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Stewart R, Conway DI, Macpherson LMD, Sherriff A. Obesity and dental caries in childhood: trends in prevalence and socioeconomic inequalities-a multicohort population-wide data linkage study. Arch Dis Child 2024; 109:642-648. [PMID: 38724064 DOI: 10.1136/archdischild-2023-326587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/04/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES To quantify levels of coexisting obesity and caries experience in children in Scotland, and any associated socioeconomic inequalities over the years 2011/2012-2017/2018. DESIGN A multicohort population-wide data linkage study. SETTING Local authority primary schools in Scotland. PATIENTS 335 361 primary 1 (approximately 5 years old) schoolchildren in Scotland between 2011/2012 and 2017/2018. MAIN OUTCOME MEASURES Prevalence and inequalities in coexisting caries and obesity. RESULTS The prevalence of coexisting obesity and caries experience was 3.4% (n=11 494 of 335 361) and did not change over the 7 years. Children living in the 20% most deprived areas had more than sixfold greater odds of coexisting obesity and caries experience than children from the 20% least deprived areas (adjusted OR=6.63 (95% CI=6.16 to 7.14; p<0.001)). There was a large persistent socioeconomic gradient across the Scottish Index of Multiple Deprivation groups, with the Slope and Relative Indices of Inequality remaining unchanged over the 7 cohort years. CONCLUSIONS Despite improvements in oral health in children in Scotland, the prevalence of coexisting obesity and caries experience has remained static, with large persistent inequalities. These conditions are likely to signal increased risk of chronic conditions including multimorbidity in adulthood and therefore early identification of children most at risk and timely intervention tackling common risk factors should be developed and evaluated.
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Affiliation(s)
- Ryan Stewart
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Department of Mathematics & Statistics, University of Strathclyde, Glasgow, UK
| | - David I Conway
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Lorna M D Macpherson
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Andrea Sherriff
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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2
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Ashraf DA, Kamran F, Hassan S, Kumar S, Samiullah F. Letter to the editor: Heart failure with stable mildly reduced ejection fraction: Prognosis and predictors of outcomes. Curr Probl Cardiol 2024; 49:102190. [PMID: 37952791 DOI: 10.1016/j.cpcardiol.2023.102190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Affiliation(s)
| | - Farooq Kamran
- Foundation university medical college, DHA-1, Islamabad Pakistan
| | - Saad Hassan
- Foundation university medical college, DHA-1, Islamabad Pakistan
| | - Satesh Kumar
- Shaheed Mohtarma Benazir Bhutto Medical College, Lyari, Karachi Pakistan
| | - Fnu Samiullah
- Shaheed Mohtarma Benazir Bhutto Medical College, Lyari, Karachi Pakistan
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Lyshol H, Gil AP, Tolonen H, Namorado S, Kislaya I, Barreto M, Antunes L, Gaio V, Santos AJ, Rodrigues AP, Dias CM. Local problem solving in the Portuguese health examination survey: a mixed method study. Arch Public Health 2022; 80:198. [PMID: 36002860 PMCID: PMC9400230 DOI: 10.1186/s13690-022-00939-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Participation rates in health surveys, recognized as an important quality dimension, have been declining over the years, which may affect representativeness and confidence in results. The Portuguese national health examination survey INSEF (2015) achieved a participation rate of 43.9%, which is in line with participation rates from other similar health examination surveys. The objective of this article is to describe how local teams of survey personnel conducted the survey, describing strategies used to solve practical survey problems and to try to increase the participation rate.
Methods
After a literature search, informal interviews were conducted with 14 public health officials from local health examination teams, regional and central authorities. Forty-one of the local staff members (survey personnel) also filled in a short questionnaire anonymously. The interviews and self-administered questionnaires were analysed using mixed methods, informed by thematic analysis.
Results
The local teams believed that the detailed manual, described as a “cookbook for making a health examination survey”, made it possible to maintain high scientific standards while allowing for improvising solutions to problems in the local context. The quality of the manual, supported by a series of training workshops with the central research and support team, gave the teams the confidence and knowledge to implement local solutions. Motivation and cohesion within the local teams were among the goals of the training process.
