Department of Medicine, University of California-San Francisco, CA, USA.
J Thorac Oncol. 2013 Mar;8(3):287-94. doi: 10.1097/JTO.0b013e31827bd7f5.
Lung cancer incidence is associated with markers of lower socioeconomic status (SES) in whites, blacks, and Asians but with markers of higher SES in Hispanics. The magnitude and etiology of this positive gradient in Hispanics remain undefined. We examined non-small-cell lung cancer (NSCLC) incidence and ever-smoking rates among California Hispanics according to measures of SES.
We computed neighborhood (n)SES-specific incidence rates by sex and race or ethnicity for 74,179 NSCLC cases in the California Cancer Registry, 1998-2002. Associations between nSES and NSCLC incidence were examined, using incidence rate ratios and linear trend tests, and stratified by age, stage, and histology. Ever-smoking rates among Hispanics were obtained from California Health Interview Survey 2001 data, and odds ratios for ever-smoking were calculated for measures of SES and acculturation.
Compared with the lowest nSES quintile, the NSCLC incidence in the highest quintile was 1.86 and 1.18 times higher for Hispanic women and men, respectively. The positive nSES gradients remained significant for all ages, stages, and nonsquamous histologies in women, and only for older age, local or regional stages, and adenocarcinoma histology in men. Ever-smoking rates were associated with English-speaking households and U.S.-born status for Hispanic women and low education and U.S.-born status for Hispanic men.
For California Hispanics, higher nSES was strongly associated with increased NSCLC incidence in women, but weakly associated in men, and ever-smoking rates were strongly correlated with increased acculturation. This finding may portend an increasing burden of NSCLC in Hispanic women, given future trends in acculturation and SES.
肺癌的发病率与白种人、黑人和亚洲人的社会经济地位（SES）标志物有关，但与西班牙裔人的 SES 标志物较高有关。西班牙裔人群中这种正梯度的幅度和病因仍未确定。我们根据 SES 指标检查了加利福尼亚州西班牙裔人群中非小细胞肺癌（NSCLC）的发病率和既往吸烟率。
我们计算了加利福尼亚癌症登记处 1998-2002 年期间 74179 例 NSCLC 病例的按性别和种族或族裔划分的邻里（n）SES 特定发病率。使用发病率比和线性趋势检验，根据年龄、分期和组织学检查 nSES 与 NSCLC 发病率之间的关联，并进行分层。从加利福尼亚健康访谈调查 2001 年的数据中获得西班牙裔人的既往吸烟率，并计算 SES 和文化适应措施的既往吸烟的比值比。
与最低 SES 五分位数相比，西班牙裔女性和男性的 NSCLC 发病率分别高出 1.86 和 1.18 倍。在女性中，所有年龄、分期和非鳞状组织学中，这种正 SES 梯度仍然显著，而在男性中仅在较年长、局部或区域分期和腺癌组织学中仍然显著。对于西班牙裔女性，讲英语家庭和美国出生身份与较高的既往吸烟率有关，而对于西班牙裔男性，低教育程度和美国出生身份与较高的既往吸烟率有关。
对于加利福尼亚州的西班牙裔人来说，较高的 nSES 与女性 NSCLC 发病率的增加密切相关，但与男性的相关性较弱，而既往吸烟率与较高的文化适应度密切相关。鉴于未来文化适应和 SES 的趋势，这一发现可能预示着西班牙裔女性 NSCLC 负担的增加。
