Assessing geographic and industry-related trends in bladder cancer in Ontario: A population-based study

Authors

  • Leandra Stringer Division of Urology, Western University, London, ON, Canada
  • Tina Luu Ly Department of Sociology, Western University, London, Ontario, Canada.
  • Nicolas Vanin Moreno Schulich School of Medicine & Dentistry
  • Christopher Macdonald Hewitt Department of Sociology, Western University, London, Ontario, Canada.
  • Michael Haan Department of Sociology, Western University, London, Ontario, Canada.
  • Nicholas Power Division of Urology, Western University, London, ON, Canada

DOI:

https://doi.org/10.5489/cuaj.7263

Keywords:

Urology, Oncology, bladder cancer, population based study, environmental exposures, occupational exposures, epidemiology

Abstract

Introduction: Bladder cancer (BC) is the fifth most prevalent cancer in Canada, with 9000 Canadians diagnosed each year. While smoking is the most important risk factor, environmental and occupational carcinogens have been found to significantly contribute to BC rates. As Canada is highly reliant on natural resource industries, this study seeks to identify geographical and industry-related trends of BC rates in Ontario.

Methods: The 1991 and 2001 Canadian Census Health and Environment Cohort (CanCHEC; Statistics Canada) was used, along with individual years of census data. Maps identifying hot and cold spots for BC within Ontario were generated, and the former were assessed for industry patterns between location and BC rates. Cox proportional hazards models were run for each age cohort to predict the likelihood of developing BC by industry of work.

Results: Significant geographical and industrial trends in BC rates were identified. For 1991–2001, hot spots included the Cochrane, Manitoulin, Parry Sound, and Sudbury (90% confidence interval [CI]), and Nipissing and Temiskaming (95% CI) regions. Toronto and York were cold spots. Concurrently, metal (p=0.039), paper and publishing (p=0.0062), and wood and furniture (p<0.0001) industries had increased rates of BC. Notably, these industries had high employment density in our hot spot areas and low density in our cold spots.

Conclusions: Significant geographical and industrial BC trends were found in Northern Ontario regions reliant on heavy employment in natural resource-based industries, such as forestry, agriculture, and wood/paper. These findings may inform future screening guidelines and aid in identifying individuals at risk of BC development.

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Author Biographies

Leandra Stringer, Division of Urology, Western University, London, ON, Canada

Dr. Leandra Stringer: Resident, Division of Urology, Western University. BHSc Physician assistant, MD.

Tina Luu Ly, Department of Sociology, Western University, London, Ontario, Canada.

Tina Luu Ly: Department of Sociology, Western University. MA

Nicolas Vanin Moreno, Schulich School of Medicine & Dentistry

Nicolas Vanin Moreno: Medicine, Western University. BMSc.

Christopher Macdonald Hewitt, Department of Sociology, Western University, London, Ontario, Canada.

Dr. Christopher Hewitt: Department of Sociology, Western University. PhD.

Michael Haan, Department of Sociology, Western University, London, Ontario, Canada.

Dr. Michael Haan: Department of Sociology, Western University. PhD.

Nicholas Power, Division of Urology, Western University, London, ON, Canada

Dr. Nicholas Power: Division of Urology, Western University. MD, FRCSC

Published

2021-09-24

How to Cite

Stringer, L., Ly, T. L., Vanin Moreno, N., Hewitt, C. M., Haan, M., & Power, N. (2021). Assessing geographic and industry-related trends in bladder cancer in Ontario: A population-based study. Canadian Urological Association Journal, 16(2), E82–7. https://doi.org/10.5489/cuaj.7263

Issue

Section

Original Research