Collatuzzo Giulia, Teglia Federica, Boffetta Paolo
Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA.
Cancers (Basel). 2022 Aug 31;14(17):4259. doi: 10.3390/cancers14174259.
Cancer occurrence is characterized globally by profound socioeconomic differences. Occupation is a fundamental component of socioeconomic status. In this review, we discuss the role of occupation as a determinant of cancer disparities. First, we address the issue of participation in cancer screening programs based on income, health insurance, occupational status and job title. Second, we review the role of occupation in contributing to disparities by acting as a mediator between cancer and (i) education and (ii) race/ethnicity. Lastly, we analyze data from a multicenter case-control study of lung cancer to calculate the mediating role of occupational exposure to diesel exhaust, silica and welding fumes in the association between education and lung cancer. By addressing the complex paths from occupation to cancer inequalities from multiple points of view, we provide evidence that occupational-related characteristics, such as income, health insurance, unemployment and hazardous exposures impinge on cancer control and outcomes. The increasing awareness of these aspects is fundamental and should lead to public health interventions to avoid inequalities rising from occupational factors.
全球癌症的发生呈现出显著的社会经济差异。职业是社会经济地位的一个基本组成部分。在本综述中，我们讨论职业作为癌症差异决定因素的作用。首先，我们探讨基于收入、健康保险、职业地位和职称参与癌症筛查项目的问题。其次，我们回顾职业通过在癌症与（i）教育和（ii）种族/民族之间充当调解人，在造成差异方面所起的作用。最后，我们分析一项多中心肺癌病例对照研究的数据，以计算职业接触柴油废气、二氧化硅和焊接烟雾在教育与肺癌关联中的中介作用。通过从多个角度阐述从职业到癌症不平等的复杂路径，我们提供证据表明，与职业相关的特征，如收入、健康保险、失业和有害暴露，会影响癌症控制和结果。对这些方面的认识不断提高至关重要，应促使采取公共卫生干预措施，以避免职业因素导致的不平等现象加剧。
