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European Journal of Epidemiology

, Volume 25, Issue 3, pp 173–182 | Cite as

Life course social mobility and risk of upper aerodigestive tract cancer in men

  • N. SchmeisserEmail author
  • D. I. Conway
  • P. A. McKinney
  • A. D. McMahon
  • H. Pohlabeln
  • M. Marron
  • S. Benhamou
  • C. Bouchardy
  • G. J. Macfarlane
  • T. V. Macfarlane
  • P. Lagiou
  • A. Lagiou
  • V. Bencko
  • I. Holcátová
  • F. Merletti
  • L. Richiardi
  • K. Kjaerheim
  • A. Agudo
  • R. Talamini
  • J. Polesel
  • C. Canova
  • L. Simonato
  • R. Lowry
  • A. Znaor
  • C. Healy
  • B. E. McCarten
  • M. Hashibe
  • P. Brennan
  • W. Ahrens
CANCER

Abstract

The aim of this study was to explore associations between social mobility and tumours of the upper aero-digestive tract (UADT), focussing on life-course transitions in social prestige (SP) based on occupational history. 1,796 cases diagnosed between 1993 and 2005 in ten European countries were compared with 1585 controls. SP was classified by the Standard International Occupational Prestige Scale (SIOPS) based on job histories. SIOPS was categorised in high (H), medium (M) and low (L). Time weighted average achieved and transitions between SP with nine trajectories: H → H, H → M, H → L, M → H, M → M, M → L, L → H, L → M and L → L were analysed. Odds ratios (ORs) and 95%-confidence intervals [95%-CIs] were estimated with logistic regression models including age, consumption of fruits/vegetables, study centre, smoking and alcohol consumption. The adjusted OR for the lowest versus the highest of three categories (time weighted average of SP) was 1.28 [1.04–1.56]. The distance of SP widened between cases and controls during working life. The downward trajectory H → L gave an OR of 1.71 [0.75–3.87] as compared to H → H. Subjects with M → M and L → L trajectories ORs were also elevated relative to subjects with H → H trajectories. The association between SP and UADT is not fully explained by confounding factors. Downward social trajectory during the life course may be an independent risk factor for UADT cancers.

Keywords

Laryngeal cancer Pharyngeal cancer Oral cavity cancer Oesophageal cancer Case–control study Socioeconomic status Occupational history 

Notes

Acknowledgments

We would like to thank all the patients and their families for their participation. We are also grateful to the support of many clinicians and staff of the hospitals, interviewers, data managers, pathology departments, and primary care clinics. GJM and TVM partly worked on this study while at the University of Manchester. They acknowledge the help of Dr A-M Biggs, Dr R Oliver and Professor M Tickle in study conduct in the Manchester centre and Professor P Sloan and Professor N Thakker who in addition co-ordinated sample collection and processing for all the UK centres. Funding was received from European Community (5th Framework Programme) grant no. QLK1-CT-2001-00182.

