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PLoS One. 2018 Feb 20;13(2):e0192999. doi: 10.1371/journal.pone.0192999. eCollection 2018.

Lung cancer and socioeconomic status in a pooled analysis of case-control studies.

Author information

1
Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany.
2
University of Montreal, Hospital Research Center (CRCHUM) and School of Public Health, Montreal, Canada.
3
Dental School, College of Medicine Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
4
International Agency for Research on Cancer (IARC), Lyon, France.
5
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
6
Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Team, Villejuif, France.
7
University Paris-Sud, UMRS 1018, Villejuif, France.
8
Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany.
9
Leibniz-Institute for Prevention Research and Epidemiology -BIPS GmbH, Bremen, Germany.
10
Institute for Statistics, University Bremen, Bremen, Germany.
11
Institute of Epidemiology I, Helmholtz Zentrum München, Neuherberg, Germany.
12
Institute of Medical Statistics and Epidemiology, Technical University Munich, Munich, Germany.
13
Unit of Epidemiology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.
14
Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy.
15
Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padova, Padova, Italy.
16
Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI-IRCCS-FLMM), Rome, Italy.
17
INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada.
18
Public Health Ontario, Toronto, Canada.
19
Cancer Care Ontario, Occupational Cancer Research Centre, Toronto, Canada.
20
National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, United States of America.
21
Molecular Epidemiology of Cancer Unit, University of Oviedo-Ciber de Epidemiologia, CIBERESP, Oviedo, Spain.
22
Institute of Carcinogenesis, Russian Cancer Research Centre, Moscow, Russia.
23
The Nofer Institute of Occupational Medicine, Lodz, Poland.
24
National Centre for Public Health, Budapest, Hungary.
25
The M Sklodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland.
26
Regional Authority of Public Health, Preventive Occupational Medicine, Banska Bystrica, Slovakia.
27
Roy Castle Lung Cancer Research Programme, Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom.
28
National Institute of Public Health, Bucharest, Romania.
29
Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
30
Masaryk Memorial Cancer Institute and Medical Faculty of Masaryk University, Dept. of Cancer Epidemiology & Genetics, Brno, Czech Republic.
31
Palacky University, Faculty of Medicine, Olomouc, Czech Republic.
32
Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
33
Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
34
The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America.

Abstract

BACKGROUND:

An association between low socioeconomic status (SES) and lung cancer has been observed in several studies, but often without adequate control for smoking behavior. We studied the association between lung cancer and occupationally derived SES, using data from the international pooled SYNERGY study.

METHODS:

Twelve case-control studies from Europe and Canada were included in the analysis. Based on occupational histories of study participants we measured SES using the International Socio-Economic Index of Occupational Status (ISEI) and the European Socio-economic Classification (ESeC). We divided the ISEI range into categories, using various criteria. Stratifying by gender, we calculated odds ratios (OR) and 95% confidence intervals (CI) by unconditional logistic regression, adjusting for age, study, and smoking behavior. We conducted analyses by histological subtypes of lung cancer and subgroup analyses by study region, birth cohort, education and occupational exposure to known lung carcinogens.

RESULTS:

The analysis dataset included 17,021 cases and 20,885 controls. There was a strong elevated OR between lung cancer and low SES, which was attenuated substantially after adjustment for smoking, however a social gradient persisted. SES differences in lung cancer risk were higher among men (lowest vs. highest SES category: ISEI OR 1.84 (95% CI 1.61-2.09); ESeC OR 1.53 (95% CI 1.44-1.63)), than among women (lowest vs. highest SES category: ISEI OR 1.54 (95% CI 1.20-1.98); ESeC OR 1.34 (95% CI 1.19-1.52)).

CONCLUSION:

SES remained a risk factor for lung cancer after adjustment for smoking behavior.

PMID:
29462211
PMCID:
PMC5819792
DOI:
10.1371/journal.pone.0192999
[Indexed for MEDLINE]
Free PMC Article

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