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Pizzato M, Martinsen JI, Heikkinen S, Vignat J, Lynge E, Sparén P, La Vecchia C, Pukkala E, Vaccarella S. Socioeconomic status and risk of lung cancer by histological subtype in the Nordic countries. Cancer Med 2022; 11:1850-1859. [PMID: 35166068 PMCID: PMC9041078 DOI: 10.1002/cam4.4548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While the excess in lung cancer risk among lower socioeconomic status individuals has been widely described, the magnitude of this association across lung cancer subtypes, as well as histotype-related long-term incidence trends, are inconclusively reported. AIMS We explored the variation in the incidence of the three main lung cancer histotypes (i.e. squamous cell carcinoma, small cell carcinoma and adenocarcinoma) by socioeconomic status (SES, i.e. upper and lower white collar, upper and lower blue collar, and farming/forestry/fishing) in the adult population of four Nordic countries (i.e. Sweden, Norway, Finland and Denmark). MATERIALS & METHODS We have used data from the Nordic Occupational Cancer Study (NOCCA), computing age-standardized incidence rates per 100,000 person-years truncated at ages 50-69 years, by sex, histotype, country and SES, for the period 1971-2005. We estimated relative risks and the corresponding 95% confidence intervals through Poisson regression models, including terms for SES, age, sex and country, as indicated. RESULTS A clear socioeconomic gradient, with a progressive increase in lung cancer risk as SES level decreases, was observed in all subtypes and in both sexes. Favourable lung cancer incidence trends were seen among men for squamous cell and small cell carcinomas, although for adenocarcinomas rates were increasing everywhere except for Finland. Among women, upward temporal trends were seen in all SES groups and for all subtypes, although rates increased to a greater extent for low, compared to high, SES, especially in Denmark and Norway. Farmers showed comparatively lower risks compared to other SES categories. DISCUSSION This prospective cohort study shows that substantial socioeconomic inequalities in the incidence of the most important lung cancer histotypes exist in the Nordic Countries, and that these inequalities are on the rise, especially among women. CONCLUSION Smoking habits are likely to largely explain the observed social gradient for lung cancer histotypes in both sexes.
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Affiliation(s)
- Margherita Pizzato
- Department of Clinical Sciences and Community HealthUniversità degli Studi di MilanoMilanItaly
| | | | | | - Jerome Vignat
- International Agency for Research on CancerLyonFrance
| | - Elsebeth Lynge
- Nykøbing Falster HospitalUniversity of CopenhagenDenmark
| | - Pär Sparén
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholm
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community HealthUniversità degli Studi di MilanoMilanItaly
| | - Eero Pukkala
- Finnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer ResearchHelsinkiFinland
- Faculty of Social Sciences, Tampere UniversityTampereFinland
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Rosskamp M, Verbeeck J, Gadeyne S, Verdoodt F, De Schutter H. Socio-Economic Position, Cancer Incidence and Stage at Diagnosis: A Nationwide Cohort Study in Belgium. Cancers (Basel) 2021; 13:cancers13050933. [PMID: 33668089 PMCID: PMC7956180 DOI: 10.3390/cancers13050933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Socio-economic position is associated with cancer incidence, but the direction and magnitude of this relationship differs across cancer types, geographical regions, and socio-economic parameters. In this nationwide cohort study, we evaluated the association between different individual-level socio-economic and -demographic factors, cancer incidence, and stage at diagnosis in Belgium. Methods: The 2001 census was linked to the nationwide Belgian Cancer Registry for cancer diagnoses between 2004 and 2013. Socio-economic parameters included education level, household composition, and housing conditions. Incidence rate ratios were assessed through Poisson regression models. Stage-specific analyses were conducted through logistic regression models. Results: Deprived groups showed higher risks for lung cancer and head and neck cancers, whereas an inverse relation was observed for malignant melanoma and female breast cancer. Typically, associations were more pronounced in men than in women. A lower socio-economic position was associated with reduced chances of being diagnosed with known or early stage at diagnosis; the strongest disparities were found for male lung cancer and female breast cancer. Conclusions: This study identified population groups at increased risk of cancer and unknown or advanced stage at diagnosis in Belgium. Further investigation is needed to build a comprehensive picture of socio-economic inequality in cancer incidence.
