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婴儿潮一代与出生证明:成年期的早期社会经济地位与癌症风险

Baby Boomers and Birth Certificates: Early-Life Socioeconomic Status and Cancer Risk in Adulthood.

作者信息

Stroup Antoinette M, Herget Kimberly A, Hanson Heidi A, Reed Diana Lane, Butler Jared T, Henry Kevin A, Harrell C Janna, Sweeney Carol, Smith Ken R

机构信息

Utah Cancer Registry, University of Utah, Salt Lake City, Utah.

Rutgers School of Public Health, Piscataway, New Jersey.

出版信息

Cancer Epidemiol Biomarkers Prev. 2017 Jan;26(1):75-84. doi: 10.1158/1055-9965.EPI-16-0371. Epub 2016 Sep 21.

Abstract

BACKGROUND

Early-life socioeconomic status (SES) may play a role in cancer risk in adulthood. However, measuring SES retrospectively presents challenges. Parental occupation on the birth certificate is a novel method of ascertaining early-life SES that has not been applied in cancer epidemiology.

METHODS

For a Baby-Boom cohort born from 1945-1959 in two Utah counties, individual-level Nam-Powers SES (Np-SES) was derived from parental industry/occupation reported on birth certificates. Neighborhood SES was estimated from average household income of census tract at birth. Cancer incidence was determined by linkage to Utah Cancer Registry records through the Utah Population Database. Hazard ratios (HR) for cancer risk by SES quartile were estimated using Cox proportional hazards regression.

RESULTS

Females with low Np-SES at birth had lower risk of breast cancer compared with those in the highest Np-SES group [HR = 0.83; 95% confidence interval (CI), 0.72-0.97; HR = 0.81; 95% CI, 0.69-0.96]. Np-SES was inversely associated with melanoma (HR = 0.81; 95% CI, 0.67-0.98) and prostate cancer (HR = 0.70; 95% CI, 0.56-0.88). Women born into lower SES neighborhoods had significantly increased risk for invasive cervical cancer (HR = 1.44; 95% CI, 1.12-1.85; HR = 1.33; 95% CI, 1.04-1.72). Neighborhood SES had similar effects for melanoma and prostate cancers, but was not associated with female breast cancer. We found no association with SES for pancreas, lung, and colon and rectal cancers.

CONCLUSIONS

Individual SES derived from parental occupation at birth was associated with altered risk for several cancer sites.

IMPACT

This novel methodology can contribute to improved understanding of the role of early-life SES on cancer risk. Cancer Epidemiol Biomarkers Prev; 26(1); 75-84. ©2016 AACR.

摘要

背景

生命早期的社会经济地位(SES)可能在成年后的癌症风险中起作用。然而,回顾性测量SES存在挑战。出生证明上的父母职业是一种尚未应用于癌症流行病学的确定生命早期SES的新方法。

方法

对于1945年至1959年在犹他州两个县出生的婴儿潮队列,个体水平的Nam-Powers SES(Np-SES)来自出生证明上报告的父母行业/职业。邻里SES根据出生时普查区的平均家庭收入估算。癌症发病率通过犹他州人口数据库与犹他州癌症登记处记录进行关联确定。使用Cox比例风险回归估计按SES四分位数划分的癌症风险的风险比(HR)。

结果

出生时Np-SES低的女性患乳腺癌的风险低于Np-SES最高组的女性[HR = 0.83;95%置信区间(CI),0.72 - 0.97;HR = 0.81;95% CI,0.69 - 0.96]。Np-SES与黑色素瘤(HR = 0.81;95% CI,0.67 - 0.98)和前列腺癌(HR = 0.70;95% CI,0.56 - 0.88)呈负相关。出生在社会经济地位较低社区的女性患浸润性宫颈癌的风险显著增加(HR = 1.44;95% CI,1.12 - 1.85;HR = 1.33;95% CI,1.04 - 1.72)。邻里SES对黑色素瘤和前列腺癌有类似影响,但与女性乳腺癌无关。我们发现SES与胰腺癌、肺癌以及结肠癌和直肠癌无关。

结论

出生时从父母职业得出的个体SES与几个癌症部位的风险改变有关。

影响

这种新方法有助于更好地理解生命早期SES对癌症风险的作用机制。《癌症流行病学、生物标志物与预防》;26(1);75 - 84。©2016美国癌症研究协会。

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