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BMJ Open. 2018 Sep 10;8(9):e021059. doi: 10.1136/bmjopen-2017-021059.

Neighbourhood deprivation and lung cancer risk: a nested case-control study in the USA.

Author information

1
Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee, USA.
2
Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
3
Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA.
4
Department of Sociology, Tennessee State University, Nashville, Tennessee, USA.
5
Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

Abstract

OBJECTIVES:

To examine the association between neighbourhood deprivation and lung cancer risk.

DESIGN:

Nested case-control study.

SETTING:

Southern Community Cohort Study of persons residing in 12 states in the southeastern USA.

PARTICIPANTS:

1334 cases of lung cancer and 5315 controls.

PRIMARY OUTCOME MEASURE:

Risk of lung cancer.

RESULTS:

After adjustment for smoking status and other confounders, and additional adjustment for individual-level measures of socioeconomic status (SES), there was no monotonic increase in risk with worsening deprivation score overall or within sex and race groups. There was an increase among current and shorter term former smokers (p=0.04) but not among never and longer term former smokers. There was evidence of statistically significant interaction by sex among whites, but not blacks, in which the effect of worsening deprivation on lung cancer existed in males but not in females.

CONCLUSIONS:

Area-level measures of SES were associated with lung cancer risk in current and shorter term former smokers only in this population.

KEYWORDS:

lung cancer; multi-level; neighborhood deprivation; nested case-control study

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