Khanolkar Amal R, Ljung Rickard, Talbäck Mats, Brooke Hannah L, Carlsson Sofia, Mathiesen Tiit, Feychting Maria
Institute of Child Health, University College London, London, UK.
Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden.
J Epidemiol Community Health. 2016 Dec;70(12):1222-1228. doi: 10.1136/jech-2015-207002. Epub 2016 Jun 20.
The aim was to investigate associations between different measures of socioeconomic position (SEP) and incidence of brain tumours (glioma, meningioma and acoustic neuroma) in a nationwide population-based cohort.
We included 4 305 265 individuals born in Sweden during 1911-1961, and residing in Sweden in 1991. Cohort members were followed from 1993 to 2010 for a first primary diagnosis of brain tumour identified from the National Cancer Register. Poisson regression was used to compute incidence rate ratios (IRR) by highest education achieved, family income, occupational group and marital status, with adjustment for age, healthcare region of residence, and time period.
We identified 5735 brain tumours among men and 7101 among women during the study period. Highly educated men (≥3 years university education) had increased risk of glioma (IRR 1.22, 95% CI 1.08 to 1.37) compared to men with primary education. High income was associated with higher incidence of glioma in men (1.14, 1.01 to 1.27). Women with ≥3 years university education had increased risk of glioma (1.23, 1.08 to 1.40) and meningioma (1.16, 1.04 to 1.29) compared to those with primary education. Men and women in intermediate and higher non-manual occupations had increased risk of glioma compared to low manual groups. Compared to those married/cohabiting, being single or previously married/cohabiting was associated with decreased risk of glioma in men. Men in non-manual occupations had ∼50% increased risk of acoustic neuroma compared to men in low manual occupations.
We observed consistent associations between higher SEP and higher risk of glioma. Completeness of cancer registration and detection bias are potential explanations for the findings.
目的是在全国基于人群的队列中调查社会经济地位（SEP）的不同衡量指标与脑肿瘤（胶质瘤、脑膜瘤和听神经瘤）发病率之间的关联。
我们纳入了1911年至1961年在瑞典出生且1991年居住在瑞典的4305265人。队列成员从1993年至2010年进行随访，以获取从国家癌症登记处确定的首次原发性脑肿瘤诊断。采用泊松回归按最高学历、家庭收入、职业类别和婚姻状况计算发病率比（IRR），并对年龄、居住的医疗保健区域和时间段进行调整。
在研究期间，我们在男性中识别出5735例脑肿瘤，在女性中识别出7101例。与小学学历男性相比，受过高等教育的男性（大学教育≥3年）患胶质瘤的风险增加（IRR 1.22，95% CI 1.08至1.37）。高收入与男性胶质瘤发病率较高相关（1.14，1.01至1.27）。与小学学历女性相比，大学教育≥3年的女性患胶质瘤（1.23，1.08至1.40）和脑膜瘤（1.16，1.04至1.29）的风险增加。与低体力劳动群体相比，从事中级和高级非体力劳动职业的男性和女性患胶质瘤的风险增加。与已婚/同居者相比，单身或曾婚/同居的男性患胶质瘤的风险降低。与低体力劳动职业的男性相比，从事非体力劳动职业的男性患听神经瘤的风险增加约50%。
我们观察到较高的SEP与较高的胶质瘤风险之间存在一致的关联。癌症登记的完整性和检测偏倚是这些发现的潜在解释。
