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 Demers; Maria Teresa Landi; Neil E Caporaso; Adonina Tardón; David Zaridze; Neonila Szeszenia-Dabrowska; Peter Rudnai; Jolanta Lissowska; Eleonora Fabianova; John K 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

doi:10.1371/journal.pone.0192999

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 Demers

Maria Teresa Landi, Neil E Caporaso, Adonina Tardón, David Zaridze, Neonila Szeszenia-Dabrowska, Peter Rudnai, Jolanta Lissowska, Eleonora Fabianova, John K 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

Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany.
University of Montreal, Hospital Research Center (CRCHUM) and School of Public Health, Montreal, Canada.
Dental School, College of Medicine Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, 104 22 Stockholm, Sweden.
University Paris-Sud, UMRS 1018, Villejuif, France.
Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany.
Leibniz-Institute for Prevention Research and Epidemiology -BIPS GmbH, Bremen, Germany.
Institute for Statistics, University Bremen, Bremen, Germany.
Institute of Epidemiology II, HMGU - Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany.
Institute of Medical Statistics and Epidemiology, Technical University Munich, Munich, Germany.
Unit of Epidemiology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and AOU Città della Salute e della Scienza di Torino, Italy.
Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padova, Padova, Italy.
Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI-IRCCS-FLMM), Rome, Italy.
INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada.
Public Health Ontario, Toronto, Canada.
Cancer Care Ontario, Occupational Cancer Research Centre, Toronto, Canada.
National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, United States of America.
Molecular Epidemiology of Cancer Unit, University of Oviedo-Ciber de Epidemiologia, CIBERESP, Oviedo, Spain.
Institute of Carcinogenesis, Russian Cancer Research Centre, Moscow, Russia.
The Nofer Institute of Occupational Medicine, Lodz, Poland.
National Centre for Public Health, Budapest, Hungary.
The M Sklodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland.
Regional Authority of Public Health, Preventive Occupational Medicine, Banska Bystrica, Slovakia.
Roy Castle Lung Cancer Research Programme, Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom.
National Institute of Public Health, Bucharest, Romania.
Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
Masaryk Memorial Cancer Institute and Medical Faculty of Masaryk University, Dept. of Cancer Epidemiology & Genetics, Brno, Czech Republic.
Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.
Institute for Risk Assessment Sciences
The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America.
Section of IARC Monographs, International Agency for Research on Cancer, Lyon, France. Electronic address: [email protected].

Research output: Contribution to journal › Article › Academic › peer-review

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 language	English
Article number	e0192999
Journal	PLoS One
Volume	13
Issue number	2
DOIs	https://doi.org/10.1371/journal.pone.0192999
Publication status	Published - 2018

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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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., ... Behrens, T. (2018). Lung cancer and socioeconomic status in a pooled analysis of case-control studies. PLoS One, 13(2), Article e0192999. https://doi.org/10.1371/journal.pone.0192999

@article{9a32687b2de4436586fa083d69e4a0df,

title = "Lung cancer and socioeconomic status in a pooled analysis of case-control studies",

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 Karl-Heinz J{\"o}ckel and Hermann Pohlabeln and Wolfgang Ahrens and Irene Br{\"u}ske and Heinz-Erich Wichmann and Per Gustavsson and Dario Consonni and Franco Merletti and Lorenzo Richiardi and Lorenzo Simonato and Cristina Fortes and Marie-Elise Parent and John McLaughlin and Paul Demers and Landi, \{Maria Teresa\} and Caporaso, \{Neil E\} and Adonina Tard{\'o}n and David Zaridze and Neonila Szeszenia-Dabrowska and Peter Rudnai and Jolanta Lissowska and Eleonora Fabianova and Field, \{John K\} 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",

year = "2018",

doi = "10.1371/journal.pone.0192999",

language = "English",

volume = "13",

journal = "PLoS One",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "2",

}

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, NE, Tardón, A, Zaridze, D, Szeszenia-Dabrowska, N, Rudnai, P, Lissowska, J, Fabianova, E, Field, JK, 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

TY - JOUR

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 E

AU - Tardón, Adonina

AU - Zaridze, David

AU - Szeszenia-Dabrowska, Neonila

AU - Rudnai, Peter

AU - Lissowska, Jolanta

AU - Fabianova, Eleonora

AU - Field, John K

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.

U2 - 10.1371/journal.pone.0192999

DO - 10.1371/journal.pone.0192999

M3 - Article

C2 - 29462211

SN - 1932-6203

VL - 13

JO - PLoS One

JF - PLoS One

IS - 2

M1 - e0192999

ER -

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

Abstract

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