Socioeconomic factors and risk of esophageal adenocarcinoma:: A nationwide Swedish case-control study
Socioeconomic factors and risk of esophageal adenocarcinoma:: A nationwide Swedish case-control study
复制标题
DOI：
10.1158/1055-9965.epi-05-0140
复制
发表时间：
2005-07-01
影响因子：
3.8
通讯作者：
Lagergren, J
中科院分区：
文献类型：
--
作者：
Jansson, C;Johansson, ALV;Lagergren, J
背景：发达国家食管腺癌发病率的增加仍无法解释。虽然低社会经济地位 (SES) 与食管鳞状细胞癌 (SCC) 风险增加有关，但与腺癌的关系尚不确定。 方法：我们在一项基于瑞典人群的病例对照研究中探讨了各种社会经济因素的重要性，该研究分别对 189 例和 262 例食管腺癌和贲门癌、167 例食管鳞状细胞癌和 820 名对照参与者进行了个人研究采访。我们对 SES 的分类源自职业史。相对风险通过 95% 置信区间 (95% CI) 的比值比进行估计，该比值比源自条件逻辑回归、粗略模型和调整模型。 结果：食管腺癌和鳞状细胞癌的风险随着 SES 的降低而增加；与年龄和性别相当的专业人员相比，非熟练工人的风险分别增加了 3.7 倍（95% CI，1.7-7.7）和 2.1 倍（95% CI，1.0-4.7）。对反流症状、体重和吸烟的调整降低了食管腺癌的额外风险，而对一部分受访者的幽门螺杆菌感染进行调整并没有影响结果。没有伴侣的生活与食管癌两种组织学类型的风险增加 2 倍以上相关，即使经过多次调整，这种关联仍然存在。结论：食管腺癌和鳞状细胞癌都与低 SES 和没有伴侣的生活有关。这些关联只能部分由已确定的风险因素解释。
Background: The increase in esophageal adenocarcinoma incidence in developed countries remains unexplained. Although low socioeconomic status (SES) is linked to an increased risk of esophageal squamous cell carcinoma (SCC), the relation with adenocarcinoma is uncertain.Methods: We addressed the importance of various socioeconomic factors in a Swedish population-based case-control study, where 189 and 262 cases of esophageal adenocarcinoma and the gastric cardia, respectively, 167 cases of esophageal SCC, and 820 control participants underwent personal interviews. Our classification of SES was derived from occupational histories. Relative risks were estimated by odds ratios with 95% confidence intervals (95% CI), derived from conditional logistic regression, in crude and adjusted models.Results: The risk of both esophageal adenocarcinoma and SCC increased with decreasing SES; unskilled workers had 3.7-fold (95% CI, 1.7-7.7) and 2.1-fold (95% CI, 1.0-4.7) increased risks, respectively, compared with age- and sex-comparable professionals. Adjustment for reflux symptoms, body mass, and tobacco smoking attenuated the excess risk for esophageal adenocarcinoma, whereas adjustment for Helicobacter pylori infection in a subset of the interviewed participants did not influence the results. Life without a partner was associated with a > 2-fold increased risk of both histologic types of esophageal cancer, associations that remained even after multiple adjustments.Conclusions: Esophageal adenocarcinoma and SCC are both linked to low SES and a life without a partner. These associations are only partly explained by established risk factors.