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Affiliation(s)
- Michael Rosskamp
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
- Correspondence: ; Tel.: +32-2-250-1010
| | - Julie Verbeeck
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
| | - Sylvie Gadeyne
- Sociology Department, Interface Demography, Vrije Universiteit Brussel, Pleinlaan 5, B-1050 Brussels, Belgium;
| | - Freija Verdoodt
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
| | - Harlinde De Schutter
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
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3
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Adie Y, Kats DJ, Tlimat A, Perzynski A, Dalton J, Gunzler D, Tarabichi Y. Neighborhood Disadvantage and Lung Cancer Incidence in Ever-Smokers at a Safety Net Health-Care System: A Retrospective Study. Chest 2020; 157:1021-1029. [PMID: 31862438 PMCID: PMC7268431 DOI: 10.1016/j.chest.2019.11.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/29/2019] [Accepted: 11/21/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Neighborhood circumstances have an influence on multiple health outcomes, but the association between neighborhood conditions and lung cancer incidence has not been studied in sufficient detail. The goal of this study was to understand whether neighborhood conditions are independently associated with lung cancer incidence in ever-smokers after adjusting for individual smoking exposure and other risk factors. METHODS A cohort of ever-smokers aged ≥ 55 years was assembled from 19 years of electronic health record data from our academic community health-care system. Patient demographic characteristics and other measures known to be associated with lung cancer were ascertained. Patient addresses at their index visit were geocoded to the census block group level to determine the area deprivation index (ADI), drawn from 5-year estimates from the American Community Survey. A multivariate Cox proportional hazards model was fit to assess the association between ADI and time to lung cancer diagnosis. Tests of statistical significance were two-sided. RESULTS The study included 19,867 male subjects and 21,748 female subjects. Fifty-three percent of the patients were white, 38% were black, and 5% were Hispanic. Of these, 1,149 developed lung cancer. After adjusting for known risk factors, patients residing in the most disadvantaged areas had a significantly increased incidence of lung cancer compared with those in the least disadvantaged areas (hazard ratio, 1.29; 95% CI 1.07-1.55). CONCLUSIONS Census-derived estimates of neighborhood conditions have a powerful association with lung cancer incidence, even when adjusting for individual variables. Further research investigating the mechanisms that link neighborhood conditions to lung cancer is warranted.
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Affiliation(s)
- Yosra Adie
- Center for Reducing Health Disparities, The MetroHealth System, Cleveland, OH
| | - Daniel J Kats
- School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Abdulhakim Tlimat
- Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH
| | - Adam Perzynski
- Center for Health Care Research and Policy, The MetroHealth System, Cleveland, OH
| | - Jarrod Dalton
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Douglas Gunzler
- Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH
| | - Yasir Tarabichi
- Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH; Division of Pulmonary, Critical Care and Sleep Medicine, The MetroHealth System, Cleveland, OH.
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Thomas DR, Hodges ID. Dietary Research on Coffee: Improving Adjustment for Confounding. Curr Dev Nutr 2020; 4:nzz142. [PMID: 31938763 PMCID: PMC6949275 DOI: 10.1093/cdn/nzz142] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/01/2019] [Accepted: 11/26/2019] [Indexed: 12/17/2022] Open
Abstract
Meta-analyses have reported higher levels of coffee consumption to be associated with lower mortality. In contrast, some systematic reviews have linked coffee consumption to increased risks for lung cancer and hypertension. Given these inconsistencies, this narrative review critically evaluated the methods and analyses of cohort studies investigating coffee and mortality. A specific focus was adjustment for confounding related to smoking, healthy and unhealthy foods, and alcohol. Assessment of 36 cohort samples showed that many did not adequately adjust for smoking. Consuming 1-5 cups of coffee per day was related to lower mortality among never smokers, in studies that adjusted for pack-years of smoking, and in studies adjusting for healthy and unhealthy foods. Possible reduced health benefits for coffee with added sugar have not been adequately investigated. Research on coffee and health should report separate analyses for never smokers, adjust for consumption of healthy and unhealthy foods, and for sugar added to coffee.
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Affiliation(s)
- David R Thomas
- Social and Community Health, University of Auckland, Auckland, New Zealand
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5
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Remen T, Pintos J, Abrahamowicz M, Siemiatycki J. Risk of lung cancer in relation to various metrics of smoking history: a case-control study in Montreal. BMC Cancer 2018; 18:1275. [PMID: 30567516 PMCID: PMC6299933 DOI: 10.1186/s12885-018-5144-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 11/27/2018] [Indexed: 12/25/2022] Open
Abstract
Background Few epidemiologic findings are as well established as the association between smoking and lung cancer. It is therefore somewhat surprising that there is not yet a clear consensus about the exposure-response relationships between various metrics of smoking and lung cancer risk. In part this is due to heterogeneity of how exposure-response results have been presented and the relative paucity of published results using any particular metric of exposure. The purposes of this study are: to provide new data on smoking-lung cancer associations and to explore the relative impact of different dimensions of smoking history on lung cancer risk. Methods Based on a large lung cancer case-control study (1203 cases and 1513 controls) conducted in Montreal in 1996–2000, we estimated the lifetime prevalence of smoking and odds ratios in relation to several smoking metrics, both categorical and continuous based on multivariable unconditional logistic regression. Results Odds ratios (ORs) for ever vs never smoking were 7.82 among males and 11.76 among females. ORs increased sharply with every metric of smoking examined, more so for duration than for daily intensity. In models using continuous smoking variables, all metrics had strong effects on OR and mutual adjustment among smoking metrics did not noticeably attenuate the OR estimates, indicating that each metric carries some independent risk-related information. Among all the models tested, the one based on a smoking index that integrates several smoking dimensions, provided the best fitting model. Similar patterns were observed for the different histologic types of lung cancer. Conclusions This study provides many estimates of exposure-response relationships between smoking and lung cancer; these can be used in future meta-analyses. Irrespective of the histologic type of lung cancer and the smoking metric examined, high levels of smoking led to high levels of risk, for both men and women. Electronic supplementary material The online version of this article (10.1186/s12885-018-5144-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- T Remen
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Canada.
