Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries.
Estimating and explaining the effect of education and income on head and neck cancer risk: INHANCE consortium pooled analysis of 31 case-control studies from 27 countries.
复制标题
DOI：
10.1002/ijc.29063
复制
发表时间：
2015-03-01
影响因子：
6.4
通讯作者：
Brennan P
中科院分区：
文献类型：
--
作者：
Conway DI;Brenner DR;McMahon AD;Macpherson LM;Agudo A;Ahrens W;Bosetti C;Brenner H;Castellsague X;Chen C;Curado MP;Curioni OA;Dal Maso L;Daudt AW;de Gois Filho JF;D'Souza G;Edefonti V;Fabianova E;Fernandez L;Franceschi S;Gillison M;Hayes RB;Healy CM;Herrero R;Holcatova I;Jayaprakash V;Kelsey K;Kjaerheim K;Koifman S;La Vecchia C;Lagiou P;Lazarus P;Levi F;Lissowska J;Luce D;Macfarlane TV;Mates D;Matos E;McClean M;Menezes AM;Menvielle G;Merletti F;Morgenstern H;Moysich K;Müller H;Muscat J;Olshan AF;Purdue MP;Ramroth H;Richiardi L;Rudnai P;Schantz S;Schwartz SM;Shangina O;Simonato L;Smith E;Stucker I;Sturgis EM;Szeszenia-Dabrowska N;Talamini R;Thomson P;Vaughan TL;Wei Q;Winn DM;Wunsch-Filho V;Yu GP;Zhang ZF;Zheng T;Znaor A;Boffetta P;Chuang SC;Ghodrat M;Amy Lee YC;Hashibe M;Brennan P
据报道，社会经济地位低与头颈部癌症风险有关。然而，之前的研究规模太小，无法通过癌症亚点、年龄、性别、全球地区和日历时间来检验这种联系，也无法从行为风险因素的角度来解释这种联系。将来自27个国家的31项研究的23,964例头颈癌患者和31,954名对照的个人参与者数据与随机效应模型汇集在一起。总体而言，低教育程度与头颈癌风险增加相关(OR=2.50；95%CI=2.02-3.09)。总体而言，三分之一的风险增加不能用吸烟和饮酒行为的分布差异来解释；在从不吸烟和不饮酒的人中，这一比例仍然很高(OR=1.61；95%CI=1.13-2.31)。吸烟和饮酒行为并不能解释更多的估计教育效果：女性比男性，年龄比年轻群体，口咽比其他地方，在南美洲/中美洲比在欧洲/北美，在收入不平等程度较大的国家表现最强。对于低家庭收入与高家庭收入的估计影响，也观察到了类似的结果。收入和教育程度最低的人患头颈癌的风险增加了2倍以上，这不能完全用这些癌症的行为风险因素的分布差异来解释，而且这种差异在癌症地点、性别、国家和国家收入不平等程度上有所不同。
Low socioeconomic status has been reported to be associated with head and neck cancer risk. However, previous studies have been too small to examine the associations by cancer subsite, age, sex, global region and calendar time and to explain the association in terms of behavioral risk factors. Individual participant data of 23,964 cases with head and neck cancer and 31,954 controls from 31 studies in 27 countries pooled with random effects models. Overall, low education was associated with an increased risk of head and neck cancer (OR = 2.50; 95% CI = 2.02 – 3.09). Overall one-third of the increased risk was not explained by differences in the distribution of cigarette smoking and alcohol behaviors; and it remained elevated among never users of tobacco and nondrinkers (OR = 1.61; 95% CI = 1.13 – 2.31). More of the estimated education effect was not explained by cigarette smoking and alcohol behaviors: in women than in men, in older than younger groups, in the oropharynx than in other sites, in South/Central America than in Europe/North America and was strongest in countries with greater income inequality. Similar findings were observed for the estimated effect of low versus high household income. The lowest levels of income and educational attainment were associated with more than 2-fold increased risk of head and neck cancer, which is not entirely explained by differences in the distributions of behavioral risk factors for these cancers and which varies across cancer sites, sexes, countries and country income inequality levels.