Lung Cancer: is There an Association with Socioeconomic Status in The Netherlands?

Overview

Journal J Epidemiol Community Health

Specialty Health Services

Date 1995 Feb 1

PMID 7707009

Citations 16

Authors

A J van Loon

R A Goldbohm

P A van den Brandt

Affiliations

Soon will be listed here.

Abstract

Study Objective: To evaluate if there are differences in lung cancer incidence between socioeconomic groups in the Netherlands and if so, if smoking habits and other lifestyle characteristics could explain these differences.

Design: Prospective cohort study. Baseline measurement included information on socioeconomic status, smoking habits, and other covariates by means of a self-administered questionnaire. Follow up was established by computerised record linkage to cancer registries and a pathology register.

Setting: Population originating from 204 municipalities in The Netherlands.

Participants: 58,279 men aged 55-69 years in September 1986. After 3.3 years of follow up 490 microscopically confirmed incident lung cancer cases were detected.

Main Results: An inverse association between lung cancer risk and highest level of education was found, which persisted after adjustment for age, smoking, dietary intake of vitamin C, beta-carotene and retinol (rate ratio (RR) highest/lowest level of education = 0.52, 95% CI 0.33, 0.82, trend p < 0.001). Men with a lower white collar profession had a significantly lower relative rate of lung cancer compared with blue collar workers (RR = 0.66, 95% CI 0.47, 0.96), but after adjustment for smoking habits this difference was reduced (RR = 0.73, 95% CI 0.51, 1.08).

Conclusions: There is an inverse association between highest level of education and lung cancer, which is still apparent after adjustment for age, smoking, dietary intake of vitamin C, beta-carotene and retinol. The significantly lower lung cancer risk of lower white collar workers compared with the risk of blue collar workers could be partially explained by smoking habits.

Citing Articles

A Regional Study to Evaluate the Impact of Coal-fired Power Plants on Lung Cancer Incident Rates.

Ige O, Ratnayake I, Martinez J, Pepper S, Alsup A, McGuirk M Prev Oncol Epidemiol. 2024; 2(1).

PMID: 38899318 PMC: 11185817. DOI: 10.1080/28322134.2024.2348469.

Exposure-Response Analyses of Asbestos and Lung Cancer Subtypes in a Pooled Analysis of Case-Control Studies.

Olsson A, Vermeulen R, Schuz J, Kromhout H, Pesch B, Peters S Epidemiology. 2017; 28(2):288-299.

PMID: 28141674 PMC: 5287435. DOI: 10.1097/EDE.0000000000000604.

Regional Inequalities in Lung Cancer Mortality in Belgium at the Beginning of the 21st Century: The Contribution of Individual and Area-Level Socioeconomic Status and Industrial Exposure.

Hagedoorn P, Vandenheede H, Willaert D, Vanthomme K, Gadeyne S PLoS One. 2016; 11(1):e0147099.

PMID: 26760040 PMC: 4711966. DOI: 10.1371/journal.pone.0147099.

Socioeconomic status and lung cancer: unraveling the contribution of genetic admixture.

Aldrich M, Selvin S, Wrensch M, Sison J, Hansen H, Quesenberry Jr C Am J Public Health. 2013; 103(10):e73-80.

PMID: 23948011 PMC: 3780736. DOI: 10.2105/AJPH.2013.301370.

Systematic review with meta-analysis of the epidemiological evidence in the 1900s relating smoking to lung cancer.

Lee P, Forey B, Coombs K BMC Cancer. 2012; 12:385.

PMID: 22943444 PMC: 3505152. DOI: 10.1186/1471-2407-12-385.

