As mortality from certain cancers has been rising amongst high-income countries, researchers are beginning to ask if someone’s job may be a risk factor.
A new study published January 2026 in The Lancet Oncology looked at nearly a half million cancer deaths that occurred between 2020-2023 among working-age adults in the U.S. by occupation. The multi-institution team, including researchers at Ohio State University and the University of Washington, generated thousands of age-adjusted cancer mortality rates by sex and more than 400 occupations. The results provide a valuable look into variation and trends in cancer burden by occupation, and signal the need for future research to understand causes and eventually inspire interventions.
“This is further evidence that not all occupations are created equal, and that it seems some occupations are going to put people at an increased risk of cancer,” said Marissa Baker, UW associate professor of environmental and occupational health sciences and study co-author. “Despite the fact that occupation is such an important contributor to the burden of cancer in the U.S., it's really de-emphasized in how we prevent and treat disease."
When considering occupation as broader categories, results were similar to other studies in that the highest overall cancer mortality rate for males was in the construction sector, and the highest mortality rate for females was in the transportation sector.
When looking at overall cancer death rates by detailed occupation and individual sex, the five occupations with the highest age-adjusted cancer mortality rates were:
Males: Agricultural and food scientists; fishing and hunting workers; surveyors, cartographers, and photogrammetrists; extraction workers; and structural metal fabricators and fitters.
Females: First-line supervisors of landscaping, lawn service, and groundskeeping workers; funeral directors; first-line supervisors of housekeeping and janitorial workers; fishing and hunting workers; and artists and related workers.
Across both sexes, the highest overall mortality rates were: fishing and hunting workers; mining machine operators; funeral directors; animal trainers; and dietitians and nutritionists.
While the carcinogens that cause cancer are well known in some industries, such as silica dust and formaldehyde in construction, these new findings suggest there may be other types of exposure or risk associated with a broader range of occupations.
Researchers said that just because an occupation has a high cancer mortality rate does not necessarily mean a workplace carcinogen is the only cause. These high rates could be due to other factors, such as lack of access to cancer-related care, inability to obtain life-saving cancer screenings and treatments, and interactions between workplace and lifestyle exposures.
“All those things can lead to the mortality burden that we see,” said Jesse Plascak, OSU associate professor of cancer prevention and control. “Once drivers of occupation-related burden in cancer mortality are known, interventions can be developed to remove identified barriers to living a long and fulfilling life following a cancer diagnosis.”
While the research does not show the causes of cancer, these connections can help form future research questions. For example, female nursing and home health aides had notably high rates of cancer mortality for most cancer types in this study. Based on these trends and other studies, the team suggested various hypotheses for this, including limited regulations in individual households leading to greater exposure to carcinogens, reduced health care access, or lower socioeconomic status.
The team also found that for some occupations, the cancer mortality rate was markedly different by sex. For example, female CEOs and legislators had a high cancer mortality rate (95 deaths per 100,000 workers), whereas their male counterparts had a lower rate (53 deaths per 100,000 workers).
The researchers hypothesized one possible explanation could be the hormone-based cancer risk associated with nulliparity, or not having given birth to children. High-powered and time intensive jobs that don’t provide support for new mothers may lead women who wish to have children to delay or forgo pregnancy. Recent fertility rates by broad occupation categories and age from the US Census shows that women who are 20-50 years old and within ‘Management, business, and financial’ occupations (of which CEOs and legislators are part) had some of the lowest fertility rates in 2022.
The details in this research will also allow for more tailored interventions. For example, while construction industries are known to have more exposure to carcinogens, certain construction occupations did not have a high risk of cancer mortality. These findings can allow people to fine-tune interventions for specific occupations rather than making blanket changes to a large category of jobs.
This is a mere snapshot of some of the findings. Researchers sifted through more than 400 detailed occupations and 22 types of cancer to understand mortality trends by sex and occupation. They’ve made these data points openly accessible on their GitHub site for further exploration.
“Having these high-quality data systems where we can capture the nuance in something like detailed occupation is so critical for us to understand the problem better,” Plascak said.
While past research has linked broad occupational categories with cancer, this is the first research to provide such granular detail by job category. This is because the U.S. began systematically recording occupation on death certificates and making those data available in official vital statistics records. Researchers used the Mortality Multiple Cause of Death data from the U.S. National Center for Health Statistics and the National Vital Statistics System for this study.
Because the data is limited to working-age adults, it doesn't include deaths from those who are retired. It also cannot catch the nuances of people moving jobs from one that may have been a contributor to their cancer. For example, a construction worker who develops lung cancer may switch to a less aerobic career in response to their health, but a death record will only list the individual’s current job.
Some people may wonder why there are still high cancer rates in occupations where there are workplace safety laws. Baker shared that these laws are written to strike a balance between protecting worker health and also ensuring businesses can still operate.
But having strong policies in place is critical for worker health, Baker said, and it shouldn’t be solely up to individuals to prevent cancer when issues are far more systemic.
“Do I have transit access in my neighborhood to take a job elsewhere? Do I have a path to education, whether it's trade or vocational school or college that allows me to take jobs with better protections and higher pay?” Baker said. “Our health care is focused on genetic factors, behavioral factors, and social factors. This paper shows occupation can have a large impact on your risk for cancer as well.”
Plascak said the next step for the team’s research is to begin to disentangle trends in cancer mortality from those of cancer incidence by looking at cancer survival by occupation. Cancer survival and occupation are connected to people’s health care access, which can be measured in population-based state cancer registries. Plascak hopes this will help them understand what’s driving the mortality patterns in individual occupations, by seeing how long people with cancer diagnoses live.
The study co-authors represent several universities and institutions. From Ohio State University: Jacob D Lesinski, Jingbo Yi, Elizabeth Ghias, James L Fisher, Arbor J L Quist, Ashley S Felix, Electra D Paskett, Mohamed I Elsaid, Debasish Sundi, Ann-Kathrin Eisfeld, Ashley E Rosko, Timothy M Pawlik, Samilia Obeng-Gyasi, Zobeida Cruz-Monserrate, William E Carson, Marisa Bittoni, Jesse J Plascak. From the University of Washington: Marissa G Baker, Anjum Hajat. From Columbia University: Adana A M Llanos. From the Men's Health Inequities Research Lab: Charles R Rogers. From the University of California, Irvine: David Richardson. Please see the study for full affiliations and notes.
Interested in learning more? Listen to Marissa Baker and Jesse Plascak discuss their research with The Lancet Oncology in conversation with podcast.