Garillon C, Chevalier A, Marshall B, Godard C, Colombani H, Callet B, Coing F
Service général de médecine de contrôle EDF-GDF, Paris.
Bull Cancer. 1997 Nov;84(11):1025-31.
Our aim was to draw up a first general view of cancer pathology among the EDF-GDF women thanks to the cancer register among active employees created by the social security department of the French national electric and gas company EDF-GDF. Between 1978 and 1992, 764 cases of cancer were diagnosed. Breast cancer was the most common (52.4%), followed by gynaecological cancers: uterus (8.6%) and ovary (6.2%), and colon and rectum cancers (5.4%). The age-standardized breast cancer incidence using the 1978-1982 period as a basis increased over time. A higher incidence for breast cancer and a lower incidence for uterus cancer were observed among the EDF-GDF women during the 1978-1982 and 1983-1987 periods, compared to French women of same age. The study of the relationship between breast cancer risk and socioeconomic status, by means of indirect standardization, showed that the breast cancer risk increased with increasing socioeconomic status. Thus manual workers had a lower breast cancer risk than the EDF-GDF woman cohort (SIR = 0.72), foremen had the same risk (SIR = 1.05) and managers had a significantly higher risk (SIR = 1.64). Moreover a case-control study showed that the change in socioeconomic status between the beginning (20 years old) and the middle of a career (35 years old) was important but it was essentially the socioeconomic status at the beginning which determined the breast cancer risk. The results support the hypothesis of a "social class" effect through risk factors during the first part of the life.
我们的目标是，借助法国国家电力和燃气公司（EDF-GDF）社会保障部门创建的在职员工癌症登记册，对EDF-GDF女性的癌症病理学情况进行初步总体观察。1978年至1992年期间，共诊断出764例癌症病例。乳腺癌最为常见（52.4%），其次是妇科癌症：子宫癌（8.6%）和卵巢癌（6.2%），以及结肠直肠癌（5.4%）。以1978 - 1982年期间为基础的年龄标准化乳腺癌发病率随时间推移有所上升。与同龄法国女性相比，在1978 - 1982年和1983 - 1987年期间，EDF-GDF女性的乳腺癌发病率较高，子宫癌发病率较低。通过间接标准化研究乳腺癌风险与社会经济地位之间的关系表明，乳腺癌风险随社会经济地位的提高而增加。因此，体力劳动者患乳腺癌的风险低于EDF-GDF女性队列（标准化发病比SIR = 0.72），工头的风险相同（SIR = 1.05），而管理人员的风险显著更高（SIR = 1.64）。此外，一项病例对照研究表明，职业生涯开始时（20岁）到中期（35岁）社会经济地位的变化很重要，但基本上是开始时的社会经济地位决定了乳腺癌风险。研究结果支持了关于生命早期通过风险因素产生“社会阶层”效应的假说。
