Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, CV4 7AL, United Kingdom.
J Epidemiol Community Health. 2013 Oct;67(10):854-60. doi: 10.1136/jech-2012-201108. Epub 2013 Aug 8.
Low socioeconomic position (SEP) has been associated with increased risks of morbidity and mortality from many diseases. We investigated the associations between gastric cancer incidence and education, occupation and income as indicators for SEP.
We searched the PubMed and EMBASE databases for studies on SEP and gastric cancer incidence published from 1966 through February 2013. We used a random-effect model to pool the risk estimates from the individual studies. The relative indexes of inequality (RIIs) with their 95% CIs were used as summary estimates. We stratified the analysis by SEP indicators, sex, country's income group, geographical area, level of adjustment for an established risk factor, publication year, study design, type of control and length of follow-up.
Of 1549 citations, 36 studies met our inclusion criteria. We observed an increased risk of gastric cancer among the lowest SEP categories in education (RII=2.97; 95% CI 1.923 to 4.58), occupation (RII=4.33; 95% CI 2.57 to 7.29) and combined SEP (RII=2.64; 95% CI 1.05 to 6.63) compared with the highest SEP categories. Although the association between the incidence of gastric cancer and the level of income is evident, it did not reach a statistically significant level (RII=1.25; 95% CI 0.93 to 1.68).
We found that the risk of gastric cancer incidence is higher among low SEP groups.
低社会经济地位（SEP）与多种疾病的发病率和死亡率增加有关。我们研究了作为 SEP 指标的教育、职业和收入与胃癌发病率之间的关联。
我们检索了 PubMed 和 EMBASE 数据库，以获取 1966 年至 2013 年 2 月期间发表的关于 SEP 和胃癌发病率的研究。我们使用随机效应模型汇总来自个体研究的风险估计值。使用相对不平等指数（RII）及其 95%置信区间作为汇总估计值。我们按 SEP 指标、性别、国家收入组、地理区域、对已确立风险因素的调整程度、出版年份、研究设计、对照类型和随访时间长短对分析进行分层。
在 1549 条引用中，有 36 项研究符合我们的纳入标准。我们观察到，在教育（RII=2.97；95%CI 1.923 至 4.58）、职业（RII=4.33；95%CI 2.57 至 7.29）和综合 SEP（RII=2.64；95%CI 1.05 至 6.63）方面，最低 SEP 类别与最高 SEP 类别相比，胃癌的发病风险更高。尽管胃癌发病率与收入水平之间的关联是明显的，但没有达到统计学显著水平（RII=1.25；95%CI 0.93 至 1.68）。
我们发现胃癌发病率在低 SEP 组中较高。