| | - J Pintos
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Canada
| | - M Abrahamowicz
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
| | - J Siemiatycki
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Canada
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Sanderson M, Aldrich MC, Levine RS, Kilbourne B, Cai Q, Blot WJ. Neighbourhood deprivation and lung cancer risk: a nested case-control study in the USA. BMJ Open 2018; 8:e021059. [PMID: 30206077 PMCID: PMC6144393 DOI: 10.1136/bmjopen-2017-021059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To examine the association between neighbourhood deprivation and lung cancer risk. DESIGN Nested case-control study. SETTING Southern Community Cohort Study of persons residing in 12 states in the southeastern USA. PARTICIPANTS 1334 cases of lung cancer and 5315 controls. PRIMARY OUTCOME MEASURE Risk of lung cancer. RESULTS After adjustment for smoking status and other confounders, and additional adjustment for individual-level measures of socioeconomic status (SES), there was no monotonic increase in risk with worsening deprivation score overall or within sex and race groups. There was an increase among current and shorter term former smokers (p=0.04) but not among never and longer term former smokers. There was evidence of statistically significant interaction by sex among whites, but not blacks, in which the effect of worsening deprivation on lung cancer existed in males but not in females. CONCLUSIONS Area-level measures of SES were associated with lung cancer risk in current and shorter term former smokers only in this population.
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Affiliation(s)
- Maureen Sanderson
- Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee, USA
| | - Melinda C Aldrich
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Robert S Levine
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Barbara Kilbourne
- Department of Sociology, Tennessee State University, Nashville, Tennessee, USA
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - William J Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
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7
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Menvielle G, Kulhánová I, Bryère J, Launoy G, Eilstein D, Delpierre C, Soerjomataram I. Tobacco-attributable burden of cancer according to socioeconomic position in France. Int J Cancer 2018; 143:478-485. [PMID: 29457849 DOI: 10.1002/ijc.31328] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 01/25/2018] [Accepted: 02/05/2018] [Indexed: 02/05/2023]
Abstract
Smoking is a major preventable cause of cancers and is increasingly concentrated among the most deprived individuals leading to increasing socioeconomic inequalities in the incidence of cancers linked to smoking. We aimed to estimate the tobacco-attributable cancer burden according to socioeconomic position in France. The analysis was restricted to cancer sites for which tobacco smoking was recognized as a risk factor. Cancer cases by sex, age group and European Deprivation Index (EDI) among people aged 30-74 between 2006 and 2009 were obtained from cancer registries covering ∼20% of the French population. The tobacco-attributable burden of cancer according to EDI was estimated applying the population attributable fraction (PAF) computed with the Peto-Lopez method. The PAF increased from 56% in the least deprived EDI quintile to 70% in the most deprived EDI quintile among men and from 26% to 38% among women. In total, 28% of the excess cancer cases in the four most deprived EDI quintiles in men and 43% in women could be prevented if smoking in these 4 EDI quintiles was similar to that of the least deprived EDI quintile. A substantial smoking-attributable burden of cancer by socioeconomic position was observed in France. The results highlight the need for policies reducing tobacco consumption. More comprehensive interventions integrating the various dimensions of health determinants and proportionate according to socioeconomic position may essentially contribute to the reduction of socioeconomic inequalities in cancer.
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Affiliation(s)
- Gwenn Menvielle
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique IPLESP, 75012, Paris, France
| | - Ivana Kulhánová
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Joséphine Bryère
- Cancers and Preventions, U1086 INSERM-UCN, Centre François Baclesse, Caen, France
| | - Guy Launoy
- Cancers and Preventions, U1086 INSERM-UCN, Centre François Baclesse, Caen, France
- University Hospital Center (CHU) of Caen, Caen, France
- University of Caen Normandy, Caen, France
| | | | - Cyrille Delpierre
- UMR 1027 INSERM, Faculty of medicine, Toulouse, France
- University of Toulouse III - Paul Sabatier, Toulouse, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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8
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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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9
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Menvielle G, Dugas J, Franck JE, Carton M, Trétarre B, Stücker I, Luce D. Occupational prestige trajectory and the risk of lung and head and neck cancer among men and women in France. Int J Public Health 2017; 63:833-845. [PMID: 29222577 DOI: 10.1007/s00038-017-1063-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 11/15/2017] [Accepted: 11/25/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES This study aimed at investigating the associations between occupational prestige trajectories and lung and head and neck (HN) cancer risk and to assess to what extent smoking, alcohol drinking, and occupational exposures contribute to these associations. METHODS Using data from the ICARE case-control study (controls (2676 men/715 women), lung cancers (2019 men/558 women), HN cancers (1793 men/305 women), we defined occupational prestige trajectories using group-based modeling of longitudinal data. We conducted logistic regression models. RESULTS Among men, a gradient was observed from the downward "low to very low" trajectory to the stable very high trajectory. The associations were reduced when adjusting for tobacco and alcohol consumption and occupational exposures. Among women, when compared to the stable high trajectory, there was an increased cancer risk in all trajectories. The associations remained globally unchanged or even increased after adjustment for tobacco and alcohol consumption and did not change when adjusting for occupational exposures. The ORs were smaller for lung than for HN cancers in men. CONCLUSIONS Occupational prestige trajectory is strongly associated with lung and HN cancer risk in men and women.
