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

Jan Hovanec 1 Jack Siemiatycki 2 David Conway 3 Ann Olsson 4 Isabelle Stücker 5 Florence Guida 5 Karl-Heinz Jöckel 6 Hermann Pohlabeln 7 Wolfgang Ahrens 8, 7 Irene Brüske 9 Heinz-Erich Wichmann 10 Per Gustavsson 4 Dario Consonni 11 Franco Merletti 12 Lorenzo Richiardi 12 Lorenzo Simonato 13 Cristina Fortes 14 Marie-Élise Parent 15 John Mclaughlin 16 Paul Demers 17 Maria Teresa Landi 18 Neil Caporaso 18 Adonina Tardón 19 David Zaridze 20 Neonila Szeszenia-Dabrowska 21 Peter Rudnai 22 Jolanta Lissowska 23 Eleonora Fabianova 24 John Field 25 Rodica Stanescu Dumitru 26 Vladimir Bencko 27 Lenka Foretova 28 Vladimír Janout 29, 30 Hans Kromhout 31 Roel Vermeulen 31 Paolo Boffetta 32 Kurt Straif 33 Joachim Schüz 33 Benjamin Kendzia 1 Beate Pesch 1 Thomas Brüning 1 Thomas Behrens 1, *
* Corresponding author
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.
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Jan Hovanec, Jack Siemiatycki, David Conway, Ann Olsson, Isabelle Stücker, et al.. Lung cancer and socioeconomic status in a pooled analysis of case-control studies. PLoS ONE, Public Library of Science, 2018, 13 (2), pp.e0192999. ⟨10.1371/journal.pone.0192999⟩. ⟨pasteur-01855951⟩

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