Department of Preventive Medicine, College of Medicine, Kangwon National University, Chunchon, Republic of Korea.
Soc Sci Med. 2011 Jan;72(1):108-15. doi: 10.1016/j.socscimed.2010.10.007. Epub 2010 Oct 26.
We sought to explore a possible association between higher parental socioeconomic position and lower child cancer mortality. We examined total cancer mortality as well as site-specific cancer mortality. We constructed a retrospective birth cohort by linking South Korean birth records to death records from 1995 to 2004. Parental socioeconomic position and birth characteristics were identified from the birth records. Parental education and occupation were examined as socioeconomic variables while sex, parental age, gestational age, birth weight, multiple birth, birth order, and the death of previous children were included as birth characteristics. Cancer deaths were identified from the death records. In total, 5711,337 births were analyzed, including 30,844,015 total person-years. The total number of deaths was 21,217, including 1102 children who died of cancer. Hazard ratios of cancer mortality according to parental socioeconomic position were calculated using a Cox proportional hazard analysis with adjustment for the birth characteristics. All socioeconomic measures except maternal occupation showed a significant inverse association with cancer mortality after adjusting for the birth characteristics. For paternal education, high school and middle school graduation or lower was associated with an increased hazard ratio of cancer mortality compared to university education or higher: 1.14 (1.00-1.29) and 1.29 (1.02-1.62), respectively. For maternal education, middle school graduation or lower was associated with a hazard ratio of 1.54 (1.21-1.95). For paternal occupation, manual work and economic inactivity were associated with increased hazard ratios as compared to non-manual work: 1.17 (1.02-1.34) and 1.34 (1.04-1.73), respectively. Inequalities were also found for leukemia and central nervous system tumors. The extent of the inequalities decreased after age 5, and only the 1-4-year-old group showed significant associations with parental socioeconomic position. We conclude that there is an inverse relationship between childhood cancer mortality and parental socioeconomic position in Korea.
我们试图探索父母社会经济地位较高与儿童癌症死亡率较低之间可能存在的关联。我们检查了总体癌症死亡率和特定部位癌症死亡率。我们通过将韩国出生记录与 1995 年至 2004 年的死亡记录相链接，构建了一个回顾性出生队列。父母的社会经济地位和出生特征从出生记录中确定。父母的教育和职业被视为社会经济变量，而性别、父母年龄、胎龄、出生体重、多胎、出生顺序和先前儿童的死亡被纳入出生特征。从死亡记录中确定癌症死亡。总共分析了 5711337 例出生，包括 30844015 人年。总死亡人数为 21217 人，其中 1102 人死于癌症。使用 Cox 比例风险分析，在校正出生特征后，根据父母的社会经济地位计算癌症死亡率的风险比。所有社会经济衡量标准，除了母亲的职业，在调整出生特征后与癌症死亡率呈显著负相关。对于父亲的教育，高中和中学毕业或以下与大学教育或更高学历相比，癌症死亡率的风险比增加：1.14（1.00-1.29）和 1.29（1.02-1.62）。对于母亲的教育，中学毕业或以下与癌症死亡率的风险比为 1.54（1.21-1.95）。对于父亲的职业，与非体力劳动相比，体力劳动和经济不活跃与更高的风险比相关：1.17（1.02-1.34）和 1.34（1.04-1.73）。白血病和中枢神经系统肿瘤也存在不平等现象。不平等程度在 5 岁以后降低，只有 1-4 岁组与父母的社会经济地位有显著关联。我们的结论是，韩国儿童癌症死亡率与父母社会经济地位之间存在反比关系。
