Hovanec, J.* ; Siemiatycki, J.* ; Conway, D.I.* ; 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, M.T.* ; Caporaso, N.* ; Tardón, A.* ; Zaridze, D.* ; Szeszenia-Dabrowska, N.* ; Rudnai, P.* ; Lissowska, J.* ; Fabianova, E.* ; Field, J.* ; Dumitru, R.S.* ; 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 13:e0192999 (2018)
    
    
    
      
      
	
	    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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        Publication type
        Article: Journal article
    
 
    
        Document type
        Scientific Article
    
 
    
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        Keywords
        Secondhand Smoke Exposure; Social-class Differences; Educational Inequalities; Occupational Exposures; Neck-cancer; Risk; Mortality; Health; Epidemiology; Bias
    
 
    
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        Language
        english
    
 
    
        Publication Year
        2018
    
 
    
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        2018
    
 
    
    
        ISSN (print) / ISBN
        1932-6203
    
 
    
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	    Volume: 13,  
	    Issue: 2,  
	    Pages: ,  
	    Article Number: e0192999 
	    Supplement: ,  
	
    
 
    
        
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            Publisher
            Public Library of Science (PLoS)
        
 
        
            Publishing Place
            Lawrence, Kan.
        
 
	
        
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        Reviewing status
        Peer reviewed
    
 
    
        Institute(s)
        Institute of Epidemiology (EPI)
    
 
    
        POF-Topic(s)
        30202 - Environmental Health
    
 
    
        Research field(s)
        Genetics and Epidemiology
    
 
    
        PSP Element(s)
        G-504000-008
    
 
    
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        Erfassungsdatum
        2018-03-14