Abstract
BackgroundLung and upper aero-digestive tract (UADT) cancer risk are associated with low socioeconomic circumstances and routinely measured using area socioeconomic indices. We investigated effect of country of birth, marital status, one area deprivation measure and individual socioeconomic variables (economic activity, education, occupational social class, car ownership, household tenure) on risk associated with lung, UADT and all cancer combined (excluding non melanoma skin cancer).MethodsWe linked Scottish Longitudinal Study and Scottish Cancer Registry to follow 203,658 cohort members aged 15+ years from 1991–2006. Relative risks (RR) were calculated using Poisson regression models by sex offset for person-years of follow-up.Results21,832 first primary tumours (including 3,505 lung, 1,206 UADT) were diagnosed. Regardless of cancer, economically inactivity (versus activity) was associated with increased risk (male: RR 1.14, 95% CI 1.10–1.18; female: RR 1.06, 95% CI 1.02–1.11). For lung cancer, area deprivation remained significant after full adjustment suggesting the area deprivation cannot be fully explained by individual variables. No or non degree qualification (versus degree) was associated with increased lung risk; likewise for UADT risk (females only). Occupational social class associations were most pronounced and elevated for UADT risk. No car access (versus ownership) was associated with increased risk (excluding all cancer risk, males). Renting (versus home ownership) was associated with increased lung cancer risk, UADT cancer risk (males only) and all cancer risk (females only). Regardless of cancer group, elevated risk was associated with no education and living in deprived areas.ConclusionsDifferent and independent socioeconomic variables are inversely associated with different cancer risks in both sexes; no one socioeconomic variable captures all aspects of socioeconomic circumstances or life course. Association of multiple socioeconomic variables is likely to reflect the complexity and multifaceted nature of deprivation as well as the various roles of these dimensions over the life course.
Highlights
Lung and upper aero-digestive tract (UADT) cancer risk are associated with low socioeconomic circumstances and routinely measured using area socioeconomic indices
We aimed to reassess more finely the socioeconomic factors associated with cancer risk through: (i) examining the consistency of relationship between an area and several individual socioeconomic status (SES) measures and cancer risk; (ii) establishing if any single measure was associated with cancer incidence; (iii) assessing if the area measure was fully explained by the individual measures; and (iv) exploring if there were any synergistic effects between the area deprivation measure and each individual SES variable
The cohort consisted of 203,658 individuals (106,819 females and 96,839 males) present in the 1991 Census with an average age of 42.8 years (Table 1). 21,832 first primary cancers were diagnosed during 3.05 million person-years of follow-up (52.3% male, 47.7% female). 3,505 lung cancer cases were diagnosed during 3.12 million person-years of follow-up (52.6% female, 47.4% male) and 1,206 UADT cancer cases during 3.12 million person-years of follow-up (52.6%. female, 47.4% male) (Tables 2 and 3)
Summary
Lung and upper aero-digestive tract (UADT) cancer risk are associated with low socioeconomic circumstances and routinely measured using area socioeconomic indices. We investigated effect of country of birth, marital status, one area deprivation measure and individual socioeconomic variables (economic activity, education, occupational social class, car ownership, household tenure) on risk associated with lung, UADT and all cancer combined (excluding non melanoma skin cancer). Lung and upper aero-digestive tract (UADT) cancers taken together are the most common cancers in the world compared to the other individual sites; 21% of global cases were diagnosed in Europe in 2008 [3]. These cancers show stark socioeconomic inequalities with greater incidence among lower socioeconomic groups [4–7]. Lung and UADT cancers contributed 90% (males) and 81% (females) to total social inequality in cancer risk in Scotland when measured using the recently developed Scottish Index of Multiple Deprivation, an area measure of social circumstances [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