Local teams felt empowered by being given large responsibilities and worked hard to incite people to attend the examination through a close and persuasive approach.
Local teams praised their INSA contacts for being available for assistance throughout the survey, and said they were inspired to try harder to reach participants to please their contacts for interpersonal reasons.
Conclusions
The theory of organizational improvisation or bricolage, which means using limited resources to solve problems, was useful to discuss and understand what took place during INSEF.
A detailed manual covering standard procedures, continuous monitoring of the data collection and face-to-face workshops, including role-play, were vital to assure high scientific standards and high participation rates in this health examination survey. Close contacts between the central team and local focal points in all regions and all survey sites were key to accommodating unexpected challenges and innovative solutions.
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Lee YCA, Al-Temimi M, Ying J, Muscat J, Olshan AF, Zevallos JP, Winn DM, Li G, Sturgis EM, Morgenstern H, Zhang ZF, Smith E, Kelsey K, McClean M, Vaughan TL, Lazarus P, Chen C, Schwartz SM, Gillison M, Schantz S, Yu GP, D'Souza G, Gross N, Monroe M, Kim J, Boffetta P, Hashibe M. Risk Prediction Models for Head and Neck Cancer in the US Population From the INHANCE Consortium. Am J Epidemiol 2020; 189:330-342. [PMID: 31781743 DOI: 10.1093/aje/kwz259] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 10/29/2019] [Accepted: 11/06/2019] [Indexed: 12/23/2022] Open
Abstract
Head and neck cancer (HNC) risk prediction models based on risk factor profiles have not yet been developed. We took advantage of the large database of the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, including 14 US studies from 1981-2010, to develop HNC risk prediction models. Seventy percent of the data were used to develop the risk prediction models; the remaining 30% were used to validate the models. We used competing-risk models to calculate absolute risks. The predictors included age, sex, education, race/ethnicity, alcohol drinking intensity, cigarette smoking duration and intensity, and/or family history of HNC. The 20-year absolute risk of HNC was 7.61% for a 60-year-old woman who smoked more than 20 cigarettes per day for over 20 years, consumed 3 or more alcoholic drinks per day, was a high school graduate, had a family history of HNC, and was non-Hispanic white. The 20-year risk for men with a similar profile was 6.85%. The absolute risks of oropharyngeal and hypopharyngeal cancers were generally lower than those of oral cavity and laryngeal cancers. Statistics for the area under the receiver operating characteristic curve (AUC) were 0.70 or higher, except for oropharyngeal cancer in men. This HNC risk prediction model may be useful in promoting healthier behaviors such as smoking cessation or in aiding persons with a family history of HNC to evaluate their risks.
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5
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Hovanec J, Siemiatycki J, Conway DI, Olsson A, Stücker I, Guida F, Jöckel KH, Pohlabeln H, Ahrens W, Brüske I, Wichmann HE, Gustavsson P, Consonni D, Merletti F, Richiardi L, Simonato L, Fortes C, Parent ME, McLaughlin J, Demers P, Landi MT, Caporaso N, Tardón A, Zaridze D, Szeszenia-Dabrowska N, Rudnai P, Lissowska J, Fabianova E, Field J, Dumitru RS, Bencko V, Foretova L, Janout V, Kromhout H, Vermeulen R, Boffetta P, Straif K, Schüz J, Kendzia B, Pesch B, Brüning T, Behrens T. Lung cancer and socioeconomic status in a pooled analysis of case-control studies. PLoS One 2018; 13:e0192999. [PMID: 29462211 PMCID: PMC5819792 DOI: 10.1371/journal.pone.0192999] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/02/2018] [Indexed: 11/19/2022] Open
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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Affiliation(s)
- Jan Hovanec
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - Jack Siemiatycki
- University of Montreal, Hospital Research Center (CRCHUM) and School of Public Health, Montreal, Canada
| | - David I. Conway
- Dental School, College of Medicine Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Ann Olsson
- International Agency for Research on Cancer (IARC), Lyon, France
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Isabelle Stücker
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Team, Villejuif, France
- University Paris-Sud, UMRS 1018, Villejuif, France
| | - Florence Guida
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Team, Villejuif, France
- University Paris-Sud, UMRS 1018, Villejuif, France
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
| | - Hermann Pohlabeln