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Affiliation(s)
- Gwenn Menvielle
- INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
| | - Julien Dugas
- INSERM, U 1085_IRSET, Pointe-À-Pitre, France.,University of Rennes 1, Rennes, France
| | - Jeanna-Eve Franck
- INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Matthieu Carton
- Institut Curie, PSL Research University, DRCI, Biométriesaint-Cloud, France
| | | | - Isabelle Stücker
- UVSQ, CESP, INSERM, Environmental Epidemiology of Cancer Team, University Paris Sud, Paris Saclay University, Villejuif, France
| | - Danièle Luce
- INSERM, U 1085_IRSET, Pointe-À-Pitre, France.,University of Rennes 1, Rennes, France
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10
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Denton EJ, Hart D, Russell PA, Wright G, Conron M. Lung cancer and socio-economic status: inextricably linked to place of residence. Intern Med J 2017; 47:563-569. [DOI: 10.1111/imj.13376] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/06/2017] [Accepted: 01/09/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Eve J. Denton
- School of Public Health and Preventative Medicine; Monash University; Melbourne Victoria Australia
- Department of Respiratory and Sleep Medicine; St Vincent's Hospital; Melbourne Victoria Australia
| | - David Hart
- Department of Respiratory and Sleep Medicine; St Vincent's Hospital; Melbourne Victoria Australia
| | - Prue A. Russell
- Department of Anatomical Pathology; St Vincent's Hospital; Melbourne Victoria Australia
| | - Gavin Wright
- Department of Surgery; Melbourne University, St Vincent's Hospital; Melbourne Victoria Australia
| | - Matthew Conron
- Department of Respiratory and Sleep Medicine; St Vincent's Hospital; Melbourne Victoria Australia
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11
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Yu XQ, Luo Q, Kahn C, Grogan P, O'Connell DL, Jemal A. Contrasting temporal trends in lung cancer incidence by socioeconomic status among women in New South Wales, Australia, 1985-2009. Lung Cancer 2017. [PMID: 28625648 DOI: 10.1016/j.lungcan.2017.02.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We examined long-term trends in lung cancer incidence for women by socioeconomic groups in New South Wales (NSW), Australia. METHODS Data on lung cancer incidence for women were extracted from the NSW Cancer Registry database. We divided the study cohort into five quintiles according to an area-based index of education and occupation (IEO) and calculated annual age-standardised incidence rates by IEO quintile for the period 1985-2009. The age-standardised incidence ratio (SIR) was estimated for IEO quintiles and 5-year period of diagnosis using the highest IEO quintile as the reference. RESULTS Overall, lung cancer incidence for women aged 25-69 years increased gradually from 19.8 per 100,000 in 1985 to 25.7 per 100,000 in 2009. The trends by IEO quintile were somewhat comparable from 1985 through to 1995, but from then on rates remained relatively stable for women residing in the highest quintile while increasing for women residing in the remaining four quintiles. Consequently, the SIR for all four of the lower IEO quintiles increased significantly over the 25-year period. For example, the SIR in the lowest IEO quintile increased from 1.16 (95% CI, 0.99-1.37) during 1985-1989 to 1.70 (95% CI, 1.50-1.93) during 2005-2009. The corresponding estimates for women aged 70 years or older showed no clear pattern of socioeconomic gradient. CONCLUSION The increasing gap in lung cancer incidence between women in the highest socioeconomic group and all others suggests that there is a continued need for the broad implementation of tobacco control interventions, so that smoking prevalence is reduced across all segments of the population and the subsequent benefits are shared more equitably across all demographic groups.
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Affiliation(s)
- Xue Qin Yu
- Cancer Research Division, Cancer Council NSW, Sydney, Australia; Sydney School of Public Health, The University of Sydney, Sydney, Australia.
