Ekberg-Aronsson Marie, Nilsson Peter M, Nilsson Jan-Ake, Pehrsson Kerstin, Löfdahl Claes-Göran
Department of Respiratory Medicine and Allergology, University of Lund, S-221 85 Lund, Sweden.
Lung Cancer. 2006 Jan;51(1):21-9. doi: 10.1016/j.lungcan.2005.08.014. Epub 2005 Dec 7.
We investigated prospectively the risk of lung cancer in relation to socio-economic status (SES) in 22,387 middle-aged individuals who attended a screening program in the city of Malmö, Sweden between 1974 and 1992. We also examined the relationship between SES and histologic subtype in smokers. By 2003, a total of 550 lung cancer cases had been identified. Relative risks (RR) were calculated with adjustment for age, current smoking, inhalation habits and marital status at baseline in the low SES group compared to high SES group. Among smokers, the RR (95% confidence interval (CI)) for lung cancer in the low SES group of men was 1.39 (1.11-1.73), and women 1.56 (1.04-2.34). Also among smokers, low SES was associated with an increased risk of squamous cell carcinoma in men; RR 1.89 (1.16-2.81) and women; RR 7.10 (1.63-30.86), and with an increased risk of mesothelioma in men RR 9.97 (1.29-76.96). We conclude that low SES groups run an increased risk of lung cancer despite accounting for smoking habits. Furthermore, low SES was positively associated with squamous cell carcinoma and mesothelioma. Our results suggest that the association between low SES and lung cancer could be mediated by unaccounted for smoking exposure, lifestyle or occupational hazards.
我们对1974年至1992年间在瑞典马尔默市参加筛查项目的22387名中年个体进行了前瞻性研究，以调查肺癌风险与社会经济地位（SES）之间的关系。我们还研究了吸烟者中SES与组织学亚型之间的关系。到2003年，共确诊了550例肺癌病例。计算低SES组与高SES组相比的相对风险（RR），并对年龄、当前吸烟情况、吸入习惯和基线婚姻状况进行调整。在吸烟者中，低SES组男性患肺癌的RR（95%置信区间（CI））为1.39（1.11 - 1.73），女性为1.56（1.04 - 2.34）。同样在吸烟者中，低SES与男性鳞状细胞癌风险增加相关；RR为1.89（1.16 - 2.81），女性为；RR为7.10（1.63 - 30.86），并且与男性间皮瘤风险增加相关RR为9.97（1.29 - 76.96）。我们得出结论，尽管考虑了吸烟习惯，低SES组患肺癌的风险仍会增加。此外，低SES与鳞状细胞癌和间皮瘤呈正相关。我们的结果表明，低SES与肺癌之间的关联可能由未考虑到的吸烟暴露、生活方式或职业危害所介导。
