Abstract
A retrospective cross-sectional analysis using Commercial Driver Medical Exam (CDME) data was performed to determine the association between colorectal cancer (CRC) risk factors and CRC incidence among long-haul truck drivers (ages 21-85), after adjustment for age. Our hypothesis was that long-haul truck drivers with poor health have a higher prevalence of CRC due to the confluence of CRC risk factors experienced by this population after adjusting for age. CRC is a common and deadly malignancy with several known risk factors, including heavy alcohol use, obesity, high consumption of processed and red meat, sedentary lifestyle, and tobacco use. Long-haul truck drivers have a high prevalence of the abovementioned risk factors, yet CRC risk has not been studied in this group. Given the reported risk factors associated with the truck driving occupation married to the lack of health literature and, a need remains to extensively examine the health of long-haul truck drivers. National survey data from January 1, 2005, to October 31, 2012, among commercial motor vehicle drivers in 48 states were examined. The CDME does not have a specific question about CRC diagnosis, text recognition was used to identify specific terms in the CDME notes and comments. Next, the entire CDME was reviewed by two researchers to determine definite versus probable CRC diagnosis, blinded to all other data. Our team also identified 311 records by searching for the following terms: colon, rectum, cancer, colorectal, CRC, and polyp. To achieve the study purpose, Kruskal-Wallis tests were employed to analyze continuous variables and Fischer's exact tests to analyze categorical variables. CRC incidence was the primary outcome, while our independent variables included demographics, body mass index, along with concomitant medication conditions verified by a medical examiner. Univariate and multivariable logistic regression was utilized to quantify the magnitude and direction of the association between our independent variables of interest and CRC incidence. Odds ratio (OR) and 95% confidence intervals (95% CI) were adjusted for age, gender, years of employment with the company, and Body Mass Index in a multivariate logistic regression. Obesity (OR=4.28; 95% CI=1.28-14.29) and increasing age (OR=1.09; 95% CI=1.06-1.12) were significantly associated with CRC incidence. Additionally, truckers with 4+ concomitant medical conditions were more likely to have CRC (OR=5.58; 95% CI=1.26 – 24.75). Despite a growing body of literature ascertaining the health of truck drivers and risk factors associated with truck driving as an occupation, knowledge gaps remain, and inadequate data is available on this population for CRC. Our findings highlight mutable risk factors and represent an opportunity for intervention that may decrease CRC morbidity and mortality among truck drivers—a unique population estimated to live up to 16 years less than the general male population.
Citation Format: Jasmine A. Lopez, Ethan M. Petersen, Folasade P. May, Ellen Brooks, Matthew S. Thiese, Carson D. Kennedy, Charles R. Rogers. Investigating factors associated with colorectal cancer incidence among long-haul truck drivers in the United States [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-184.