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Cancer Epidemiol. 2012 Jun;36(3):e164-70. doi: 10.1016/j.canep.2012.01.007. Epub 2012 Mar 20.
Lung and upper aero-digestive tract (UADT) cancer risk is associated with socioeconomic inequality (SEI) but the degree of socioeconomic burden by age, tumour subtype, and sex is not known.
We reviewed 216,305 cases excluding non melanoma skin cancer (All Cancer) comprising 37,274 lung; 8216 head and neck; and 6534 oesophageal cancers from 2000 to 2007 classified into anatomical or morphology subtypes. Deprivation was measured using the Scottish Index of Multiple Deprivation and SEI was measured using the Slope Index of Inequality and the Relative Index of Inequality (RII). Analyses were partitioned by 5-year age group and sex. RII was adapted to rank tumour type contribution to All Cancer SEI and to examine subtype by age and sex simultaneously. Rank was defined as proportion of All Cancer SEI.
All Cancer SEI was greater for males (RII=0.366; female RII=0.279); the combination of lung and UADT SEI contributed 91% and 81% respectively to All Cancer SEI. For both sexes lung and UADT subtypes showed significant SEI (P<0.001) except oesophageal adenocarcinoma in males (P=0.193); for females, SEI was borderline significant (P=0.048). Although RII rank differed by sex, all lung and larynx subtypes contributed most to All Cancer SEI with RII rank for oral cavity, oesophagus-squamous cell, and oropharynx following. For males 40-44 years, SEI increased abruptly peaking at 55-59 years. For females, SEI gradually peaked 10 years later. In both sexes, the SEI peak preceded peak incidence.
SEI in lung and UADT cancers vary greatly by age, tumour subtype and sex; these variations are likely to largely reflect differences between the sexes in risk behaviours which vary by birth cohort and are socioeconomically patterned.
肺癌和上呼吸消化道（UADT）癌症的风险与社会经济不平等（SEI）有关，但年龄、肿瘤亚型和性别的社会经济负担程度尚不清楚。
我们回顾了 2000 年至 2007 年间的 216305 例排除非黑色素瘤皮肤癌（所有癌症）的病例，其中包括 37274 例肺癌、8216 例头颈部癌和 6534 例食管癌，分为解剖学或形态学亚型。剥夺程度使用苏格兰多因素剥夺指数进行衡量，SEI 使用斜率不平等指数和相对不平等指数（RII）进行衡量。分析按 5 岁年龄组和性别进行划分。RII 用于对肿瘤类型对所有癌症 SEI 的贡献进行排名，并同时检查年龄和性别亚组。排名定义为所有癌症 SEI 的比例。
男性的所有癌症 SEI 更高（RII=0.366；女性 RII=0.279）；肺癌和 UADT 的组合分别占所有癌症 SEI 的 91%和 81%。对于男性和女性，所有肺癌和 UADT 亚型均显示出显著的 SEI（P<0.001），除了男性的食管腺癌（P=0.193）；对于女性，SEI 呈边缘显著（P=0.048）。尽管 RII 排名因性别而异，但所有肺癌和喉癌亚型对所有癌症 SEI 的贡献最大，口腔癌、食管鳞状细胞癌和口咽癌的 RII 排名紧随其后。对于男性 40-44 岁，SEI 急剧增加，在 55-59 岁时达到峰值。对于女性，SEI 逐渐在 10 年后达到峰值。在男性和女性中，SEI 峰值均先于发病率峰值。
肺癌和 UADT 癌症的 SEI 因年龄、肿瘤亚型和性别而异；这些差异很可能主要反映了不同性别之间的风险行为差异，这些差异因出生队列而异，并且具有社会经济模式。