References

Wynder E, Stellman S . Comparative epidemiology of tobacco-related cancers. Cancer Res. 1977; 37(12):4608-22. View

Williams R, Horm J . Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. J Natl Cancer Inst. 1977; 58(3):525-47. DOI: 10.1093/jnci/58.3.525. View

Sterling T, WEINKAM J . Smoking patterns by occupation, industry, sex, and race. Arch Environ Health. 1978; 33(6):313-7. DOI: 10.1080/00039896.1978.10667354. View

Kvale G, BJELKE E, GART J . Dietary habits and lung cancer risk. Int J Cancer. 1983; 31(4):397-405. DOI: 10.1002/ijc.2910310402. View

Pastorino U, Berrino F, Gervasio A, Pesenti V, Riboli E, Crosignani P . Proportion of lung cancers due to occupational exposure. Int J Cancer. 1984; 33(2):231-7. DOI: 10.1002/ijc.2910330211. View

Graham S . Epidemiology of retinoids and cancer. J Natl Cancer Inst. 1984; 73(6):1423-8. View

Teppo L . Cancer incidence by living area, social class and occupation. Scand J Work Environ Health. 1984; 10(6 Spec No):361-6. DOI: 10.5271/sjweh.2306. View

Vagero D, Persson G . Occurrence of cancer in socioeconomic groups in Sweden. An analysis based on the Swedish Cancer Environment Registry. Scand J Soc Med. 1986; 14(3):151-60. DOI: 10.1177/140349488601400308. View

Byers T, Graham S, Haughey B, Marshall J, Swanson M . Diet and lung cancer risk: findings from the Western New York Diet Study. Am J Epidemiol. 1987; 125(3):351-63. DOI: 10.1093/oxfordjournals.aje.a114542. View

10.

Pearce N, Howard J . Occupation, social class and male cancer mortality in New Zealand, 1974-78. Int J Epidemiol. 1986; 15(4):456-62. DOI: 10.1093/ije/15.4.456. View

11.

Zurayk H, Halabi S, Deeb M . Measures of social class based on education for use in health studies in developing countries. J Epidemiol Community Health. 1987; 41(2):173-9. PMC: 1052605. DOI: 10.1136/jech.41.2.173. View

12.

Slater C, Carlton B . Behavior, lifestyle, and socioeconomic variables as determinants of health status: implications for health policy development. Am J Prev Med. 1985; 1(5):25-33. View

13.

Liberatos P, Link B, Kelsey J . The measurement of social class in epidemiology. Epidemiol Rev. 1988; 10:87-121. DOI: 10.1093/oxfordjournals.epirev.a036030. View

14.

Levi F, Negri E, La Vecchia C, Te V . Socioeconomic groups and cancer risk at death in the Swiss Canton of Vaud. Int J Epidemiol. 1988; 17(4):711-7. DOI: 10.1093/ije/17.4.711. View

15.

Rosen M, Hanning M, Wall S . Changing smoking habits in Sweden: towards better health, but not for all. Int J Epidemiol. 1990; 19(2):316-22. DOI: 10.1093/ije/19.2.316. View

16.

van den Brandt P, Schouten L, Goldbohm R, Dorant E, Hunen P . Development of a record linkage protocol for use in the Dutch Cancer Registry for Epidemiological Research. Int J Epidemiol. 1990; 19(3):553-8. DOI: 10.1093/ije/19.3.553. View

17.

Baquet C, Horm J, Gibbs T, Greenwald P . Socioeconomic factors and cancer incidence among blacks and whites. J Natl Cancer Inst. 1991; 83(8):551-7. DOI: 10.1093/jnci/83.8.551. View

18.

Winkleby M, Jatulis D, Frank E, Fortmann S . Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992; 82(6):816-20. PMC: 1694190. DOI: 10.2105/ajph.82.6.816. View

19.

Hein H, Suadicani P, Gyntelberg F . Lung cancer risk and social class. The Copenhagen Male Study--17-year follow up. Dan Med Bull. 1992; 39(2):173-6. View

20.

Jockel K, Ahrens W, Wichmann H, Becher H, Bolm-Audorff U, Jahn I . Occupational and environmental hazards associated with lung cancer. Int J Epidemiol. 1992; 21(2):202-13. DOI: 10.1093/ije/21.2.202. View