References

  1. 1.
    Tarvainen L, Kyyronen P, Kauppinen T, Pukkala E. Cancer of the mouth and pharynx, occupation and exposure to chemical agents in Finland [in 1971–95]. Int J Cancer. 2008;123:653–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P. Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol. 2007;18:581–92.CrossRefPubMedGoogle Scholar
  3. 3.
    Baron AE, Franceschi S, Barra S, Talamini R, La VC. A comparison of the joint effects of alcohol and smoking on the risk of cancer across sites in the upper aerodigestive tract. Cancer Epidemiol Biomarkers Prev. 1993;2:519–23.PubMedGoogle Scholar
  4. 4.
    Freedman ND, Park Y, Subar AF, Hollenbeck AR, Leitzmann MF, Schatzkin A, et al. Fruit and vegetable intake and head and neck cancer risk in a large United States prospective cohort study. Int J Cancer. 2008;122:2330–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Sapkota A, Hsu CC, Zaridze D, Shangina O, Szeszenia-Dabrowska N, Mates D, et al. Dietary risk factors for squamous cell carcinoma of the upper aerodigestive tract in central and eastern Europe. Cancer Causes Control. 2008;19(10):1161–70.CrossRefPubMedGoogle Scholar
  6. 6.
    Boeing H, Dietrich T, Hoffmann K, Pischon T, Ferrari P, Lahmann PH, et al. Intake of fruits and vegetables and risk of cancer of the upper aero-digestive tract: the prospective EPIC-study. Cancer Causes Control. 2006;17:957–69.CrossRefPubMedGoogle Scholar
  7. 7.
    Boffetta P, Kogevinas M, Simonato L, Wilbourn J, Saracci R. Current perspectives on occupational cancer risks. Int J Occup Environ Health. 1995;1:315–25.PubMedGoogle Scholar
  8. 8.
    Makela P, Valkonen T, Martelin T. Contribution of deaths related to alcohol use of socioeconomic variation in mortality: register based follow up study. BMJ. 1997;315:211–6.PubMedGoogle Scholar
  9. 9.
    Makela P. Alcohol-related mortality as a function of socio-economic status. Addiction. 1999;94:867–86.CrossRefPubMedGoogle Scholar
  10. 10.
    Hemstrom O. Alcohol-related deaths contribute to socioeconomic differentials in mortality in Sweden. Eur J Public Health. 2002;12:254–62.CrossRefPubMedGoogle Scholar
  11. 11.
    Bosetti C, Franceschi S, Negri E, Talamini R, Tomei F, La VC. Changing socioeconomic correlates for cancers of the upper digestive tract. Ann Oncol. 2001;12:327–30.CrossRefPubMedGoogle Scholar
  12. 12.
    Conway DI, Petticrew M, Marlborough H, Berthiller J, Hashibe M, Macpherson LM. Socioeconomic inequalities and oral cancer risk: a systematic review and meta-analysis of case-control studies. Int J Cancer. 2008;122:2811–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Conway DI, McKinney PA, McMahon AD, Ahrens W, Schmeisser N, Benhamou S, Bouchardy C, Macfarlane GJ, Macfarlane TV, Lagiou P, Minaki P, Bencko V, Holcatova I, Merletti F, Richiardi L, Kjaerheim K, Agudo A, Castellsague X, Talamini R, Barzan L, Canova C, Simonato L, Lowry RJ, Znaor A, Healy CM, McCartan BE, Marron M, Hashibe M, Brennan P. Socioeconomic factors associated with risk of upper aerodigestive tract cancer in Europe. Eur J Cancer. 2009. doi: 10.1016/j.ejca.2009.09.028
  14. 14.
    Jansson C, Johansson AL, Nyren O, Lagergren J. Socioeconomic factors and risk of esophageal adenocarcinoma: a nationwide Swedish case-control study. Cancer Epidemiol Biomarkers Prev. 2005;14:1754–61.CrossRefPubMedGoogle Scholar
  15. 15.
    Menvielle G, Luce D, Goldberg P, Leclerc A. Smoking, alcohol drinking, occupational exposures and social inequalities in hypopharyngeal and laryngeal cancer. Int J Epidemiol. 2004;33:799–806.CrossRefPubMedGoogle Scholar
  16. 16.