| | - Qingwei Luo
- Cancer Research Division, Cancer Council NSW, Sydney, Australia; Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Clare Kahn
- Cancer Research Division, Cancer Council NSW, Sydney, Australia
| | - Paul Grogan
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Cancer Council Australia, Sydney, Australia
| | - Dianne L O'Connell
- Cancer Research Division, Cancer Council NSW, Sydney, Australia; Sydney School of Public Health, The University of Sydney, Sydney, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
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12
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Brown P, Jiang H, Ezzat S, Sawka AM. A detailed spatial analysis on contrasting cancer incidence patterns in thyroid and lung cancer in Toronto women. BMC Public Health 2016; 16:950. [PMID: 27609137 PMCID: PMC5016996 DOI: 10.1186/s12889-016-3634-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 09/02/2016] [Indexed: 11/18/2022] Open
Abstract
Background Thyroid cancer has been rapidly rising in incidence in Canada; however, in contrast, lung cancer appears to be decreasing in incidence in Canadian men and stable in women. Moreover, disease-related mortality risk is generally very low in TC but high in LC. We performed a geographic spatial analysis in metropolitan Toronto, Canada to determine if there is regional variability of respective risks of thyroid cancer (TC) and lung cancer (LC), among women. Women were of particular interest for this study, given their known predilection for thyroid cancer. Methods The postal codes of all females with TC or LC, residing in metropolitan Toronto from 2004 to 2008, were geocoded to point locations according to 2006 Canadian Census data. The data were analysed using a log-Gaussian Cox Process, where the intensity of age-adjusted cancer cases was modelled as a log-linear combination of the population at risk, explanatory variables (race, immigration, and median household income), and a residual spatially varying random effect. For each respective malignancy, statistical models were fit to make quantify the relationship between cancer incidence and explanatory variables. Results We included 2230 women with TC and 2412 with LC. The distribution of TC and LC cases contrasted inversely among Toronto neighbourhoods with the highest TC incidence in the Northeast and the highest LC incidence in the Southeast. A higher proportion of Asian ethnicity was associated with higher regional risk of TC and lower risk of LC. A higher proportion of recent immigrants was associated with increased LC and lower TC risk, whereas median household income and proportions of African ethnicity were not significantly associated with risk of either cancer, after adjustment for other socio-demographic variables. Conclusions We observed contrasting regional distributions of female TC and LC cases in Toronto. The differences were partly attributed to ethnic composition variability and the proportion of recent immigrants, but substantial unexplained residual variation of incidence patterns of these malignancies exists, suggesting that more individual-level research is needed to explain the regional variability of incidence of these malignancies.
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Affiliation(s)
- Patrick Brown
- Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, M5G 2L7, Canada
| | - Hedy Jiang
- Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, M5G 2L7, Canada
| | - Shereen Ezzat
- Endocrine Oncology, Princess Margaret Cancer Centre, 585 University Avenue, 9NU-986, Toronto, Ontario, M5G 2N2, Canada
| | - Anna M Sawka
- Division of Endocrinology, Department of Medicine, University Health Network and University of Toronto, Toronto General Hospital, 200 Elizabeth Street, 12 EN-212, Toronto, Ontario, M5G 2C4, Canada.
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13
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Menvielle G, Franck JE, Radoï L, Sanchez M, Févotte J, Guizard AV, Stücker I, Luce D. Quantifying the mediating effects of smoking and occupational exposures in the relation between education and lung cancer: the ICARE study. Eur J Epidemiol 2016; 31:1213-1221. [PMID: 27417979 DOI: 10.1007/s10654-016-0182-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 07/06/2016] [Indexed: 11/25/2022]
Abstract
Smoking only partly explains the higher lung cancer incidence observed among socially deprived people. Occupational exposures may account for part of these inequalities, but this issue has been little investigated. We investigated the extent to which smoking and occupational exposures to asbestos, silica and diesel motor exhaust mediated the association between education and lung cancer incidence in men. We analyzed data from a large French population-based case-control study (1976 lung cancers, 2648 controls). Detailed information on lifelong tobacco consumption and occupational exposures to various carcinogens was collected. We conducted inverse probability-weighted marginal structural models. A strong association was observed between education and lung cancer. The indirect effect through smoking varied by educational level, with the strongest indirect effect observed for those with the lowest education (OR = 1.34 (1.14-1.57)). The indirect effect through occupational exposures was substantial among men with primary (OR = 1.22 (1.15-1.30) for asbestos and silica) or vocational secondary education (OR = 1.18 (1.12-1.25)). The contribution of smoking to educational differences in lung cancer incidence ranged from 22 % (10-34) for men with primary education to 31 % (-3 to 84) for men with a high school degree. The contribution of occupational exposures to asbestos and silica ranged from 15 % (10-20) for men with a high school degree to 20 % (13-28) for men with vocational secondary education. Our results highlight the urgent need for public health policies that aim at decreasing exposure to carcinogens at work, in addition to tobacco control policies, if we want to reduce socioeconomic inequalities in the cancer field.
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Affiliation(s)
- Gwenn Menvielle
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France.