- Leibniz-Institute for Prevention Research and Epidemiology -BIPS GmbH, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz-Institute for Prevention Research and Epidemiology -BIPS GmbH, Bremen, Germany
- Institute for Statistics, University Bremen, Bremen, Germany
| | - Irene Brüske
- Institute of Epidemiology I, Helmholtz Zentrum München, Neuherberg, Germany
| | - Heinz-Erich Wichmann
- Institute of Epidemiology I, Helmholtz Zentrum München, Neuherberg, Germany
- Institute of Medical Statistics and Epidemiology, Technical University Munich, Munich, Germany
| | - Per Gustavsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Dario Consonni
- Unit of Epidemiology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Franco Merletti
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Lorenzo Richiardi
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Lorenzo Simonato
- Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Cristina Fortes
- Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI-IRCCS-FLMM), Rome, Italy
| | - Marie-Elise Parent
- INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada
| | | | - Paul Demers
- Cancer Care Ontario, Occupational Cancer Research Centre, Toronto, Canada
| | - Maria Teresa Landi
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, United States of America
| | - Neil Caporaso
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, United States of America
| | - Adonina Tardón
- Molecular Epidemiology of Cancer Unit, University of Oviedo-Ciber de Epidemiologia, CIBERESP, Oviedo, Spain
| | - David Zaridze
- Institute of Carcinogenesis, Russian Cancer Research Centre, Moscow, Russia
| | | | - Peter Rudnai
- National Centre for Public Health, Budapest, Hungary
| | - Jolanta Lissowska
- The M Sklodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Eleonora Fabianova
- Regional Authority of Public Health, Preventive Occupational Medicine, Banska Bystrica, Slovakia
| | - John Field
- Roy Castle Lung Cancer Research Programme, Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom
| | | | - Vladimir Bencko
- Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lenka Foretova
- Masaryk Memorial Cancer Institute and Medical Faculty of Masaryk University, Dept. of Cancer Epidemiology & Genetics, Brno, Czech Republic
| | - Vladimir Janout
- Palacky University, Faculty of Medicine, Olomouc, Czech Republic
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Hans Kromhout
- Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Roel Vermeulen
- Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Kurt Straif
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), Lyon, France
| | - Benjamin Kendzia
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - Beate Pesch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
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Farsi NJ, Rousseau MC, Schlecht N, Castonguay G, Allison P, Nguyen-Tan PF, Souliéres D, Coutlée F, Hier M, Madathil S, Franco EL, Nicolau B. Aetiological heterogeneity of head and neck squamous cell carcinomas: the role of human papillomavirus infections, smoking and alcohol. Carcinogenesis 2017; 38:1188-1195. [PMID: 29029021 DOI: 10.1093/carcin/bgx106] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/26/2017] [Indexed: 12/19/2022] Open
Abstract
Tobacco and alcohol consumption are the main risk factors for head and neck squamous cell carcinoma (HNSCC). In addition, human papillomavirus (HPV) infection plays a causal role in oropharyngeal cancer (OPC), a subset of HNSCC. We assessed the independent effects of tobacco, alcohol and HPV infection on OPC risk in the head and neck cancer (HeNCe) Life study, a hospital-based case-control study of HNSCC with frequency-matched controls by age and sex from four Montreal hospitals. Interviewers collected information on socio-demographic and behavioural factors. We tested exfoliated oral cells for HPV DNA by polymerase chain reaction (PCR). We included only OPC cases (n = 188) and controls (n = 427) without missing values for HPV, smoking or alcohol. We examined associations by estimating odds ratios (ORs) and corresponding 95% confidence intervals (CI) using unconditional logistic regression. Smoking (OR = 1.90, 95% CI: 1.04-3.45) and alcohol (OR = 2.74, 95% CI: 1.45-5.15) were associated with an increased risk of OPC independent of HPV status. Positivity for HPV 16 among heavy smokers and heavy alcohol users was associated with a 30.4-fold (95% CI: 8.94-103.26) and 18.6-fold (95% CI: 5.75-60.13) elevation in risk of OPC relative to participants who were HPV negative, respectively. Moreover, the combined effect of heavy smoking and alcohol comsumption with HPV 16 infection substantially increased OPC risk (OR = 48.76, 95% CI: 15.83-150.17) and (OR = 50.60, 95% CI: 15.96-160.40), respectively. Our results support the independent roles of smoking, alcohol and HPV infection in OPC risk and a possible combined effect. Efforts should be made to tackle these major risk factors simultaneously.
