BACKGROUND: The nature of the association between occupational social prestige, social mobility, and risk of lung cancer remains uncertain. Using data from the international pooled SYNERGY case-control study, we studied the association between lung cancer and the level of time-weighted average occupational social prestige as well as its lifetime trajectory. METHODS: We included 11,433 male cases and 14,147 male control subjects. Each job was translated into an occupational social prestige score by applying Treiman's Standard International Occupational Prestige Scale (SIOPS). SIOPS scores were categorized as low, medium, and high prestige (reference). We calculated odds ratios (OR) with 95 % confidence intervals (CI), adjusting for study center, age, smoking, ever employment in a job with known lung carcinogen exposure, and education. Trajectories in SIOPS categories from first to last and first to longest job were defined as consistent, downward, or upward. We conducted several subgroup and sensitivity analyses to assess the robustness of our results. RESULTS: We observed increased lung cancer risk estimates for men with medium (OR = 1.23; 95 % CI 1.13-1.33) and low occupational prestige (OR = 1.44; 95 % CI 1.32-1.57). Although adjustment for smoking and education reduced the associations between occupational prestige and lung cancer, they did not explain the association entirely. Traditional occupational exposures reduced the associations only slightly. We observed small associations with downward prestige trajectories, with ORs of 1.13, 95 % CI 0.88-1.46 for high to low, and 1.24; 95 % CI 1.08-1.41 for medium to low trajectories. CONCLUSIONS: Our results indicate that occupational prestige is independently associated with lung cancer among men.

Cancer Care Ontario Occupational Cancer Research Centre Toronto Canada

Dental School College of Medicine Veterinary and Life Sciences University of Glasgow Glasgow G2 3JZ UK

Department of Cancer Epidemiology and Genetics Masaryk Memorial Cancer Institute and Medical Faculty of Masaryk University Brno Czech Republic

Department of Medical Sciences Unit of Cancer Epidemiology University of Turin Turin Italy

Department of Molecular and Clinical Cancer Medicine Institute of Translational Medicine University of Liverpool Liverpool UK

Department of Molecular Medicine Laboratory of Public Health and Population Studies University of Padova Padova Italy

Environmental Epidemiology Division Institute for Risk Assessment Sciences Utrecht University Utrecht The Netherlands

Epidemiology Unit Istituto Dermopatico dell'Immacolata Rome Italy

Faculty of Medicine Palacky University Olomouc Czech Republic

Faculty of Medicine University of Ostrava Ostrava Czech Republic

Hospital Research Center and School of Public Health University of Montreal Montreal Canada

INRS Institut Armand Frappier Université du Québec Laval Québec Canada

Inserm Centre for Research in Epidemiology and Population Health U1018 Environmental Epidemiology of Cancer Team F 94807 Villejuif France

Institute for Medical Informatics Biometry and Epidemiology University Hospital Essen Essen Germany

Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr Universität Bochum Bürkle de la Camp Platz 1 44789 Bochum Germany

Institute for Statistics University Bremen Bremen Germany

Institute of Carcinogenesis Russian Cancer Research Centre Moscow Russia

Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden

Institute of Epidemiology 1 Helmholtz Zentrum München Neuherberg Germany

Institute of Hygiene and Epidemiology 1st Faculty of Medicine Charles University Prague Czech Republic

Institute of Medical Statistics and Epidemiology Technical University Munich Munich Germany

International Agency for Research on Cancer Lyon France

Leibniz Institute for Prevention Research and Epidemiology BIPS GmbH Bremen Germany

Molecular Epidemiology of Cancer Unit University of Oviedo Ciber de Epidemiologia CIBERESP Oviedo Spain

National Cancer Institute Division of Cancer Epidemiology and Genetics Bethesda USA

National Centre for Public Health Budapest Hungary

National Institute of Public Health Bucharest Romania

Regional Authority of Public Health Preventive Occupational Medicine Banska Bystrica Slovakia

Roy Castle Lung Cancer Research Programme The University of Liverpool Cancer Research Centre Liverpool UK

The M Sklodowska Curie Cancer Center and Institute of Oncology Warsaw Poland

The Nofer Institute of Occupational Medicine Lodz Poland

The Tisch Cancer Institute and Institute for Translational Epidemiology Icahn School of Medicine at Mount Sinai New York USA

Unit of Epidemiology Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy

University Paris Sud UMRS 1018 F 94807 Villejuif France

Zobrazit více v PubMed

Braveman PA, Cubbin C, Egerter S, Williams D, Pamuk E. Socioeconomic disparities in health in the United States: what the patterns tell us. Am J Public Health. 2010;1008(Suppl 19):S186–96. doi: 10.2105/AJPH.2009.166082. PubMed DOI PMC

Sharpe KH, McMahon AD, McClements P, Watling C, Brewster DH, Conway DI. Socioeconomic inequalities in incidence of lung and upper aero-digestive tract cancer by age, tumour subtype and sex: a population-based study in Scotland (2000–2007) Cancer Epidemiol. 2012;36(3):e164–70. doi: 10.1016/j.canep.2012.01.007. PubMed DOI

Menvielle G, Boshuizen H, Kunst AE, Dalton SO, Vineis P, Bergmann MM, et al. The role of smoking and diet in explaining educational inequalities in lung cancer incidence. J Natl Cancer Inst. 2009;101(5):321–330. doi: 10.1093/jnci/djn513. PubMed DOI PMC

