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Cancer risk in relationship to different indicators of adult socioeconomic position in Turin, Italy

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Abstract

Objective

To determine the magnitude of social inequalities in cancer incidence according to different socioeconomic indicators and to assess the independent role of each indicator.

Methods

Data from the Turin Longitudinal Study and the Piedmont Cancer Registry (1985–1999) were used to analyse the relationship of cancer incidence with three dimensions of individual socioeconomic position (education, occupation, and material living conditions) and with an area-based deprivation index. Multivariate Poisson regression models were used to estimate both relative risks and relative indexes of inequality (RIIs).

Results

Results showed an independent role of all the socioeconomic indicators. The overall gradients of inequalities, expressed by the RIIs for total cancer incidence, varied from 9 to 26% among men; among women, we estimated a 22% protection at the bottom of the educational hierarchy, and a 12% gradient for decreasing ease of living conditions. For most cancer sites, socioeconomic position in early adult life was as important as later socioeconomic position, while the area-based deprivation index played only an additional role.

Conclusions

Different socioeconomic indicators pinpoint to a series of specific risk factors that are related to specific phases of the life course. Individual level data, rather than ecological data, is preferred to accurately monitor social inequalities in cancer risk.

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Acknowledgments

We wish to thank Dr. Mauricio Avendano and Dr. Nicola Caranci for their support in discussing and refining statistical analyses. We also thank two anonymous reviewers for precious suggestions. This study was partially funded by the European Commission, through the Eurocadet Project (from the commission of the European communities research directorate-general, Grant No. EUROCADET: SP23-CT-2005-006528) and by the Italian Ministry of Labour, Health and Social Policy, through the National Centre for the Prevention and Control of Diseases (CCM).

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Authors and Affiliations

  1. Regional Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco, Italy

    Teresa Spadea, Nicolás Zengarini & Giuseppe Costa

  2. Department of Social Medicine, University of Amsterdam, Amsterdam, The Netherlands

    Anton Kunst

  3. Piedmont Cancer Registry, CPO Piedmont Region, Turin, Italy

    Roberto Zanetti & Stefano Rosso

  4. Department of Hygiene and Public Health, University of Turin, Turin, Italy

    Giuseppe Costa

  5. Servizio di Epidemiologia ASL TO3, via Sabaudia 164, 10095, Grugliasco (TO), Italy

    Teresa Spadea

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  1. Teresa Spadea
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  2. Nicolás Zengarini
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  3. Anton Kunst
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  4. Roberto Zanetti
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  5. Stefano Rosso
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  6. Giuseppe Costa
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Correspondence to Teresa Spadea.

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Spadea, T., Zengarini, N., Kunst, A. et al. Cancer risk in relationship to different indicators of adult socioeconomic position in Turin, Italy. Cancer Causes Control 21, 1117–1130 (2010). https://doi.org/10.1007/s10552-010-9539-0

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  • DOI: https://doi.org/10.1007/s10552-010-9539-0

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