Bremen Institute for Prevention Research and Social Medicine, Linzer Strasse 10, Bremen, Germany.
Eur J Epidemiol. 2010 Mar;25(3):173-82. doi: 10.1007/s10654-010-9429-5. Epub 2010 Feb 9.
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.
本研究旨在探讨社会流动性与上呼吸道-消化道（UADT）肿瘤之间的关联，重点关注基于职业史的社会地位（SP）的生命历程变化。10 个欧洲国家在 1993 年至 2005 年间诊断出的 1796 例病例与 1585 例对照进行了比较。SP 是根据职业史使用标准国际职业声望量表（SIOPS）进行分类的。SIOPS 分为高（H）、中（M）和低（L）三个等级。采用九个轨迹分析时间加权平均达到的轨迹和 SP 之间的变化：H-->H、H-->M、H-->L、M-->H、M-->M、M-->L、L-->H、L-->M 和 L-->L。使用包括年龄、水果/蔬菜摄入量、研究中心、吸烟和饮酒在内的逻辑回归模型估计比值比（OR）和 95%置信区间[95%-CI]。最低与最高三个类别（SP 的时间加权平均值）相比，调整后的 OR 为 1.28[1.04-1.56]。病例与对照组在工作期间 SP 差距扩大。与 H-->H 相比，H-->L 的轨迹 OR 为 1.71[0.75-3.87]。与 H-->H 轨迹相比，M-->M 和 L-->L 轨迹的受试者的 OR 也升高。SP 和 UADT 之间的关联不能完全用混杂因素来解释。生命历程中社会地位的下降轨迹可能是 UADT 癌症的一个独立危险因素。