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Affiliation(s)
- Nada J Farsi
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Saudi Arabia.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Canada
| | - Marie-Claude Rousseau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Canada
| | - Nicolas Schlecht
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Canada.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, USA
| | - Geneviève Castonguay
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Canada
| | - Paul Allison
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Canada.,Department of Oncology, Division of Cancer Epidemiology, McGill University, Canada
| | - Phuc Félix Nguyen-Tan
- Department of Radiation Oncology, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Canada
| | - Denis Souliéres
- Department of Hemato-Oncology, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Canada
| | - Francois Coutlée
- Department of Oncology, Division of Cancer Epidemiology, McGill University, Canada.,Department of Microbiology and Infectious Diseases, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Canada
| | - Michael Hier
- Faculty of Medicine, McGill University, Department of Otolaryngology-Head and Neck Surgery, Canada
| | - Sreenath Madathil
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Canada
| | - Eduardo L Franco
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Canada.,Department of Oncology, Division of Cancer Epidemiology, McGill University, Canada
| | - Belinda Nicolau
- Division of Oral Health and Society, Faculty of Dentistry, McGill University, Canada.,Department of Oncology, Division of Cancer Epidemiology, McGill University, Canada
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7
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Factors influencing inclusion in digestive cancer clinical trials: A population-based study. Dig Liver Dis 2015; 47:891-6. [PMID: 26089036 DOI: 10.1016/j.dld.2015.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 05/05/2015] [Accepted: 05/16/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Inclusion in a randomized therapeutic trial represents an optimal therapeutic strategy. AIMS To determine the influence of demographic characteristics and deprivation on the enrolment of patients in digestive cancer clinical trials. METHODS Between 2004 and 2010, 4632 patients were recorded by the Burgundy Digestive Cancer Registry. According to a balancing score, the 136 patients included in a clinical trial were matched with 272 patients who met the eligibility criteria for trials. Deprivation was measured by the ecological European deprivation index. A conditional multivariate logistic regression was performed. RESULTS Patients aged over 75 years were significantly less likely to be included in clinical trials than younger patients (odds ratio 0.33; [0.13-0.87]). Patients treated in private institutions were also less likely to be enrolled than those treated in public institutions (odds ratio 0.04; [0.01-0.16]; p<0.001). A relationship between type of institution and the European deprivation index was observed (p=0.017). Deprived patients were less likely to be included in clinical trials when they were managed in private institutions (odds ratio 0.706; [0.524-0.952]; p=0.022). The European deprivation index had no impact when patients were managed in other institutions. CONCLUSION The relationship between type of institution and deprivation underlines the necessity for improving patients' chance of being recruited in digestive cancer clinical trials.
