibid.