Factors Associated with Colorectal Cancer Prevalence Among Long-Haul Truck Drivers in the United States

Abstract

Purpose To determine the age-adjusted association between colorectal cancer (CRC) risk factors and CRC prevalence among long-haul truck drivers (aged 21–85), after adjustment for age. Design Pooled cross-sectional analysis using Commercial Driver Medical Exam (CDME) data. Setting. National survey data from January 1, 2005, to October 31, 2012. Participants 47,786 commercial motor vehicle drivers in 48 states. Measures CRC prevalence was the primary outcome; independent variables included demographics, body mass index (BMI), and concomitant medical conditions. Analysis Kruskal-Wallis tests to analyze continuous variables; Fischer’s exact tests to analyze categorical variables; univariate and multivariable logistic regression for rare events (Firth method) to quantify the association between the independent variables of interest and CRC prevalence. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for age, gender, years with current employer, year of exam, and BMI in a multivariate logistic regression. Results Many factors were statistically significant. Obesity (OR = 3.14; 95% CI = 1.03–9.61) and increasing age (OR = 1.10 per year; 95% CI = 1.07–1.13) were significantly associated with CRC prevalence. Truckers with 4 or more concomitant medical conditions were significantly more likely to have CRC (OR = 7.03; 95% CI = 1.83–27.03). Conclusions 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 in the United States estimated to live up to 16 years less than the general population.