Socio-demographic and geographical factors in esophageal and gastric cancer mortality in Sweden.
Socio-demographic and geographical factors in esophageal and gastric cancer mortality in Sweden.
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DOI：
10.1371/journal.pone.0062067
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Lagergren J
中科院分区：
文献类型：
--
作者：
Ljung R;Drefahl S;Andersson G;Lagergren J
社会人口因素和居住地区可能影响食管癌和胃癌的发生。大规模的基于人口的研究可以确定这些因素的作用。这项以人群为基础的队列研究包括1990-2007年间年龄在30-84岁之间的所有瑞典居民。研究人员评估了受教育程度、婚姻状况、出生地和居住地与食管癌或胃癌死亡率的关系。Cox回归得到95%可信区间（CI）的风险比（HR），校正了潜在的混杂因素。在84 920 565人/年中，食管癌和胃癌分别导致5125人和12 230人死亡。高学历降低了食管癌（女性HR = 0.61, 95%CI 0.42 ~ 0.90，男性HR = 0.71, 95%CI 0.60 ~ 0.84）和胃癌（女性HR = 0.80, 95%CI 0.63 ~ 1.03，男性HR = 0.73, 95%CI 0.64 ~ 0.83）的HR。未婚增加了食管癌的HR（女性HR = 1.64, 95%CI 1.35 ~ 1.99，男性HR = 1.64, 95%CI 1.50 ~ 1.80），但没有增加胃癌的HR。出生在人口密度低的地区会增加胃癌的HR（女性HR = 1.23, 95%CI 1.10-1.38，男性HR = 1.37, 95%CI 1.25-1.50），而与食管癌没有明显的相关性。生活在人口稠密地区的人患食管癌的风险比增加（女性HR = 1.31, 95%CI 1.14-1.50，男性HR = 1.40, 95%CI 1.29-1.51），但胃癌的风险比没有增加。癌症死亡率方面的这些社会人口不平等，要求我们努力调查可能的预防机制，并在贫困群体中促进和支持更健康的生活方式。
Socio-demographic factors and area of residence might influence the development of esophageal and gastric cancer. Large-scale population-based research can determine the role of such factors. This population-based cohort study included all Swedish residents aged 30–84 years in 1990–2007. Educational level, marital status, place of birth, and place of residence were evaluated with regard to mortality from esophageal or gastric cancer. Cox regression yielded hazard ratios (HR) with 95% confidence intervals (CI), adjusted for potential confounding. Among 84 920 565 person-years, 5125 and 12 230 deaths occurred from esophageal cancer and gastric cancer, respectively. Higher educational level decreased the HR of esophageal cancer (HR = 0.61, 95%CI 0.42–0.90 in women, HR = 0.71, 95%CI 0.60–0.84 in men) and gastric cancer (HR = 0.80, 95%CI 0.63–1.03 in women, HR = 0.73, 95%CI 0.64–0.83 in men). Being unmarried increased HR of esophageal cancer (HR = 1.64, 95%CI 1.35–1.99 in women, HR = 1.64, 95%CI 1.50–1.80 in men), but not of gastric cancer. Being born in low density populated areas increased HR of gastric cancer (HR = 1.23, 95%CI 1.10–1.38 in women, HR = 1.37, 95%CI 1.25–1.50 in men), while no strong association was found with esophageal cancer. Living in densely populated areas increased HR of esophageal cancer (HR = 1.31, 95%CI 1.14–1.50 in women, HR = 1.40, 95%CI 1.29–1.51 in men), but not of gastric cancer. These socio-demographic inequalities in cancer mortality warrant efforts to investigate possible preventable mechanisms and to promote and support healthier lifestyles among deprived groups.
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