Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.
Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer and Research, Helsinki, Finland.
Int J Epidemiol. 2024 Jun 12;53(4). doi: 10.1093/ije/dyae104.
The impact of societal factors on the occurrence of head and neck cancers (HNCs) remains understudied, especially in the Nordic countries.
To quantify the association between socio-economic status (SES) and the occurrence of HNCs, this cohort study uses data from the Nordic Occupational Cancer project that combine occupational and cancer registry data from 1961 to 2005 of 14.9 million individuals aged between 30 and 64 years. Occupational categories were combined into seven socio-economic categories. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for the entire national study populations used as reference rates.
Altogether, 83 997 HNCs-72% in men and 28% in women-were recorded. Among men, a gradient of risk associated with SES was observed for cancers of the tongue, other oral cavity subsites, pharynx, oropharynx and larynx in groups with lower SES. Managers showed decreased SIRs of 0.50 to -0.90 also for cancers of the lip, tongue, other oral cavity subsites, oropharynx, nasopharynx, nose and larynx. In contrast, excess risks of tongue, other oral cavity subsites, pharyngeal, oropharyngeal and laryngeal cancers were observed among clerical (SIRs 1.05-1.16), skilled workers (1.04-1.14), unskilled workers (1.16-1.26) and economically inactive men (1.38-1.87). Among women, no risk gradient similar to that in men was revealed.
The current study underscores the influence of SES on the incidence of HNCs and highlights the need for targeted interventions, including tobacco and alcohol control policies, and improved access to healthcare services, particularly for socio-economically disadvantaged populations.
社会因素对头颈部癌症（HNC）发生的影响仍研究不足，尤其是在北欧国家。
为了定量评估社会经济地位（SES）与 HNC 发生之间的关联，本队列研究利用北欧职业癌症项目的数据，该项目将 1961 年至 2005 年间 1490 万名 30 至 64 岁个体的职业和癌症登记数据进行了整合。职业类别被合并为七个 SES 类别。使用整个国家研究人群的癌症发病率作为参考率，进行标准化发病比（SIR）分析。
共记录了 83997 例 HNC-72%为男性，28%为女性。在男性中，SES 较低的组别中，与 SES 相关的风险呈梯度上升趋势，与癌症发生相关的部位包括舌、其他口腔亚部位、咽、口咽和喉。经理人群中，唇、舌、其他口腔亚部位、口咽、鼻咽、鼻和喉的癌症 SIR 也降低至 0.50 至 -0.90。相比之下，在文书（SIR 为 1.05-1.16）、熟练工人（1.04-1.14）、非熟练工人（1.16-1.26）和经济不活跃的男性（1.38-1.87）中，观察到舌、其他口腔亚部位、咽、口咽和喉的癌症风险增加。在女性中，没有发现类似于男性的风险梯度。
本研究强调了 SES 对头颈部癌症发病的影响，并突出了需要采取有针对性的干预措施，包括控制烟草和酒精以及改善医疗保健服务的可及性，特别是针对社会经济弱势群体。
