Journal
PLOS ONE
Volume 13, Issue 2, Pages -Publisher
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0192999
Keywords
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Categories
Funding
- German Social Accident Insurance [FP 271]
- Canadian Institutes for Health Research
- Guzzo-SRC Chair in Environment and Cancer
- National Cancer Institute of Canada
- Canadian Cancer Society
- Occupational Cancer Research Centre
- Workplace Safety and Insurance Board
- Cancer Care Ontario
- European Commission's INCO Copernicus program [IC15-CT96-0313]
- European Union Nuclear Fission Safety Program [F14P-CT96-0055]
- French Agency of Health Security (ANSES)
- Fondation de France
- French National Research Agency (ANR)
- National Institute of Cancer (INCA)
- Fondation pour la Recherche Medicale
- French Institute for Public Health Surveillance (InVS)
- Health Ministry
- Organization for the Research on Cancer (ARC)
- FrenchMinistry of work, solidarity, and public function
- Federal Ministry of Education, Science, Research, and Technology [01 HK 173/0]
- Federal Ministry of Science [01 HK 546/8]
- Ministry of Labour and Social Affairs [III b7-27/13]
- Research Grants Council of the Hong Kong Special Administrative Region, China [CUHK4460/03M]
- Environmental Epidemiology Program of the Lombardy Region
- INAIL
- Italian Association for Cancer Research
- Region Piedmont
- Compagnia di San Paolo
- Lazio Region
- Health Research Council of New Zealand
- New Zealand Department of Labour
- Cancer Society of New Zealand
- Polish State Committee for Scientific Research [SPUB-M-COPERNICUS/P-05/DZ-30/99/2000]
- Institute Universitario de Oncologia
- Universidad de Oviedo, Asturias
- Fondo de Investigacion Sanitaria (FIS)
- Ciber de Epidemiologia y Salud Publica (CIBERESP)
- Swedish Council for Work Life Research
- Dutch Ministry of Health, Welfare and Sports
- Europe Against Cancer Program
- Roy Castle Foundation
- Intramural Research Program of the National Institutes of Health
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland
- Lottery Health Research
- Swedish Environmental Protection Agency
- National Institute of Public Health and the Environment
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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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