Risk factors of cancer among the working population in China: baseline findings of WECAN project

Background: Global cancer burden is growing rapidly, and the risk of cancer significantly increases in aged 40 and above, primarily the working population. This study aims to assess the status quo of cancer risk factors among the working population to develop targeted intervention strategies for workplace cancer prevention. Methods: We utilized the baseline data of a randomized controlled trial “Comprehensive Workplace Intervention for Cancer Prevention in China (WECAN)” to conduct the cross-sectional analysis. 937 employees from three cities in China were surveyed on demographics, lifestyle, exposures, disease history, cancer family history, women's reproductive history, and anthropometrics. Findings: The mean age was 40.4±8.9 years and 61.1% were males. 57.2% were blue-collars (from production workshops), while 42.8% were white-collars (from offices). The proportions of participants with junior high school or below, high school, junior college, and bachelor's degree or higher were 13.1%, 20.9%, 31.0%, and 35.0%, respectively. Overall smoking rate is 37.7%, with significantly higher rates among aged 40 and above (42.8% versus 32.1%, p<0.0001), males (59.2% versus 3.9%, p<0.0001), blue-collars (45.9% versus 26.7%, p<0.0001). Smoking rates notably increased as educational levels decreased (p<0.0001). Overall alcohol consumption rate was 62.9%, with an average alcohol intake of 12.7±20.4 g/day. Males reported a higher rate (74.7% versus 44.2%, p<0.0001) and alcohol intake (15.9±22.1 g/day versus 4.4±11.6 g/day, p<0.0001). Employees aged 40 or older consumed more alcohol (15.2±22.9 g/day versus 10.1±17.0 g/day, p=0.0020). As educational levels rose, drinking rate significantly increased (p<0.0001), while alcohol intake substantially reduced (p=0.0012). The proportion of employees who achieved 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week was 51.9% and the average amount was 1740.2±2390.1 Mets·min. Overweight (BMI=24∼27.9 kg/m2) and obesity (BMI≥28 kg/m2) rates were 36.0% and 23.9%, with males significantly higher (40.1% versus 29.4%, 28.6% versus 16.5%, p<0.0001). Obesity increased with lower education (p=0.0007). Central obesity affected 56.0%, particularly males (66.8% versus 39.0%, p<0.0001), blue-collars (61.8% versus 48.4%, p<0.0001), aged 40 or older (61.7% versus 49.8%, p=0.0002), and lower education (p<0.0001). Daily average dietary intakes were: whole grains 48.0±80.2 g, tubers 37.8±47.3 g, vegetables 284.2±209.3 g, fruits 127.0±126.2 g, red meat 129.2±99.0 g, and processed meat 7.5±15.9 g. Males (98.4±104.2 g versus 172.0±143.6 g, p<0.0001), blue-collars (114.3±112.5 g versus 144.0±140.7 g, p=0.0005) consumed less fruits. Males (140.9±106.2 g vs 110.6±83.5 g, p<0.0001) and aged under 40 (141.2±113.7 g versus 118.2±82.2 g, p=0.0005) ate more red meat. Hepatitis B virus and helicobacter pylori virus infection rates were 3.7% and 9.8%, while the reported hepatitis B vaccination rate was 70.2%. 38.0% of the population had an exposure history to occupational hazards. Women with breastfeeding history averaged 11.0±5.5 months of cumulative breastfeeding. The cervical cancer vaccination rate is 26.7%. Interpretation: The situation regarding cancer risk factors among working populations is severe, with high smoking and drinking rate, lack of physical activity, overweight/obesity, unhealthy diet and low vaccination rates for cervical cancer and hepatitis B. Significant disparities across demographic groups were found. These findings highlight areas for cancer prevention through targeted approaches in the workplace.