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

Author

Listed:
  • 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 Gustavsson
  • Dario Consonni
  • Franco Merletti
  • Lorenzo Richiardi
  • Lorenzo Simonato
  • Cristina Fortes
  • Marie-Elise Parent
  • John McLaughlin
  • Paul Demers
  • Maria Teresa Landi
  • Neil Caporaso
  • Adonina Tardón
  • David Zaridze
  • Neonila Szeszenia-Dabrowska
  • Peter Rudnai
  • Jolanta Lissowska
  • Eleonora Fabianova
  • John Field
  • Rodica Stanescu Dumitru
  • Vladimir Bencko
  • Lenka Foretova
  • Vladimir Janout
  • Hans Kromhout
  • Roel Vermeulen
  • Paolo Boffetta
  • Kurt Straif
  • Joachim Schüz
  • Benjamin Kendzia
  • Beate Pesch
  • Thomas Brüning
  • Thomas Behrens

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.

Suggested Citation

  • 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.
    • Handle: RePEc:plo:pone00:0192999
    DOI: 10.1371/journal.pone.0192999
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    References listed on IDEAS

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    1. 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.
    2. Ganzeboom, H.B.G. & de Graaf, P.M. & Treiman, D.J. & de Leeuw, J., 1992. "A standard international socio-economic index of occupational status," WORC Paper 92.01.001/1, Tilburg University, Work and Organization Research Centre.
    3. Wadsworth, M. E. J., 1997. "Health inequalities in the life course perspective," Social Science & Medicine, Elsevier, vol. 44(6), pages 859-869, March.
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