| | - Jeanna-Eve Franck
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France
| | - Loredana Radoï
- Inserm UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France
- University of Paris Descartes, Paris, France
| | - Marie Sanchez
- Inserm UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France
- University of Paris Sud 11, Kremlin-Bicêtre, France
| | - Joëlle Févotte
- Unité Mixte de Recherche Épidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE), Université Claude Bernard Lyon 1, 69373, Lyon, France
| | | | - Isabelle Stücker
- Inserm UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France
- University of Paris Sud 11, Kremlin-Bicêtre, France
| | - Danièle Luce
- Inserm U 1085, IRSET, Pointe-à-Pitre, France
- University of Rennes 1, Rennes, France
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14
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Behrens T, Groß I, 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, Zaridze D, Szeszenia-Dabrowska N, Rudnai P, Lissowska J, Fabianova E, Tardón A, Field JK, Dumitru RS, Bencko V, Foretova L, Janout V, Kromhout H, Vermeulen R, Boffetta P, Straif K, Schüz J, Hovanec J, Kendzia B, Pesch B, Brüning T. Occupational prestige, social mobility and the association with lung cancer in men. BMC Cancer 2016; 16:395. [PMID: 27388894 PMCID: PMC4936282 DOI: 10.1186/s12885-016-2432-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 06/10/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The nature of the association between occupational social prestige, social mobility, and risk of lung cancer remains uncertain. Using data from the international pooled SYNERGY case-control study, we studied the association between lung cancer and the level of time-weighted average occupational social prestige as well as its lifetime trajectory. METHODS We included 11,433 male cases and 14,147 male control subjects. Each job was translated into an occupational social prestige score by applying Treiman's Standard International Occupational Prestige Scale (SIOPS). SIOPS scores were categorized as low, medium, and high prestige (reference). We calculated odds ratios (OR) with 95 % confidence intervals (CI), adjusting for study center, age, smoking, ever employment in a job with known lung carcinogen exposure, and education. Trajectories in SIOPS categories from first to last and first to longest job were defined as consistent, downward, or upward. We conducted several subgroup and sensitivity analyses to assess the robustness of our results. RESULTS We observed increased lung cancer risk estimates for men with medium (OR = 1.23; 95 % CI 1.13-1.33) and low occupational prestige (OR = 1.44; 95 % CI 1.32-1.57). Although adjustment for smoking and education reduced the associations between occupational prestige and lung cancer, they did not explain the association entirely. Traditional occupational exposures reduced the associations only slightly. We observed small associations with downward prestige trajectories, with ORs of 1.13, 95 % CI 0.88-1.46 for high to low, and 1.24; 95 % CI 1.08-1.41 for medium to low trajectories. CONCLUSIONS Our results indicate that occupational prestige is independently associated with lung cancer among men.
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Affiliation(s)
- Thomas Behrens
- />Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Isabelle Groß
- />Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Jack Siemiatycki
- />Hospital Research Center (CRCHUM) and School of Public Health, University of Montreal, Montreal, Canada
| | - David I. Conway
- />Dental School, College of Medicine Veterinary and Life Sciences, University of Glasgow, Glasgow, G2 3JZ UK
| | - 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, F-94807 Villejuif, France
- />University Paris-Sud, UMRS 1018, F-94807 Villejuif, France
| | - Florence Guida
- />Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Team, F-94807 Villejuif, France
- />University Paris-Sud, UMRS 1018, F-94807 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
- />Department of Medical Sciences, Unit of Cancer Epidemiology, University of Turin, Turin, Italy
| | - Lorenzo Richiardi
- />Department of Medical Sciences, Unit of Cancer Epidemiology, University of Turin, Turin, Italy
| | - Lorenzo Simonato
- />Department of Molecular Medicine, Laboratory of Public Health and Population Studies, University of Padova, Padova, Italy
| | - Cristina Fortes
- />Epidemiology Unit, Istituto Dermopatico dell’Immacolata, Rome, Italy
| | - Marie-Elise Parent
- />INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec Canada
| | - John McLaughlin
- />Cancer Care Ontario, Occupational Cancer Research Centre, Toronto, 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, USA
| | - Neil Caporaso
- />National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, USA
| | - 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
| | - Adonina Tardón
- />Molecular Epidemiology of Cancer Unit, University of Oviedo-Ciber de Epidemiologia, CIBERESP, Oviedo, Spain
| | - John K. Field
- />Roy Castle Lung Cancer Research Programme, The University of Liverpool Cancer Research Centre, Liverpool, UK
- />Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | | | - Vladimir Bencko
- />Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lenka Foretova
- />Department of Cancer Epidemiology & Genetics, Masaryk Memorial Cancer Institute and Medical Faculty of Masaryk University, Brno, Czech Republic
| | - Vladimir Janout
- />Faculty of Medicine, Palacky University, Olomouc, Czech Republic
- />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 and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Kurt Straif
- />International Agency for Research on Cancer (IARC), Lyon, France
| | - Joachim Schüz
- />International Agency for Research on Cancer (IARC), Lyon, France
| | - Jan Hovanec
- />Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Benjamin Kendzia
- />Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Beate Pesch
- />Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Thomas Brüning
- />Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
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Kirkham TL, Siemiatycki J, Labrèche F, Lavoué J. Impact of aggregating exposure information from cases and controls when building a population-based job-exposure matrix from past expert evaluations. Occup Environ Med 2016; 73:474-81. [PMID: 27030203 DOI: 10.1136/oemed-2014-102690] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 03/07/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess whether the inclusion of data from cases would bias a job-exposure matrix (JEM), we evaluated whether exposures were systematically different between cases and controls from a large historical case-control study. METHODS Data included 10 381 jobs assessed for occupational exposure to 294 agents within a lung cancer case-control study. For each sex, 1 JEM was developed from case jobs, and 1 from control jobs: with occupation (four-digit occupational codes), time period (1945-1959, 1960-1984, 1985-1995) and agent axes. We estimated concordance in exposure status (defined as probability of exposure threshold ≥5%) and exposure metrics of probability and intensity of exposure, between the 2 JEMs. RESULTS Of all hypothetical occupation-period-agent combinations, most had no or few observations. Among males there were 8136 common cells (24-occupational codes, 3-periods, 226-agents), containing sufficient observations for comparison with 92% concordance in exposure status; discordance was equally likely to be towards cases or controls. Females had 1710 common cells (9-occupational codes, 3-periods, 114-agents) with 93% concordance in exposure status; discordant cells were more likely to reflect greater exposure among cases. Among concordantly exposed cells, probability and intensity of exposures were highly correlated between the case JEM and control JEM (Kendall τ>0.50), and absolute differences were small (median difference in probability <1.5%, median ratio in intensity=1.00) for both sexes. CONCLUSIONS Agreement between the case JEM and control JEM was high, suggesting that aggregating the case and control information in our study into a single JEM is justifiable given the benefits of increased sample size.
