Occupational and environmental epidemiology specialists from the National Cancer Institute have raised concerns regarding the limited representation of women and outdated research approaches in workplace cancer studies; factors leading to missed opportunities in identifying risk factors for female-specific cancers and evaluating sex-specific differences in risk.
The specialists focus on findings highlighted in the University of Montreal study into occupations with an elevated risk of ovarian cancer.
They emphasize the limited understanding of occupational causes of ovarian and other cancers in women. Currently, only asbestos is recognized as an established occupational carcinogen for ovarian cancer, and there has been little progress in identifying other occupational risk factors in the past decade.
A review by the International Agency for Research on Cancer (IARC) in 2018 identified 47 occupational agents that were proven to cause cancer in humans. However, in a more recent summary, only a few agents were found to have sufficient evidence for causing breast and female reproductive system cancers.
The IARC has not identified any occupational risk factors for uterine or cervical cancer. Moreover, few occupational studies have sufficient power to examine sex-specific risks for cancers that are not gender-specific.
The Montreal study faced several challenges commonly encountered in studying occupational cancer risks among women in population-based studies. These include small study sizes, low exposure prevalence, exposure metrics based on observations from both men and women, and correlated exposures.
The study's results are seen as generating hypotheses, but they were unable to narrow down the list of potential causative agents. This highlights the need for improvement in studying women's occupational risks.
To address these issues, studies of occupational cancer among women should employ approaches that minimize exposure misclassification. Treating men and women the same in terms of exposure may mask potential risk factors. It is important to recognize that women may perform different tasks for different durations even within the same jobs. Relying solely on job titles, such as using job-exposure matrices, may not capture important gender differences in tasks and exposure.
Read the paper: Identifying occupational risk factors for cancer in women: a need for further action, here