Porter Alyx B, Lachance Daniel H, Johnson Derek R
Division of Hematology and Medical Oncology, Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
Division of Clinical Biochemistry and Immunology, Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Cancer Causes Control. 2015 Feb;26(2):179-185. doi: 10.1007/s10552-014-0496-x. Epub 2014 Nov 25.
Socioeconomic status (SES) is associated with risk of various cancer types because of correlation between SES and causal factors or increased case ascertainment, or both. Studies evaluating the association between glioblastoma and occupational or SES factors have yielded inconsistent results. We evaluated the association between SES and glioblastoma risk using a large, population-based cancer registry dataset.
Data of the Surveillance, Epidemiology, and End Results Program were used to evaluate the impact of SES on glioblastoma risk. SES was divided into quintiles on the basis of census tract of residence. Census tracts are small, geographically defined areas with relatively homogeneous population characteristics.
Higher SES was strongly associated with increased risk of glioblastoma (p < .001). Relative to persons living in census tracts of the lowest SES quintile, the highest SES quintile had a rate ratio of 1.45 (95 % CI 1.39-1.51) (p < .001). Similar associations were seen in population subgroups defined by age, sex, and race.
The strong association between higher SES and greater glioblastoma risk is unlikely to represent an ascertainment effect because glioblastoma is rapidly progressive and ultimately fatal. A number of previously proposed glioma risk factors may be correlated with SES, including atopy and allergy rates, cellular telephone use, and body morphometric measures. Further research is needed to define the mechanism of this association.
社会经济地位(SES)与多种癌症类型的风险相关,这是由于SES与病因或病例确诊增加之间存在关联,或两者兼而有之。评估胶质母细胞瘤与职业或SES因素之间关联的研究结果并不一致。我们使用基于人群的大型癌症登记数据集评估了SES与胶质母细胞瘤风险之间的关联。
利用监测、流行病学和最终结果计划的数据来评估SES对胶质母细胞瘤风险的影响。SES根据居住普查区分为五个五分位数。普查区是地理上定义的小区域,人口特征相对同质。
较高的SES与胶质母细胞瘤风险增加密切相关(p <.001)。与生活在SES最低五分位数普查区的人相比,最高SES五分位数的发病率比为1.45(95%CI 1.39 - 1.51)(p <.001)。在按年龄、性别和种族定义的人群亚组中也观察到类似的关联。
较高的SES与较高的胶质母细胞瘤风险之间的密切关联不太可能代表确诊效应,因为胶质母细胞瘤进展迅速且最终致命。一些先前提出的胶质瘤风险因素可能与SES相关,包括特应性和过敏率、使用手机以及身体形态测量指标。需要进一步研究来确定这种关联的机制。