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)

1 RUB - Ruhr University Bochum = Ruhr-Universität Bochum
2 CHUM - Centre Hospitalier de l'Université de Montréal
3 University of Glasgow
4 Karolinska Institutet [Stockholm]
5 CESP - Centre de recherche en épidémiologie et santé des populations
6 Uniklinik Essen - Universitätsklinikum Essen [Universität Duisburg-Essen]
7 Leibniz Institute for Prevention Research and Epidemiology - BIPS
8 University of Bremen
9 Helmholtz Zentrum München = German Research Center for Environmental Health
10 TUM - Technische Universität Munchen - Technical University Munich - Université Technique de Munich
11 Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico
12 UNITO - Università degli studi di Torino = University of Turin
13 Unipd - Università degli Studi di Padova = University of Padua
14 IDI-IRCCS - Istituto dermopatico dell'immacolata
15 INRS-IAF - Institut Armand Frappier
16 Public Health Ontario - Santé publique Ontario
17 Occupational Cancer Research Centre
18 NCI-NIH - National Cancer Institute [Bethesda]
19 CIBERESP - Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health
20 Russian Cancer Research Centre
21 NIOM - Nofer Institute of Occupational Medicine
22 National center for public health [Hungary]
23 MCMCC - Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology
24 RAPH - Regional Authority of Public Health [Slovaquia]
25 University of Liverpool
26 INSP - National Institute of Public Health [Romania]
27 UK - Univerzita Karlova [Praha, Česká republika] = Charles University [Prague, Czech Republic]
28 MUNI - Masaryk University [Brno]
29 Palacky University Olomouc
30 Ostravská univerzita / University of Ostrava
31 Universiteit Utrecht / Utrecht University [Utrecht]
32 MSSM - Icahn School of Medicine at Mount Sinai [New York]
33 CIRC - IARC - Centre International de Recherche contre le Cancer - International Agency for Research on Cancer

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.

Domaines: Sciences du Vivant [q-bio]

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, 2018, 13 (2), pp.e0192999. ⟨10.1371/journal.pone.0192999⟩. ⟨pasteur-01855951⟩