OCCUPATION AS A RISK IDENTIFIER FOR BREAST-CANCER

Objectives. Breast cancer mortality may be reduced if the disease is d etected early through targeted screening programs. Current screening g uidelines are based solely on a woman's age. Because working populatio ns are accessible for intervention, occupational identification may be a way of helping to define and locate risk groups and target preventi on. Methods. We used a database consisting of 2.9 million occupational ly coded death certificates collected from 23 states between 1979 and 1987 to calculate age-adjusted, race-specific proportionate mortality ratios for breast cancer according to occupation. We performed case-co ntrol analyses on occupational groups and on stratifications within th e teaching profession. Results. We found a number of significant assoc iations between occupation and frequency of breast cancer. For example , white female professional, managerial, and clerical workers all had high proportions of breast cancer death. High rates of breast cancer i n teachers were found in both proportionate mortality ratio and case-c ontrol analyses. Conclusions. These findings may serve as in an aid in the effective targeting of work-site health promotion programs. They suggest that occupationally coded mortality data can be a useful adjun ct in the difficult task of identifying groups at risk of preventable disease.