Hrubá Frantiska, Fabiáová Eleonóra, Bencko Vladimír, Cassidy Adrian, Lissowska Jolanta, Mates Dana, Rudnai Péter, Zaridze David, Foretová Lenka, Janout Vladimir, Szeszenia-Dabrowska Neonilia, Brennan Paul, Boffetta Paolo
Regional Authority of Public Health, Banska Bystrica, Slovakia.
Cent Eur J Public Health. 2009 Sep;17(3):115-21. doi: 10.21101/cejph.a3516.
Social inequalities have been shown to contribute to the risk of lung cancer in industrialized countries, but it is unclear whether they also play a role in former socialist countries of Europe.
A case-control study involving 3,403 cases and 3,670 controls was conducted in Central European countries (Czech Republic, Hungary, Poland, Romania, Slovakia), Russia, and in the UK. Indicators of socioeconomic status, including education and white/blue collar occupation based on lifetime occupations were analysed as indicators of risk factors for lung cancer development, after adjustment for tobacco smoking and exposure to occupational carcinogens.
Both indicators of socioeconomic status: low education and blue collar occupations were found as significant risk factors for lung cancer in men. The odds ratio of lung cancer for blue collar occupations compared to white collar occupations was 1.37 (95% confidence interval 1.15-1.62), that for low education compared to high education (analysis restricted to Central European countries) was 1.35 (95% confidence interval 1.03-1.77). No such effects were observed in women.
The confirmation of the significant inverse association between the indicators of socioeconomic status and lung cancer risk in men may serve as a strong incentive for adoption of occupational and public health measures in lung cancer prevention.
在工业化国家,社会不平等已被证明会增加患肺癌的风险,但在欧洲前社会主义国家,社会不平等是否也起作用尚不清楚。
在中欧国家(捷克共和国、匈牙利、波兰、罗马尼亚、斯洛伐克)、俄罗斯和英国开展了一项病例对照研究,涉及3403例病例和3670例对照。在对吸烟和接触职业致癌物进行调整后,分析了社会经济地位指标,包括基于终生职业的教育程度和白领/蓝领职业,作为肺癌发生风险因素的指标。
社会经济地位的两个指标,即低教育程度和蓝领职业,均被发现是男性患肺癌的重要风险因素。蓝领职业与白领职业相比,患肺癌的比值比为1.37(95%置信区间1.15 - 1.62),低教育程度与高教育程度相比(分析仅限于中欧国家)为1.35(95%置信区间1.03 - 1.77)。在女性中未观察到此类影响。
社会经济地位指标与男性肺癌风险之间存在显著负相关这一结论,可能会有力地促使人们采取职业和公共卫生措施来预防肺癌。