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 Jöckel, Hermann Pohlabeln, Wolfgang Ahrens, Irene Brüske, Heinz-Erich Wichmann, Per Gustavsson, Dario Consonni, Franco Merletti, Lorenzo Richiardi, Lorenzo Simonato, Cristina Fortes, Marie-Elise Parent, John McLaughlin, Paul DemersMaria 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

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
Pages (from-to)e0192999
JournalPLoS One
Volume13
Issue number2
DOIs
Publication statusPublished - 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

Keywords

  • Age Factors
  • Aged
  • Canada
  • Europe
  • Female
  • Humans
  • Logistic Models
  • Lung Neoplasms/epidemiology
  • Male
  • Middle Aged
  • Occupational Exposure
  • Odds Ratio
  • Risk Factors
  • Sex Factors
  • Smoking/epidemiology
  • Social Class

Cite this

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; Jöckel, 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, 2018, p. e0192999.

Research output: Contribution to journalArticle

Hovanec, J, Siemiatycki, J, Conway, DI, Olsson, A, Stücker, I, Guida, F, Jöckel, K-H, Pohlabeln, H, Ahrens, W, Brüske, I, Wichmann, H-E, Gustavsson, P, Consonni, D, Merletti, F, Richiardi, L, Simonato, L, Fortes, C, Parent, M-E, 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, pp. 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;13(2):e0192999. https://doi.org/10.1371/journal.pone.0192999
Hovanec, Jan ; Siemiatycki, Jack ; Conway, David I ; Olsson, Ann ; Stücker, Isabelle ; Guida, Florence ; Jöckel, 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. pp. e0192999.
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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.",
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T1 - Lung cancer and socioeconomic status in a pooled analysis of case-control studies

AU - Hovanec, Jan

AU - Siemiatycki, Jack

AU - Conway, David I

AU - Olsson, Ann

AU - Stücker, Isabelle

AU - Guida, Florence

AU - Jöckel, 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

Y1 - 2018

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.

KW - Age Factors

KW - Aged

KW - Canada

KW - Europe

KW - Female

KW - Humans

KW - Logistic Models

KW - Lung Neoplasms/epidemiology

KW - Male

KW - Middle Aged

KW - Occupational Exposure

KW - Odds Ratio

KW - Risk Factors

KW - Sex Factors

KW - Smoking/epidemiology

KW - Social Class

U2 - 10.1371/journal.pone.0192999

DO - 10.1371/journal.pone.0192999

M3 - Article

C2 - 29462211

VL - 13

SP - e0192999

JO - PLoS One

JF - PLoS One

SN - 1932-6203

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ER -