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8
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Gupta B, Lalloo R, Johnson NW. Life course models for upper aero-digestive tract cancer. Int Dent J 2015; 65:111-9. [PMID: 25939378 DOI: 10.1111/idj.12167] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Upper aero-digestive tract (UADT) cancers are collectively cancers of various human body sites, such as the oral cavity, pharynx, oesophagus and larynx. Worldwide, they are the fourth most frequent cancer type and the fourth most common cause of mortality from cancer. Many studies have shown that several chronic diseases, such as cancer, which occur more commonly in later adulthood, are influenced by social and psychological circumstances during birth, childhood, adolescence and early adult life. It is suggested that the build up of problematic circumstances throughout life is the cause of disease, rather than circumstances that happen at one point in time. UADT cancer is a chronic disease of complex multifactorial origin and most of the underlying exposures/risks cannot be considered as individual factors or in isolation, as they act at different levels, which differ from time to time. Thus, life-course epidemiology, rather than drawing false dichotomies between different risk factors of the underlying disease, attempts to integrate biological and social risk processes that cause the chronic disease. It studies how socially patterned exposures during all stages of life--childhood, adolescence and early adult--influence disease risk in adulthood and socio-economic position and hence may account for social inequalities in adult health and mortality. Furthermore, varying health effects, according to the timing or duration of exposure to socio-economic circumstances, may indicate important traces to the causes of cancer. In this paper, we have attempted to draw a conceptual framework on the relationships between socio-economic inequalities, oral health risk factors along the life-course of an individual and incidence of UADT cancer.
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Affiliation(s)
- Bhawna Gupta
- Population and Social Health Research Programme, Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia.,School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia
| | - Ratilal Lalloo
- School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia.,Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Newell W Johnson
- Population and Social Health Research Programme, Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia
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9
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Life course social mobility and risk of upper aerodigestive tract cancer in men. Eur J Epidemiol 2010; 25:173-82. [PMID: 20143252 DOI: 10.1007/s10654-010-9429-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Accepted: 01/20/2010] [Indexed: 10/19/2022]
Abstract
The aim of this study was to explore associations between social mobility and tumours of the upper aero-digestive tract (UADT), focussing on life-course transitions in social prestige (SP) based on occupational history. 1,796 cases diagnosed between 1993 and 2005 in ten European countries were compared with 1585 controls. SP was classified by the Standard International Occupational Prestige Scale (SIOPS) based on job histories. SIOPS was categorised in high (H), medium (M) and low (L). Time weighted average achieved and transitions between SP with nine trajectories: H --> H, H --> M, H --> L, M --> H, M --> M, M --> L, L --> H, L --> M and L --> L were analysed. Odds ratios (ORs) and 95%-confidence intervals [95%-CIs] were estimated with logistic regression models including age, consumption of fruits/vegetables, study centre, smoking and alcohol consumption. The adjusted OR for the lowest versus the highest of three categories (time weighted average of SP) was 1.28 [1.04-1.56]. The distance of SP widened between cases and controls during working life. The downward trajectory H --> L gave an OR of 1.71 [0.75-3.87] as compared to H --> H. Subjects with M --> M and L --> L trajectories ORs were also elevated relative to subjects with H --> H trajectories. The association between SP and UADT is not fully explained by confounding factors. Downward social trajectory during the life course may be an independent risk factor for UADT cancers.
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10
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Eyre R, Feltbower RG, Mubwandarikwa E, Eden TOB, McNally RJQ. Epidemiology of bone tumours in children and young adults. Pediatr Blood Cancer 2009; 53:941-52. [PMID: 19618453 DOI: 10.1002/pbc.22194] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although the epidemiology of malignant bone tumours in children and young adults has been explored, no definitive causation of any specific tumour has yet been identified. We performed a literature review (1970-2008) to find all papers covering possible aetiological factors involved in the development of bone tumours in children and young adults. Several associations have been reported with some consistency: the presence of hernias and Ewing sarcoma; high fluoride exposure and osteosarcoma; and parental farming and residence on a farm, younger age at puberty and family history of cancer for all bone tumours, especially osteosarcoma. Clearly further research is needed to confirm or refute these putative risk factors. It is likely that studies of gene-environment interactions may prove to be the most fruitful of future research.
