Long-term cancer trends among male Taiwanese farmers: an age-period-cohort analysis (2000-2023).
This nationwide Taiwanese observational study reports increasing overall cancer incidence among male farmers from 2000 to 2023, including significant increases in lung and lip cancers and a decrease in liver cancer.
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This nationwide Taiwanese observational study reports increasing overall cancer incidence among male farmers from 2000 to 2023, including significant increases in lung and lip cancers and a decrease in liver cancer.
Research significance
The evidence identifies population-level cancer trends but no intervention; it can only be hypothesized that identifying and reducing specific agricultural exposures could support prevention or targeted surveillance for lung and lip cancers among farmers.
Source abstract
PURPOSE: Male farmers are frequently exposed to various environmental and occupational hazards that may be related to cancer risk. Long-term cancer incidence trends in male farmers in Taiwan remain unclear. This study examined temporal trends in cancer incidence among male farmers over a 24-year period. METHODS: Using Taiwan's Longitudinal Health Insurance Database of Patients with Catastrophic Illnesses (2000-2023), we conducted a nationwide cohort study of agricultural workers whose aged 15-84 (N= 2,426,531). ICD-O-3 and the corresponding ICD-9-CM and ICD-10-CM codes from the Taiwan Cancer Registry Annual Report were used to identify annually incident cancer cases. Age-standardized incidence rates, age-standardized rate ratios, and age-standardized incidence ratios were calculated. A Joinpoint regression and age-period-cohort model were used to identify and examine temporal trends across the study period. RESULTS: Overall cancer incidence was higher among male farmers compared to the male general population, with an increasing temporal trend from 2000 to 2023. Lip and lung cancers showed a significantly increased annual average percentage change (AAPC) value, age effect, period effect, and cohort effect for the study period, while liver cancer showed a decreasing AAPC, period effect, and cohort effect, with an increasing age effect over the entire study period. CONCLUSION: This study provides evidence that lung and lip cancer incidence among male farmers increased significantly over the study period, while liver cancer decreased. As exposure varies by agricultural activity and farm type, further research is needed to identify specific exposures that are related to the higher risk of cancer in this population.