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

Jan Hovanec, Jack Siemiatycki, David I. Conway, Ann Olsson, Isabelle Stücker, Florence Guida, Karl Heinz Jockel, Hermann Pohlabeln, Wolfgang Ahrens, Irene Brüske, Heinz Erich Wichmann, Per Gustavsson, Dario Consonni, Franco Merletti, Lorenzo Richiardi, Lorenzo Simonato, Cristina Fortes, Marie Elise Parent, John McLaughlin, Paul Demers & 22 others Maria Teresa Landi, Neil Caporaso, Adonina Tardón, David Zaridze, Neonila Szeszenia-Dabrowska, Peter Rudnai, Jolanta Lissowska, Eleonora Fabianova, John Field, Rodica Stanescu Dumitru, Vladimir Bencko, Lenka Foretova, Vladimir Janout, Hans Kromhout, Roel Vermeulen, Paolo Boffetta, Kurt Straif, Joachim Schüz, Benjamin Kendzia, Beate Pesch, Thomas Brüning, Thomas Behrens

Research output: Contribution to journalArticle

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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.

Original languageEnglish
Article numbere0192999
JournalPLoS One
Volume13
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

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socioeconomic status
lung neoplasms
case-control studies
Social Class
Case-Control Studies
Lung Neoplasms
Economics
Odds Ratio
odds ratio
Confidence Intervals
confidence interval
Smoking
socioeconomics
Behavior Control
Carcinogens
Occupational Exposure
Logistics
occupational exposure
Canada
Education

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Hovanec, J., Siemiatycki, J., Conway, D. I., Olsson, A., Stücker, I., Guida, F., ... Behrens, T. (2018). Lung cancer and socioeconomic status in a pooled analysis of case-control studies. PLoS One, 13(2), [e0192999]. https://doi.org/10.1371/journal.pone.0192999

Lung cancer and socioeconomic status in a pooled analysis of case-control studies. / Hovanec, Jan; Siemiatycki, Jack; Conway, David I.; Olsson, Ann; Stücker, Isabelle; Guida, Florence; Jockel, Karl Heinz; Pohlabeln, Hermann; Ahrens, Wolfgang; Brüske, Irene; Wichmann, Heinz Erich; Gustavsson, Per; Consonni, Dario; Merletti, Franco; Richiardi, Lorenzo; Simonato, Lorenzo; Fortes, Cristina; Parent, Marie Elise; McLaughlin, John; Demers, Paul; Landi, Maria Teresa; Caporaso, Neil; Tardón, Adonina; Zaridze, David; Szeszenia-Dabrowska, Neonila; Rudnai, Peter; Lissowska, Jolanta; Fabianova, Eleonora; Field, John; Dumitru, Rodica Stanescu; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Kromhout, Hans; Vermeulen, Roel; Boffetta, Paolo; Straif, Kurt; Schüz, Joachim; Kendzia, Benjamin; Pesch, Beate; Brüning, Thomas; Behrens, Thomas.

In: PLoS One, Vol. 13, No. 2, e0192999, 01.02.2018.

