Associations between occupations and the occurrence of sarcomas: results of the French population-based case-control study ETIOSARC

Objective Sarcomas are rare tumors of connective tissue that can develop in soft-tissue, viscera organs, or bones. Previous occupational studies have mainly focused on men and soft-tissue sarcomas. This study describes associations between occupations and sarcomas, in men and women, for soft-tissue sarcomas (STS), including visceral sarcomas, and bone sarcomas (BS). Methods The ETIOSARC study was a multicenter case-control study conducted across six French geographical areas between 2019 and 2023. Occupational histories were collected by interview and coded according to the International Standard Classification of Occupations (2008). Conditional logistic regression models were applied to estimate odds ratios with 90% confidence intervals for each occupation included in the study. Results A total of 374 male cases (336 STS and 38 BS), 371 female cases (335 STS and 36 BS), and 1,387 controls were included. Positive associations were observed among male STS for painters (OR=5.37, 90% CI=1.83-15.71), waiters (OR=4.54, 90% CI=1.88-10.97), and among male BS for electricians (OR=3.67, 90% CI=0.91-14.86). Among women, increased STS risk was found among real estate agents (OR=3.48, 90% CI=1.03-11.79), food preparation assistants (OR=3.47, 90% CI=1.09-11.04), and administrative and executive secretaries (OR=2.37, 90% CI=1.45-3.86). For BS, a higher risk was observed among sales workers (OR=5.61, 90% CI=1.65-18.99). Conclusions Our study highlights hitherto unreported occupational associations with sarcomas, among both men and women, as well as the importance of sex-stratified analyses. Further research should aim to confirm these results and disentangle the respective roles of occupational exposures, environmental factors, and lifestyle characteristics.