Prostate Cancer in Firemen: Early Diagnosis Because of Increased Diagnostic Pressure?

Study Overview
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Brief Summary
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Firefighters, police, military personnel and pilots are all shown to have a higher incidence of prostate cancer than the general population. A possible explanation for this is that these four groups of employees need regular mandatory health-checkups. If these checkups increase the chances of having a PSA or DRE performed one could expect the workers in question to have a higher probability than the general population of being diagnosed with prostate cancer. If this is the case the four groups should have cancers that are lower grade and have better survival. The investigators wish to examine this by comparing the four groups with a control group made up of all other workers with regards to prognostic factors at the time of diagnosis and survival rates. This will be done by extracting data from the Cancer Registry of Norway, coupled with employment data from Statistics Norway. This study is also a part of a project on cancer in firefighters. If the prostate cancers in firefighters differ significantly from the other three specified groups, this could point to an exposure specific for firefighters, e.g. fire smoke, as an etiologic factor.

Official Title
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Early Detection of Prostate Cancer in Firefighters - a Register-based Study of Prognostic Factors and Survival

Conditions
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Prostate Cancer

Intervention / Treatment
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* Other: None, observational study


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All cases of prostate cancer as registered by the Cancer Registry of Norway Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Firefighters<br> | Other: None, observational study<br>* None, observational study<br>|
| Pilots<br> | Other: None, observational study<br>* None, observational study<br>|
| Police<br> | Other: None, observational study<br>* None, observational study<br>|
| Military personnel<br> | Other: None, observational study<br>* None, observational study<br>|
| Controls<br>Control group matched for geographic location (county), and year of diagnosis. Consisting of all other workers than the four specified groups. | Other: None, observational study<br>* None, observational study<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cause-specific mortality rate for prostate cancer |  | From January 1st 1960 until December 31st 2018 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| TNM staging |  | January 1st 1960 until December 31st 2018 | 
| Gleason score | Score based on microscopic appearance of prostate cancer tissue. Sum of two scores, each ranging from 1-5 (only whole numbers), meaning the final score ranges from 2-10. A higher score is associated with a more aggressive/less differentiated tumor. It is normal to group scores 2-6 together in >7. It is also normal to differentiate between 7 (4+3) (worse), and 7 (3+4) (better). | January 1st 1960 until December 31st 2018 | 
| PSA at time of diagnosis |  | January 1st 1960 until December 31st 2018 | 
| Functional status at time of diagnosis (WHO classification) |  | January 1st 1960 until December 31st 2018 |