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特定生命阶段不利的社会经济地位可能会增加患前列腺癌的风险及侵袭性。

Disadvantageous Socioeconomic Position at Specific Life Periods May Contribute to Prostate Cancer Risk and Aggressiveness.

作者信息

Madathil Sreenath, Blaser Christine, Nicolau Belinda, Richard Hugues, Parent Marie-Élise

机构信息

Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, Laval, QC, Canada.

Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.

出版信息

Front Oncol. 2018 Nov 15;8:515. doi: 10.3389/fonc.2018.00515. eCollection 2018.

Abstract

Previous studies on socioeconomic position (SEP) and risk of prostate cancer (PCa) have produced contradictory results. Most measured SEP only once during the individuals' life span. The aim of the study was to identify life course models that describe best the relationship between SEP measured during childhood/adolescence, early- and late-adulthood, and risk of PCa overall as well as according to tumor aggressiveness at diagnosis. We used data from a population-based case-control study of PCa conducted in the predominantly French-speaking population in Montreal, Canada. Cases ( = 1,930) with new, histologically-confirmed PCa were ascertained across hospitals deserving the French-speaking population in 2005-2009. Controls ( = 1,991), selected from Quebec's list of French-speaking electors, were frequency-matched to cases (±5 years). In-person interviews collected information on socio-demographic and lifestyle characteristics, and a complete occupational history. Measures of SEP during childhood/adolescence included parents' ownership of a car and father's longest occupation, while the subject's first and longest occupations were used to indicate early- and late-adulthood SEP, respectively. We used the Bayesian relevant life course exposure model to investigate the relationship between lifelong SEP and PCa risk. Cumulative exposure to disadvantageous SEP was associated with about a 50% increase in odds of developing PCa. Late-adulthood SEP was identified as a sensitive period for aggressive PCa. Childhood/adolescence SEP based on parents' ownership of a car was associated with non-aggressive PCa. Associations were independent from PCa screening. Disadvantageous SEP over the life course was associated with higher PCa incidence, with consistent evidence of sensitive time periods for cancer aggressiveness. The mechanisms through which disadvantageous SEP relates to PCa risk need to be further elucidated.

摘要

以往关于社会经济地位(SEP)与前列腺癌(PCa)风险的研究结果相互矛盾。大多数研究仅在个体生命过程中测量一次SEP。本研究的目的是确定能最佳描述儿童期/青少年期、成年早期和成年晚期测量的SEP与总体PCa风险以及诊断时肿瘤侵袭性之间关系的生命历程模型。我们使用了在加拿大蒙特利尔以法语为主要语言的人群中进行的一项基于人群的PCa病例对照研究的数据。2005年至2009年期间,在为讲法语人群服务的各医院确定了1930例新的、经组织学确诊的PCa病例。从魁北克讲法语选民名单中选取的1991名对照与病例进行频率匹配(±5岁)。通过面对面访谈收集了社会人口学和生活方式特征以及完整职业史的信息。儿童期/青少年期SEP的测量指标包括父母是否拥有汽车以及父亲最长的职业,而受试者的第一份和最长的职业分别用于表示成年早期和成年晚期的SEP。我们使用贝叶斯相关生命历程暴露模型来研究终身SEP与PCa风险之间的关系。累积暴露于不利的SEP与患PCa的几率增加约50%相关。成年晚期SEP被确定为侵袭性PCa的敏感期。基于父母拥有汽车情况的儿童期/青少年期SEP与非侵袭性PCa相关。这些关联独立于PCa筛查。生命历程中不利的SEP与较高的PCa发病率相关,有一致证据表明存在癌症侵袭性的敏感时期。不利的SEP与PCa风险相关的机制需要进一步阐明。

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