Research output: Contribution to journalArticle

Hovanec, J, Siemiatycki, J, Conway, DI, Olsson, A, Stücker, I, Guida, F, Jockel, 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 2018, 'Lung cancer and socioeconomic status in a pooled analysis of case-control studies', PLoS One, vol. 13, no. 2, e0192999. https://doi.org/10.1371/journal.pone.0192999
Hovanec J, Siemiatycki J, Conway DI, Olsson A, Stücker I, Guida F et al. Lung cancer and socioeconomic status in a pooled analysis of case-control studies. PLoS One. 2018 Feb 1;13(2). e0192999. https://doi.org/10.1371/journal.pone.0192999
Hovanec, Jan ; Siemiatycki, Jack ; Conway, David I. ; Olsson, Ann ; Stücker, Isabelle ; Guida, Florence ; Jockel, Karl Heinz ; Pohlabeln, Hermann ; Ahrens, Wolfgang ; Brüske, Irene ; Wichmann, Heinz Erich ; Gustavsson, Per ; Consonni, Dario ; Merletti, Franco ; Richiardi, Lorenzo ; Simonato, Lorenzo ; Fortes, Cristina ; Parent, Marie Elise ; McLaughlin, John ; Demers, Paul ; Landi, Maria Teresa ; Caporaso, Neil ; Tardón, Adonina ; Zaridze, David ; Szeszenia-Dabrowska, Neonila ; Rudnai, Peter ; Lissowska, Jolanta ; Fabianova, Eleonora ; Field, John ; Dumitru, Rodica Stanescu ; Bencko, Vladimir ; Foretova, Lenka ; Janout, Vladimir ; Kromhout, Hans ; Vermeulen, Roel ; Boffetta, Paolo ; Straif, Kurt ; Schüz, Joachim ; Kendzia, Benjamin ; Pesch, Beate ; Brüning, Thomas ; Behrens, Thomas. / Lung cancer and socioeconomic status in a pooled analysis of case-control studies. In: PLoS One. 2018 ; Vol. 13, No. 2.
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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.",
author = "Jan Hovanec and Jack Siemiatycki and Conway, {David I.} and Ann Olsson and Isabelle St{\"u}cker and Florence Guida and Jockel, {Karl Heinz} and Hermann Pohlabeln and Wolfgang Ahrens and Irene Br{\"u}ske and Wichmann, {Heinz Erich} and Per Gustavsson and Dario Consonni and Franco Merletti and Lorenzo Richiardi and Lorenzo Simonato and Cristina Fortes and Parent, {Marie Elise} and John McLaughlin and Paul Demers and Landi, {Maria Teresa} and Neil Caporaso and Adonina Tard{\'o}n and David Zaridze and Neonila Szeszenia-Dabrowska and Peter Rudnai and Jolanta Lissowska and Eleonora Fabianova and John Field and Dumitru, {Rodica Stanescu} and Vladimir Bencko and Lenka Foretova and Vladimir Janout and Hans Kromhout and Roel Vermeulen and Paolo Boffetta and Kurt Straif and Joachim Sch{\"u}z and Benjamin Kendzia and Beate Pesch and Thomas Br{\"u}ning and Thomas Behrens",
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AU - Hovanec, Jan

AU - Siemiatycki, Jack

AU - Conway, David I.

AU - Olsson, Ann

AU - Stücker, Isabelle

AU - Guida, Florence

AU - Jockel, Karl Heinz

AU - Pohlabeln, Hermann

AU - Ahrens, Wolfgang

AU - Brüske, Irene

AU - Wichmann, Heinz Erich

AU - Gustavsson, Per

AU - Consonni, Dario

AU - Merletti, Franco

AU - Richiardi, Lorenzo

AU - Simonato, Lorenzo

AU - Fortes, Cristina

AU - Parent, Marie Elise

AU - McLaughlin, John

AU - Demers, Paul

AU - Landi, Maria Teresa

AU - Caporaso, Neil

AU - Tardón, Adonina

AU - Zaridze, David

AU - Szeszenia-Dabrowska, Neonila

AU - Rudnai, Peter

AU - Lissowska, Jolanta

AU - Fabianova, Eleonora

AU - Field, John

AU - Dumitru, Rodica Stanescu

AU - Bencko, Vladimir

AU - Foretova, Lenka

AU - Janout, Vladimir

AU - Kromhout, Hans

AU - Vermeulen, Roel

AU - Boffetta, Paolo

AU - Straif, Kurt

AU - Schüz, Joachim

AU - Kendzia, Benjamin

AU - Pesch, Beate

AU - Brüning, Thomas

AU - Behrens, Thomas

PY - 2018/2/1

Y1 - 2018/2/1

N2 - 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.

AB - 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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