Occupational risk factors for endometrial cancer among textile workers in Shanghai, China

Objective A case-cohort study was conducted to investigate associations between occupational exposures and endometrial cancer nested within a large cohort of textile workers in Shanghai, China. Methods The study included 176 incident endometrial cancer cases diagnosed from 1989 to 1998 and a randomly-selected age-stratified reference subcohort (n=3,061). Study subjects' complete work histories were linked to a job-exposure matrix developed specifically for the textile industry to assess occupational exposures. Hazard ratios (HR) and 95% confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design, adjusting for age at menarche and a composite variable of gravidity and parity. Results An increased risk of endometrial cancer was detected among women who had worked for >= 10 years in silk production (HR = 3.8, 95% CI 1.2-11.8) and had exposure to silk dust (HR =1.7,95% CI 0.9-3.4). Albeit with few exposed women (two cases and eight subcohort women), there was a 7.4 fold increased risk associated with >= 10 years of silica dust exposure (95% CI 1.4-39.7). Conclusions The findings suggest that some textile industry exposures might play a role in endometrial carcinoma and should be further replicated in other occupational settings.