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Affiliation(s)
- Tracy L Kirkham
- University of Montreal Hospital Research Center (CRCHUM), Montréal, Quebec, Canada
| | - Jack Siemiatycki
- University of Montreal Hospital Research Center (CRCHUM), Montréal, Quebec, Canada
| | - France Labrèche
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail du Québec (IRSST), Direction de la recherche, Montréal, Quebec, Canada Department of Environmental and Occupational Health, University of Montréal, Montréal, Quebec, Canada
| | - Jérôme Lavoué
- University of Montreal Hospital Research Center (CRCHUM), Montréal, Quebec, Canada Department of Environmental and Occupational Health, University of Montréal, Montréal, Quebec, Canada
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Gruer L, Hart CL, Watt GCM. After 50 years and 200 papers, what can the Midspan cohort studies tell us about our mortality? Public Health 2015; 142:186-195. [PMID: 26255248 DOI: 10.1016/j.puhe.2015.06.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 06/23/2015] [Accepted: 06/28/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To distil the main findings from published papers on mortality in three cohorts involving over 27,000 adults, recruited in Scotland between 1965 and 1976 and followed up ever since. METHOD We read and summarized 48 peer-reviewed papers about all-cause and cause-specific mortality in these cohorts, published between 1978 and 2013. RESULTS Mortality rates were substantially higher among cigarette smokers in all social classes and both genders. Exposure to second-hand smoke was also damaging. Exposure to higher levels of black smoke pollution was associated with higher mortality. After smoking, diminished lung function was the risk factor most strongly related to higher mortality, even among never-smokers. On average, female mortality rates were much lower than male but the same risk factors were predictors of mortality. Mortality rates were highest among men whose paternal, own first and most recent jobs were manual. Specific causes of death were associated with different life stages. Upward and downward social mobility conferred intermediate mortality rates. Low childhood cognitive ability was strongly associated with low social class in adulthood and higher mortality before age 65 years. There was no evidence that daily stress contributed to higher mortality among people in lower social positions. Men in manual occupations with fathers in manual occupations, who smoked and drank >14 units of alcohol a week had cardiovascular disease mortality rates 4.5 times higher than non-manual men with non-manual fathers, who neither smoked nor drank >14 units. Men who were obese and drank >14 units of alcohol per day had a mortality rate due to liver disease 19 times that of normal or underweight non-drinkers. Among women who never smoked, mortality rates were highest in severely obese women in the lowest occupational classes. CONCLUSION These studies highlight the cumulative effect of adverse exposures throughout life, the complex interplay between social circumstances, culture and individual capabilities, and the damaging effects of smoking, air pollution, alcohol and obesity.
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Affiliation(s)
- L Gruer
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - C L Hart
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - G C M Watt
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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18
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El-Zein M, Parent ME, Siemiatycki J, Rousseau MC. History of allergic diseases and lung cancer risk. Ann Allergy Asthma Immunol 2014; 112:230-6. [PMID: 24439421 DOI: 10.1016/j.anai.2013.12.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 12/02/2013] [Accepted: 12/22/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND The exact nature and direction of the association between a history of allergic diseases and lung cancer risk remain controversial. OBJECTIVE To examine the association between self-reported history of allergic diseases and lung cancer using data from a population-based case-control study conducted in the Montreal metropolitan area (1996-2002). METHODS The study is based on interview data collected from 1,169 incident lung cancer cases and 1,486 controls. Separate logistic regression models were used to estimate the relative risk of lung cancer, using odds ratios (ORs) and 95% confidence intervals (CIs), in subjects with vs without asthma, eczema, or hay fever after adjustment for several sociodemographic and lifestyle factors, including smoking. RESULTS For asthma, the OR was 0.90 (95% CI 0.65-1.24), which decreased to 0.76 (95% CI 0.54-1.08) for subjects whose onset was more than 2 years before lung cancer diagnosis or interview and then to 0.64 (95% CI 0.44-0.93) when restricted to subjects who reported using medication for their asthma. For eczema, the point estimate was 0.73 (95% CI 0.48-1.12), which decreased to 0.63 (95% CI 0.38-1.07) when considering eczema only in those who reported medication use. Hay fever showed the strongest inverse association with lung cancer (OR 0.37, 95% CI 0.24-0.59). CONCLUSION All 3 allergic diseases examined were inversely associated with lung cancer, although the strength of the protective effect varied. History of allergic diseases seems to have a protective role in lung cancer incidence, after consideration of potential confounders, including lifetime smoking history.