    Nagel G, Linseisen J, Boshuizen HC, Pera G, Del GG, Westert GP, et al. Socioeconomic position and the risk of gastric and oesophageal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). Int J Epidemiol. 2007;36:66–76.CrossRefPubMedGoogle Scholar
  17. 17.
    Treiman D. Occupational prestige in comparitive perspective-quantitative studies in social relations. New York: Academic Press; 1977.Google Scholar
  18. 18.
    Wolf C. Sozioökonomischer Status und berufliches Prestige. Ein kleines Kompendium sozialwissenschaftlicher Skalen auf der Basis der beruflichen Stellung und Tätigkeit. ZUMA-Nachrichten. 1995;37(19):102–36.Google Scholar
  19. 19.
    Lantz PM, House JS, Lepkowski JM, Williams DR, Mero RP, Chen J. Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults. JAMA. 1998;279:1703–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Schrijvers CT, Stronks K, van de Mheen HD, Mackenbach JP. Explaining educational differences in mortality: the role of behavioral and material factors. Am J Public Health. 1999;89:535–40.CrossRefPubMedGoogle Scholar
  21. 21.
    Shavers VL. Measurement of socioeconomic status in health disparities research. J Natl Med Assoc. 2007;99:1013–23.PubMedGoogle Scholar
  22. 22.
    Conway DI, McMahon AD, Smith K, Taylor JC, McKinney PA. Socioeconomic factors influence selection and participation in a population-based case-control study of head and neck cancer in Scotland. J Clin Epidemiol. 2008;61:1187–93.CrossRefPubMedGoogle Scholar
  23. 23.
    Lagiou P, Georgila C, Minaki P, Ahrens W, Pohlabeln H, Benhamou S, et al. Alcohol-related cancers and genetic susceptibility in Europe: the ARCAGE project: study samples and data collection. Eur J Cancer Prev. 2009;18:76–84.CrossRefPubMedGoogle Scholar
  24. 24.
    International Labour Office. International standard classification of occupations. ISCO68. Revised ed. Geneva: International Labour Office; 1968.Google Scholar
  25. 25.
    Lagiou P, Talamini R, Samoli E, Lagiou A, Ahrens W, Pohlabeln H, et al. Diet and upper-aerodigestive tract cancer in Europe: the ARCAGE study. Int J Cancer. 2009;124:2671–6.CrossRefPubMedGoogle Scholar
  26. 26.
    Altieri A, Bosetti C, Gallus S, Franceschi S, Dal ML, Talamini R, et al. Wine, beer and spirits and risk of oral and pharyngeal cancer: a case-control study from Italy and Switzerland. Oral Oncol. 2004;40:904–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Ferraroni M, Negri E, La VC, D’Avanzo B, Franceschi S. Socioeconomic indicators, tobacco and alcohol in the aetiology of digestive tract neoplasms. Int J Epidemiol. 1989;18:556–62.CrossRefPubMedGoogle Scholar
  28. 28.
    Morse DE, Psoter WJ, Cleveland D, Cohen D, Mohit-Tabatabai M, Kosis DL, et al. Smoking and drinking in relation to oral cancer and oral epithelial dysplasia. Cancer Causes Control. 2007;18:919–29.CrossRefPubMedGoogle Scholar
  29. 29.
    Schlecht NF, Franco EL, Pintos J, Negassa A, Kowalski LP, Oliveira BV, et al. Interaction between tobacco and alcohol consumption and the risk of cancers of the upper aero-digestive tract in Brazil. Am J Epidemiol. 1999;150:1129–37.PubMedGoogle Scholar
  30. 30.
    Saxena S, George J, Barber J, Fitzpatrick J, Majeed A. Association of population and practice factors with potentially avoidable admission rates for chronic diseases in London: cross sectional analysis. J R Soc Med. 2006;99:81–9.CrossRefPubMedGoogle Scholar
  31. 31.
    Galobardes B, Lynch JW, Smith GD. Is the association between childhood socioeconomic circumstances and cause-specific mortality established? Update of a systematic review. J Epidemiol Commun Health. 2008;62:387–90.CrossRefGoogle Scholar
  32. 32.
