Family Socioeconomic Position and Lung Cancer Risk: A Meta-Analysis and a Mendelian Randomization Study

An umbrella review of socioeconomic status and cancer

Extensive evidence underscores the pivotal role of socioeconomic status (SES) in shaping cancer-related outcomes. However, synthesizing definitive and actionable insights from the expansive body of literature remains a significant challenge. To elucidate the associations between SES, cancer outcomes, and the overall cancer burden, we conducted a comprehensive burden estimation coupled with an umbrella review of relevant meta-analyses. Our findings reveal that robust or highly suggestive meta-analytic evidence supports only a limited number of these associations. Individuals with lower SES, compared to those with higher SES, are disproportionately disadvantaged by reduced access to immunotherapy, KRAS testing for colorectal cancer, targeted cancer therapies, and precision treatments for melanoma. Additionally, they exhibit lower rates of breast cancer screening and higher incidence rates of lung cancer. Furthermore, countries with a higher Human Development Index demonstrate a substantially greater burden related cancer incidence, with this disparity being more pronounced among men than women.

Lung Cancer in Women-Sociodemographic, Clinical and Psychological Characteristics with Comparison to Men

(1) Background: There is a difference in the course of lung cancer between women and men. Therefore, there is a need to evaluate various factors in the patient population treated in daily practice. The purpose of this study was to analyze the clinical, sociodemographic and psychological aspects of female lung cancer. To better express the results, we compared women and men. (2) Methods: Consecutive patients with a history of lung cancer treatment admitted to the outpatient oncology clinic (Department of Lung Cancer and Chest Tumours, Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw) and the Department of Internal Medicine, Pulmonary Diseases and Allergy, were enrolled. We conducted analyses of the clinical, psychological and socioeconomic factors of women with lung cancer treated in everyday practice, including a comparison with a group of men. Demographic data were collected from a self-administered questionnaire. We used the Perceived Stress Scale (PSS-10) and Acceptance of Illness Scale (AIS) questionnaires for psychological evaluation. (3) Results: A total of 100 patients with confirmed primary lung cancer with a history of treatment were enrolled in the study (50 women and 50 men). We found a significantly shorter history of smoking in the group of women; at the same time, there were no differences in the reported incidence of COPD. Despite comparable results to men on the psychological questionnaire (PSS-10, AIS), women more often reported a willingness to be supported by a psychologist or psychiatrist due to lung cancer. However, they did not decide to consult them more often than men. Immunotherapy was a significantly less frequently used method in women. (4) Conclusions: We should be more active in finding out the willingness to consult a psychologist or psychiatrist among women with lung cancer. The diagnosis of COPD should be considered more often among women due to the lack of differences in the reported incidence of COPD between men and women, despite a clear contrast in the number of pack-years.

Socioeconomic status, obesity, individual behaviors, diabetes, and risk for frozen shoulder: A Mendelian randomization study

There are few studies on risk factors for frozen shoulder, and even fewer Mendelian randomization (MR) studies on frozen shoulder. Therefore, we conducted a two-sample MR study to explore whether socioeconomic status (years of schooling, average total household income before tax), obesity (body mass index and waist circumference), individual behaviors (smoking initiation, alcohol intake frequency, coffee intake, nonoily fish intake, tea intake, beef intake, bread intake, cheese intake, oily fish intake, and fresh fruit intake), and diabetes (type 1 and type 2 diabetes) are associated with frozen shoulder. The exposure datasets and the outcome dataset were extracted from the MRC Integrative Epidemiology Unit at the University of Bristol Open genome-wide association studies project (https://gwas.mrcieu.ac.uk/). We conducted MR analyses using the inverse variance weighted (primary method), MR-Egger, and weighted median methods and conducted heterogeneity and pleiotropy analyses. Type 1 diabetes (OR: 1.103; 95% CI: 1.053-1.156; P = .0000410) was associated with an increased risk of frozen shoulder. Cheese intake (OR: 0.490; 95% CI: 0.267-0.899; P = .0213), non-oily fish intake (OR: 0.0993; 95% CI: 0.0220-0.448; P = .00267), years of schooling (OR: 0.453; 95% CI: 0.349-0.588; P = .00000000277), and average total household income before tax (OR: 0.434; 95% CI: 0.253-0.743; P = .00236) were discovered as protective factors. No horizontal pleiotropy was found in all analyzes we performed (P > .05). Our study indicated that type 1 diabetes was a risk factor for frozen shoulder while cheese intake, non-oily fish intake, years of schooling, and average total household income before tax were considered as protective factors for frozen shoulder.

Estimating 10-year risk of lung and breast cancer by occupation in Switzerland

Introduction

Lung and breast cancer are important in the working-age population both in terms of incidence and costs. The study aims were to estimate the 10-year risk of lung and breast cancer by occupation and smoking status and to create easy to use age-, and sex-specific 10-year risk charts.

Methods

New lung and breast cancer cases between 2010 and 2014 from all 5 cancer registries of Western Switzerland, matched with the Swiss National Cohort were used. The 10-year risks of lung and breast cancer by occupational category were estimated. For lung cancer, estimates were additionally stratified by smoking status using data on smoking prevalence from the 2007 Swiss Health Survey.

Results

The risks of lung and breast cancer increased with age and were the highest for current smokers. Men in elementary professions had a higher 10-year risk of developing lung cancer compared to men in intermediate and managerial professions. Women in intermediate professions had a higher 10-year risk of developing lung cancer compared to elementary and managerial professions. However, women in managerial professions had the highest risk of developing breast cancer.

Discussion

The 10-year risk of lung and breast cancer differs substantially between occupational categories. Smoking creates greater changes in 10-year risk than occupation for both sexes. The 10-year risk is interesting for both patients and professionals to inform choices related to cancer risk, such as screening and health behaviors. The risk charts can also be used as public health indicators and to inform policies to protect workers.