Baris D, Brown L M, Silverman D T, Hayes R, Hoover R N, Swanson G M, Dosemeci M, Schwartz A G, Liff J M, Schoenberg J B, Pottern L M, Lubin J, Greenberg R S, Fraumeni J F
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-7240, USA.
Am J Public Health. 2000 Aug;90(8):1277-81. doi: 10.2105/ajph.90.8.1277.
This study examined the relation between socioeconomic status (SES) and risk of multiple myeloma among Blacks and Whites in the United States.
This population-based case-control study included 573 cases (206 Blacks and 367 Whites) with new diagnoses of multiple myeloma identified between August 1, 1986, and April 30, 1989, and 2131 controls (967 Blacks and 1164 Whites) from 3 US geographic areas. Information on occupation, income, and education was obtained by personal interview.
Inverse gradients in risk were associated with occupation-based SES, income, and education. Risks were significantly elevated for subjects in the lowest categories of occupation-based SES (odds ratio [OR] = 1.71, 95% confidence interval [CI] = 1.16, 2.53), education (OR = 1.36, 95% CI = 1.06, 1.75), and income (OR = 1.43, 95% CI = 1.05, 1.93). Occupation-based low SES accounted for 37% of multiple myeloma in Blacks and 17% in Whites, as well as 49% of the excess incidence in Blacks. Low education and low income accounted for 17% and 28% of the excess incidence in Blacks, respectively.
Our results indicate that the measured SES-related factors account for a substantial amount of the Black-White differential in multiple myeloma incidence.
本研究调查了美国黑人和白人社会经济地位（SES）与多发性骨髓瘤风险之间的关系。
这项基于人群的病例对照研究纳入了1986年8月1日至1989年4月30日期间新诊断为多发性骨髓瘤的573例患者（206例黑人，367例白人），以及来自美国3个地理区域的2131名对照（967例黑人，1164例白人）。通过个人访谈获取职业、收入和教育方面的信息。
基于职业的SES、收入和教育与风险呈反向梯度关系。基于职业的SES处于最低类别的受试者风险显著升高（优势比[OR]=1.71，95%置信区间[CI]=1.16，2.53），教育程度最低类别的受试者风险显著升高（OR=1.36，95%CI=1.06，1.75），收入最低类别的受试者风险显著升高（OR=1.43，95%CI=1.05，1.93）。基于职业的低SES在黑人多发性骨髓瘤病例中占37%，在白人中占17%，在黑人额外发病率中占49%。低教育程度和低收入在黑人额外发病率中分别占17%和28%。
我们的结果表明，所测量的与SES相关的因素在很大程度上解释了黑人和白人在多发性骨髓瘤发病率上的差异。