    Pekkanen J, Tuomilehto J, Uutela A, Vartiainen E, Nissinen A. Social class, health behaviour, and mortality among men and women in eastern Finland. BMJ. 1995;311:589–93.PubMedGoogle Scholar
  33. 33.
    Winkleby MA, Fortmann SP, Rockhill B. Trends in cardiovascular disease risk factors by educational level: the Stanford Five-City Project. Prev Med. 1992;21:592–601.CrossRefPubMedGoogle Scholar
  34. 34.
    Davey SG, Hart C, Hole D, MacKinnon P, Gillis C, Watt G, et al. Education and occupational social class: which is the more important indicator of mortality risk? J Epidemiol Commun Health. 1998;52:153–60.CrossRefGoogle Scholar
  35. 35.
    Ahrens W, Jockel KH, Patzak W, Elsner G. Alcohol, smoking, and occupational factors in cancer of the larynx: a case-control study. Am J Ind Med. 1991;20:477–93.CrossRefPubMedGoogle Scholar
  36. 36.
    Martikainen P, Valkonen T. Bias related to the exclusion of the economically inactive in studies on social class differences in mortality. Int J Epidemiol. 1999;28:899–904.CrossRefPubMedGoogle Scholar
  37. 37.
    Bobak M, Room R, Pikhart H, Kubinova R, Malyutina S, Pajak A, et al. Contribution of drinking patterns to differences in rates of alcohol related problems between three urban populations. J Epidemiol Commun Health. 2004;58:238–42.CrossRefGoogle Scholar
  38. 38.
    Casswell S, Pledger M, Hooper R. Socioeconomic status and drinking patterns in young adults. Addiction. 2003;98:601–10.CrossRefPubMedGoogle Scholar
  39. 39.
    Viner RM, Taylor B. Adult outcomes of binge drinking in adolescence: findings from a UK national birth cohort. J Epidemiol Commun Health. 2007;61:902–7.CrossRefGoogle Scholar
  40. 40.
    Hemmingsson T, Lundberg I, Diderichsen F, Allebeck P. Explanations of social class differences in alcoholism among young men. Soc Sci Med. 1998;47:1399–405.CrossRefPubMedGoogle Scholar
  41. 41.
    Hemmingsson T, Lundberg I, Diderichsen F. The roles of social class of origin, achieved social class and intergenerational social mobility in explaining social-class inequalities in alcoholism among young men. Soc Sci Med. 1999;49:1051–9.CrossRefPubMedGoogle Scholar
  42. 42.
    Rehm J, Gmel G. Patterns of alcohol consumption and social consequences. Results from an 8-year follow-up study in Switzerland. Addiction. 1999;94:899–912.CrossRefPubMedGoogle Scholar
  43. 43.
    Smith GW, Shevlin M. Patterns of alcohol consumption and related behaviour in Great Britain: a latent class analysis of the alcohol use disorder identification test (AUDIT). Alcohol Alcohol. 2008;43:590–4.PubMedGoogle Scholar
  44. 44.
    Gruer L, Hart CL, Gordon DS, Watt GC. Effect of tobacco smoking on survival of men and women by social position: a 28 year cohort study. BMJ. 2009;338:b480.CrossRefPubMedGoogle Scholar
  45. 45.
    La VC, Negri E, Franceschi S. Education and cancer risk. Cancer. 1992;70:2935–41.CrossRefGoogle Scholar
  46. 46.
    Marshall B, Chevalier A, Garillon C, Goldberg M, Coing F. Socioeconomic status, social mobility and cancer occurrence during working life: a case-control study among French electricity and gas workers. Cancer Causes Control. 1999;10:495–502.CrossRefPubMedGoogle Scholar
  47. 47.
    Adams JM, White M. Biological ageing: a fundamental, biological link between socio-economic status and health? Eur J Public Health. 2004;14:331–4.CrossRefPubMedGoogle Scholar
  48. 48.
    Epel ES, Blackburn EH, Lin J, Dhabhar FS, Adler NE, Morrow JD, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci U S A. 2004;101:17312–5.CrossRefPubMedGoogle Scholar
  49. 49.
    Cherkas LF, Aviv A, Valdes AM, Hunkin JL, Gardner JP, Surdulescu GL, et al. The effects of social status on biological aging as measured by white-blood-cell telomere length. Aging Cell. 2006;5:361–5.CrossRefPubMedGoogle Scholar