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Affiliation(s)
- Mariam El-Zein
- INRS-Institut Armand-Frappier, Université du Québec, Laval, Quebec, Canada
| | - Marie-Elise Parent
- INRS-Institut Armand-Frappier, Université du Québec, Laval, Quebec, Canada; Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Jack Siemiatycki
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Marie-Claude Rousseau
- INRS-Institut Armand-Frappier, Université du Québec, Laval, Quebec, Canada; Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada; University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
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Kachuri L, Villeneuve PJ, Parent MÉ, Johnson KC, Harris SA. Occupational exposure to crystalline silica and the risk of lung cancer in Canadian men. Int J Cancer 2013; 135:138-48. [PMID: 24272527 DOI: 10.1002/ijc.28629] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 11/07/2013] [Indexed: 01/08/2023]
Abstract
Crystalline silica is a recognized carcinogen, but the association with lung cancer at lower levels of exposure has not been well characterized. This study investigated the relationship between occupational silica exposure and lung cancer and the combined effects of cigarette smoking and silica exposure on lung cancer risk. A population-based case-control study was conducted in eight Canadian provinces between 1994 and 1997. Self-reported questionnaires were used to obtain a lifetime occupational history and information on other risk factors. Occupational hygienists assigned silica exposures to each job based on concentration, frequency and reliability. Data from 1681 incident lung cancer cases and 2053 controls were analyzed using logistic regression to estimate odds ratios (OR) and their 95% confidence intervals (CI). Models included adjustments for cigarette smoking, lifetime residential second-hand smoke and occupational exposure to diesel and gasoline engine emissions. Relative to the unexposed, increasing duration of silica exposure at any concentration was associated with a significant trend in lung cancer risk (OR ≥ 30 years: 1.67, 1.21-2.24; ptrend = 0.002). The highest tertile of cumulative silica exposure was associated with lung cancer (OR = 1.81, 1.34-2.42; ptrend = 0.004) relative to the lowest. Men exposed to silica for ≥30 years with ≥40 cigarette pack-years had the highest risk relative to those unexposed with <10 pack-years (OR = 42.53, 23.54-76.83). The joint relationship with smoking was consistent with a multiplicative model. Our findings suggest that occupational exposure to silica is a risk factor for lung cancer, independently from active and passive smoking, as well as from exposure to other lung carcinogens.
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Affiliation(s)
- Linda Kachuri
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, ON; Occupational Cancer Research Centre, Toronto, ON; Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON
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Hystad P, Carpiano RM, Demers PA, Johnson KC, Brauer M. Neighbourhood socioeconomic status and individual lung cancer risk: Evaluating long-term exposure measures and mediating mechanisms. Soc Sci Med 2013; 97:95-103. [DOI: 10.1016/j.socscimed.2013.08.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 08/04/2013] [Accepted: 08/08/2013] [Indexed: 12/12/2022]
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Lung Cancer Screening: Review and Performance Comparison Under Different Risk Scenarios. Lung 2013; 192:55-63. [DOI: 10.1007/s00408-013-9517-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 10/02/2013] [Indexed: 02/04/2023]
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Hochgatterer K, Moshammer H, Haluza D. Dust is in the air: effects of occupational exposure to mineral dust on lung function in a 9-year study. Lung 2013; 191:257-63. [PMID: 23568145 DOI: 10.1007/s00408-013-9463-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 03/18/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Occupational mineral dust exposure is a well-known risk factor for numerous respiratory and systemic diseases. The aim of the present longitudinal study was to assess the influence of work-associated dust exposure on spirometric results. Furthermore, the impact of implementation of stricter limit values for occupational contact with quartz dust on lung function was evaluated. METHODS Anthropometric data (age, gender, BMI), smoking behavior, and lung function parameters (FVC, FEV1, MEF50) from 7,204 medical examinations of 3,229 female and male workers during the years 2002-2010 were examined following Austrian standards for occupational medicine and the guidelines of the European Respiratory Society. Analysis of data was performed using models of multiple linear regression. RESULTS Lung function decrease over time was associated with smoking habits and duration of occupational dust exposure. Specifically, occupational quartz exposure negatively influenced the annual lung function parameters (FVC, -6.68 ml; FEV1, -6.71 ml; and MEF50, -16.15 ml/s, all p < 0.001). Thus, an overadditive effect of smoking and work-related contact with quartz was found regarding decline in MEF50 (p < 0.05). Implementation of stricter occupational limit values for dust exposure resulted in a highly significant deceleration of the annual decrease in respiratory function (p = 0.001). CONCLUSIONS Individual smoking habits and occupational dust exposure had a negative impact on lung function. To reduce the risk of loss of respiratory capacity, smoking cessation is especially recommended to workers exposed to quartz dust. Moreover, stricter limit values could prevent chronic occupational damage to the respiratory system.
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