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Affiliation(s)
- Rachel Eyre
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, England, United Kingdom
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11
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Conway DI, McKinney PA, McMahon AD, Ahrens W, Schmeisser N, Benhamou S, Bouchardy C, Macfarlane GJ, Macfarlane TV, Lagiou P, Minaki P, Bencko V, Holcátová I, Merletti F, Richiardi L, Kjaerheim K, Agudo A, Castellsague X, Talamini R, Barzan L, Canova C, Simonato L, Lowry RJ, Znaor A, Healy CM, McCartan BE, Marron M, Hashibe M, Brennan P. Socioeconomic factors associated with risk of upper aerodigestive tract cancer in Europe. Eur J Cancer 2009; 46:588-98. [PMID: 19857956 DOI: 10.1016/j.ejca.2009.09.028] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 09/25/2009] [Accepted: 09/30/2009] [Indexed: 11/25/2022]
Abstract
INTRODUCTION In the European Union, there are 180,000 new cases of upper aerodigestive tract (UADT) cancer cases per year--more than half of whom will die of the disease. Socioeconomic inequalities in UADT cancer incidence are recognised across Europe. We aimed to assess the components of socioeconomic risk both independently and through their influence on the known behavioural risk factors of smoking, alcohol consumption and diet. PATIENTS AND METHODS A multicentre case-control study with 2198 cases of UADT cancer and 2141 controls from hospital and population sources was undertaken involving 14 centres from 10 countries. Personal interviews collected information on demographics, lifetime occupation history, smoking, alcohol consumption and diet. Socioeconomic status was measured by education, occupational social class and unemployment. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using unconditional logistic regression. RESULTS When controlling for age, sex and centre significantly increased risks for UADT cancer were observed for those with low versus high educational attainment OR=1.98 (95% CI 1.67, 2.36). Similarly, for occupational socioeconomic indicators--comparing the lowest versus highest International Socio-Economic Index (ISEI) quartile for the longest occupation gave OR=1.60 (1.28, 2.00); and for unemployment OR=1.64 (1.24, 2.17). Statistical significance remained for low education when adjusting for smoking, alcohol and diet behaviours OR=1.29 (1.06, 1.57) in the multivariate analysis. Inequalities were observed only among men but not among women and were greater among those in the British Isles and Eastern European countries than in Southern and Central/Northern European countries. Associations were broadly consistent for subsite and source of controls (hospital and community). CONCLUSION Socioeconomic inequalities for UADT cancers are only observed among men and are not totally explained by smoking, alcohol drinking and diet.
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Affiliation(s)
- D I Conway
- Dental School, Faculty of Medicine, University of Glasgow, 378 Sauchiehall Street, Glasgow G2 3JZ, UK.
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Conway DI, McMahon AD, Smith K, Black R, Robertson G, Devine J, McKinney PA. Components of socioeconomic risk associated with head and neck cancer: a population-based case-control study in Scotland. Br J Oral Maxillofac Surg 2009; 48:11-7. [PMID: 19481316 DOI: 10.1016/j.bjoms.2009.03.020] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2009] [Indexed: 10/20/2022]
Abstract
The complex associations between socioeconomic circumstances and risk for head and neck cancer are under-explored. We investigated components of social class and their relative influence on the risk of head and neck cancers by studying 103 patients (age range 24-80 years) who had been diagnosed with cancer of the head and neck between April 2002 and December 2004, and 91 controls who were randomly selected from general practitioners' lists. Information about occupation, education, smoking, and alcohol consumption was collected at personal interview. Socioeconomic circumstances were measured at an individual level (education, occupational social class, unemployment), and by area-based measures of deprivation. Odds ratios (OR) and 95% confidence intervals (CI) were computed using unconditional logistic regression and multivariate analyses. People living in the most deprived areas (OR=4.66, 95% CI 1.79-12.18); and those who were unemployed (OR=2.27, 95% CI 1.21-4.26) had a significantly higher risk of cancer than those with high levels of educational attainment (OR=0.17, 95% CI 0.05-0.58). Significance was lost for all measures of social class when adjustments were made for smoking and consumption of alcohol. Smoking was the only significant risk factor (OR=15.53, 95% CI 5.36-44.99) in the multivariate analysis. A high risk of head and neck cancer was consistently associated with poor socioeconomic circumstances, and there were strong links for specific components however smoking dominated the overall profile of risk. We propose a framework for future socioeconomic analyses.
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Affiliation(s)
- David I Conway
- University of Glasgow, Faculty of Medicine, Dental School, Glasgow, UK.
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