  50. 50.
    Cawthon RM, Smith KR, O’Brien E, Sivatchenko A, Kerber RA. Association between telomere length in blood and mortality in people aged 60 years or older. Lancet. 2003;361:393–5.CrossRefPubMedGoogle Scholar
  51. 51.
    Marmot M, Siegrist J, Theorell T. Health and the psychosocial environment at work. In: Marmot M, Wilkinson WR, editors. Social determinants of health. Oxford: Oxford University Press; 2006. p. 97–130.Google Scholar
  52. 52.
    O’Byrne KJ, Dalgleish AG. Chronic immune activation and inflammation as the cause of malignancy. Br J Cancer. 2001;85:473–83.CrossRefPubMedGoogle Scholar
  53. 53.
    Bachner-Melman R, Zohar AH, Elizur Y, Kremer I, Golan M, Ebstein R. Protective self-presentation style: association with disordered eating and anorexia nervosa mediated by sociocultural attitudes towards appearance. Eat Weight Disord. 2009;14:1–12.PubMedGoogle Scholar
  54. 54.
    Neumark-Sztainer D, Story M, Resnick MD, Blum RW. Correlates of inadequate fruit and vegetable consumption among adolescents. Prev Med. 1996;25:497–505.CrossRefPubMedGoogle Scholar
  55. 55.
    Riediger ND, Shooshtari S, Moghadasian MH. The influence of sociodemographic factors on patterns of fruit and vegetable consumption in Canadian adolescents. J Am Diet Assoc. 2007;107:1511–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • N. Schmeisser
    • 1
    Email author
  • D. I. Conway
    • 2
    • 3
  • P. A. McKinney
    • 3
    • 4
  • A. D. McMahon
    • 2
  • H. Pohlabeln
    • 1
  • M. Marron
    • 5
  • S. Benhamou
    • 6
    • 7
  • C. Bouchardy
    • 8
  • G. J. Macfarlane
    • 9
  • T. V. Macfarlane
    • 9
  • P. Lagiou
    • 10
  • A. Lagiou
    • 10
    • 11
  • V. Bencko
    • 12
  • I. Holcátová
    • 12
  • F. Merletti
    • 13
  • L. Richiardi
    • 13
  • K. Kjaerheim
    • 14
  • A. Agudo
    • 15
  • R. Talamini
    • 16
  • J. Polesel
    • 16
  • C. Canova
    • 17
  • L. Simonato
    • 18
  • R. Lowry
    • 18
  • A. Znaor
    • 19
  • C. Healy
    • 20
  • B. E. McCarten
    • 20
    • 21
  • M. Hashibe
    • 5
  • P. Brennan
    • 5
  • W. Ahrens
    • 1
  1. 1.Bremen Institute for Prevention Research and Social Medicine (BIPS)BremenGermany
  2. 2.Faculty of Medicine, Dental SchoolUniversity of GlasgowGlasgowUK
  3. 3.NHS NSS ISDEdinburghUK
  4. 4.Centre for Epidemiology and BiostatisticsUniversity of LeedsLeedsUK
  5. 5.International Agency for Research on CancerLyonFrance
  6. 6.INSERM, U946Fondation Jean Dausset—CEPHParisFrance
  7. 7.CNRS FRE2939Gustave-Roussy InstituteVillejuifFrance
  8. 8.Geneva Cancer RegistryGenevaSwitzerland
  9. 9.University of AberdeenAberdeenUK
  10. 10.Department of Hygiene, Epidemiology and Medical StatisticsUniversity of Athens Medical SchoolAthensGreece
  11. 11.Faculty of Health ProfessionsAthens Technological Educational InstituteAthensGreece
  12. 12.1st Faculty of Medicine, Institute of Hygiene & EpidemiologyCharles University PraguePragueCzech Republic
  13. 13.Unit of Cancer EpidemiologyCeRMS and University of TurinTurinItaly
  14. 14.Cancer Registry of NorwayOsloNorway
  15. 15.Institut Catala d’OncologieaBarcelonaSpain
  16. 16.Unit of Epidemiology and BiostatisticsCentro di Riferimento Oncologico—IRCCSAvianoItaly
  17. 17.Department of Environmental Medicine and Public HealthUniversity of PadovaPaduaItaly
  18. 18.University of Newcastle Dental SchoolNewcastleUK
  19. 19.Croatian National Cancer RegistryZagrebCroatia
  20. 20.Trinity College School of Dental ScienceDublinIreland
  21. 21.Department of Dental AnatomyRoyal College of Surgeons in IrelandDublinIreland

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