Department of Sociology - Interface Demography, Economic and Social Sciences and Solvay Business School - Vrije Universiteit Brussel, Brussels, Belgium.
BMJ Open. 2017 Nov 12;7(11):e015216. doi: 10.1136/bmjopen-2016-015216.
This study probes into site-specific cancer mortality inequalities by employment and occupational group among Belgians, adjusted for other indicators of socioeconomic (SE) position.
This cohort study is based on record linkage between the Belgian censuses of 1991 and 2001 and register data on emigration and mortality for 01/10/2001 to 31/12/2011.
Belgium.
The study population contains all Belgians within the economically active age (25-65 years) at the census of 1991.
Both absolute and relative measures were calculated. First, age-standardised mortality rates have been calculated, directly standardised to the Belgian population. Second, mortality rate ratios were calculated using Poisson's regression, adjusted for education, housing conditions, attained age, region and migrant background.
This study highlights inequalities in site-specific cancer mortality, both related to being employed or not and to the occupational group of the employed population. Unemployed men and women show consistently higher overall and site-specific cancer mortality compared with the employed group. Also within the employed group, inequalities are observed by occupational group. Generally manual workers and service and sales workers have higher site-specific cancer mortality rates compared with white-collar workers and agricultural and fishery workers. These inequalities are manifest for almost all preventable cancer sites, especially those cancer sites related to alcohol and smoking such as cancers of the lung, oesophagus and head and neck. Overall, occupational inequalities were less pronounced among women compared with men.
Important SE inequalities in site-specific cancer mortality were observed by employment and occupational group. Ensuring financial security for the unemployed is a key issue in this regard. Future studies could also take a look at other working regimes, for instance temporary employment or part-time employment and their relation to health.
本研究通过就业和职业群体探讨比利时特定部位癌症死亡率的不平等现象，并调整其他社会经济（SE）地位指标。
本队列研究基于 1991 年和 2001 年比利时人口普查记录与移民和死亡率登记数据的链接，死亡时间为 2011 年 10 月 1 日至 12 月 31 日。
比利时。
该研究人群包括 1991 年人口普查时处于经济活跃年龄（25-65 岁）的所有比利时人。
计算了绝对和相对指标。首先，计算了年龄标准化死亡率，直接按比利时人口标准化。其次，使用泊松回归计算死亡率比，调整了教育、住房条件、达到年龄、地区和移民背景。
本研究强调了特定部位癌症死亡率的不平等，既与就业与否有关，也与就业人群的职业群体有关。失业男性和女性的总体和特定部位癌症死亡率普遍高于就业人群。在就业人群中，也观察到职业群体的不平等。一般来说，体力劳动者和服务和销售人员的特定部位癌症死亡率高于白领工人和农业和渔业工人。这些不平等现象在几乎所有可预防的癌症部位都存在，特别是与酒精和吸烟有关的癌症部位，如肺癌、食管癌和头颈部癌症。总体而言，与男性相比，女性的职业不平等现象不太明显。
通过就业和职业群体观察到特定部位癌症死亡率的重要社会经济不平等。确保失业人员的经济安全是这方面的关键问题。未来的研究还可以研究其他工作制度，例如临时就业或兼职就业及其与健康的关系。
