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Neighbourhood socioeconomic status and individual lung cancer risk: Evaluating long-term exposure measures and mediating mechanisms

Author

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  • Hystad, Perry
  • Carpiano, Richard M.
  • Demers, Paul A.
  • Johnson, Kenneth C.
  • Brauer, Michael

Abstract

Neighbourhood socioeconomic status (SES) has been associated with numerous chronic diseases, yet little information exists on its association with lung cancer incidence. This outcome presents two key empirical challenges: a long latency period that requires study participants' residential histories and long-term neighbourhood characteristics; and adequate data on many risk factors to test hypothesized mediating pathways between neighbourhood SES and lung cancer incidence. Analysing data on urban participants of a large Canadian population-based lung cancer case-control study, we investigate three issues pertaining to these challenges. First, we examine whether there is an association between long-term neighbourhood SES, derived from 20 years of residential histories and five national censuses, and lung cancer incidence. Second, we determine how this long-term neighbourhood SES association changes when using neighbourhood SES measures based on different latency periods or at time of study entry. Third, we estimate the extent to which long-term neighbourhood SES is mediated by a range of individual-level smoking behaviours, other health behaviours, and environmental and occupational exposures. Results of hierarchical logistic regression models indicate significantly higher odds of lung cancer cases residing in the most compared to the least deprived quintile of the long-term neighbourhood SES index (OR: 1.46; 95% CI: 1.13–1.89) after adjustment for individual SES. This association remained significant (OR: 1.38; 1.01–1.88) after adjusting for smoking behaviour and other known and suspected lung cancer risk factors. Important differences were observed between long-term and study entry neighbourhood SES measures, with the latter attenuating effect estimates by over 50 percent. Smoking behaviour was the strongest partial mediating pathway of the long-term neighbourhood SES effect. This research is the first to examine the effects of long-term neighbourhood SES on lung cancer risk and more research is needed to further identify specific, modifiable pathways by which neighbourhood context may influence lung cancer risk.

Suggested Citation

  • Hystad, Perry & Carpiano, Richard M. & Demers, Paul A. & Johnson, Kenneth C. & Brauer, Michael, 2013. "Neighbourhood socioeconomic status and individual lung cancer risk: Evaluating long-term exposure measures and mediating mechanisms," Social Science & Medicine, Elsevier, vol. 97(C), pages 95-103.
    • Handle: RePEc:eee:socmed:v:97:y:2013:i:c:p:95-103
    DOI: 10.1016/j.socscimed.2013.08.005
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    2. Min Weng & Jianhua Pi & Bingqing Tan & Shiliang Su & Zhongliang Cai, 2017. "Area Deprivation and Liver Cancer Prevalence in Shenzhen, China: A Spatial Approach Based on Social Indicators," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 133(1), pages 317-332, August.
    3. Ryan J. Scalsky & Yi-Ju Chen & Zhekang Ying & James A. Perry & Charles C. Hong, 2022. "The Social and Natural Environment’s Impact on SARS-CoV-2 Infections in the UK Biobank," IJERPH, MDPI, vol. 19(1), pages 1-9, January.
    4. Jan Hovanec & Jack Siemiatycki & David I Conway & Ann Olsson & Isabelle Stücker & Florence Guida & Karl-Heinz Jöckel & Hermann Pohlabeln & Wolfgang Ahrens & Irene Brüske & Heinz-Erich Wichmann & Per G, 2018. "Lung cancer and socioeconomic status in a pooled analysis of case-control studies," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-18, February.

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