Menvielle G, Truong T, Jellouli F, Stücker I, Brenner H, Field JK, et al. Education and lung cancer among never smokers. Epidemiology. 2014;25(6):934–935. doi: 10.1097/EDE.0000000000000183. PubMed DOI PMC

Hrubá F, Fabiánová E, Bencko V, Cassidy A, Lissowska J, Mates D, et al. Socioeconomic indicators and risk of lung cancer in Central and Eastern Europe. Cent Eur J Public Health. 2009;17(3):115–121. PubMed

Krieger N, Williams DR, Moss NE. Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health. 1997;18:341–378. doi: 10.1146/annurev.publhealth.18.1.341. PubMed DOI

Adler NE, Ostrove JM. Socioeconomic status and health: what we know and what we don’t. Ann NY Acad Sci. 1999;896:3–15. doi: 10.1111/j.1749-6632.1999.tb08101.x. PubMed DOI

Fein O. The influence of social class on health status: American and British research on health inequalities. J General Internal Med. 1995;10(10):577–86. doi: 10.1007/BF02640369. PubMed DOI

Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey SG. Indicators of socioeconomic position (part 1) J Epidemiol Community Health. 2006;60(1):7–12. doi: 10.1136/jech.2004.023531. PubMed DOI PMC

Chida Y, Hamer M, Wardle J, Steptoe A. Do stress-related psychosocial factors contribute to cancer incidence and survival? Nat Clin Pract Oncol. 2008;5(8):466–75. doi: 10.1038/ncponc1134. PubMed DOI

Galobardes B, Shaw M, Lawlor DA, Lynch JW, Smith GD. Indicators of socioeconomic position (part 2) J Epidemiol Community Health. 2006;60(2):95–101. doi: 10.1136/jech.2004.028092. PubMed DOI PMC

Treiman DJ. Occupational prestige in comparative perspective. New York-San Francisco-London: Academic; 1977.

Schmeisser N, Conway DI, McKinney PA, MacMahon AD, Pohlabeln H, Marron M, et al. Life course social mobility and risk of upper aerodigestive tract cancer in men. Eur J Epidemiol. 2010;25(3):173–182. doi: 10.1007/s10654-010-9429-5. PubMed DOI

Marshall B, Chevalier A, Garillon C, Goldberg M, Coing F. Socioeconomic status, social mobility and cancer occurrence during working life: a case–control study among French electricity and gas workers. Cancer Causes Control. 1999;10(6):495–502. doi: 10.1023/A:1008921720493. PubMed DOI

Jahn I, Becker U, Jöckel KH, Pohlabeln H. Occupational life course and lung cancer risk in men. Findings from a socio-epidemiological analysis of job-changing histories in a case–control study. Soc Sci Med. 1995;40(7):961–975. doi: 10.1016/0277-9536(94)00151-I. PubMed DOI

Olsson AC, Gustavsson P, Kromhout H, Peters S, Vermeulen R, Brüske I, et al. Exposure to diesel motor exhaust and lung cancer risk in a pooled analysis from case–control studies in Europe and Canada. Am J Respir Crit Care Med. 2011;183(7):941–948. doi: 10.1164/rccm.201006-0940OC. PubMed DOI PMC

Pesch B, Kendzia B, Gustavsson P, Jöckel KH, Johnen G, Pohlabeln H, et al. Cigarette smoking and lung cancer-relative risk estimates for the major histological types from a pooled analysis of case–control studies. Int J Cancer. 2012;131(5):1210–1219. doi: 10.1002/ijc.27339. PubMed DOI PMC

Roelfs DJ, Shor E, Davidson KW, Schwartz JE. Losing life and livelihood: a systematic review and meta-analysis of unemployment and all-cause mortality. Soc Sci Med. 2011;72(6):840–854. doi: 10.1016/j.socscimed.2011.01.005. PubMed DOI PMC

Martikainen P, Valkonen T. Bias related to the exclusion of the economically inactive in studies on social class differences in mortality. Int J Epidemiol. 1999;28(5):899–904. doi: 10.1093/ije/28.5.899. PubMed DOI

Ahrens W, Merletti F. A standard tool for the analysis of occupational lung cancer in epidemiologic studies. Int J Occup Environ Health. 1998;4(4):236–240. doi: 10.1179/oeh.1998.4.4.236. PubMed DOI

Mirabelli D, Chiusolo M, Calisti R, Massacesi S, Richiardi L, Nesti M, et al. Database di occupazioni e attività industriali che comportano rischio di tumore del polmone [Database of occupations and industrial activities that involve the risk of pulmonary tumors] Epidemiologia e Prevenzione. 2001;25(4–5):215–221. PubMed

UNESCO Institute for Statistics . International Standard Classification of Education - ISCED 1997. 2006.

Hoffmeyer-Zlotnik J. Stellung im Beruf als Ersatz für eine Berufsklassifikation zur Ermittlung von sozialem Prestige [Occupational status as substitute for an occupational classification to determine social prestige] ZUMA-Nachrichten. 2003;27(53):114–27.

Valkonen T. Problems in the measurement and international comparisons of socio-economic differences in mortality. Soc Sci Med. 1993;36(4):409–418. doi: 10.1016/0277-9536(93)90403-Q. PubMed DOI

Menvielle G, Boshuizen H, Kunst AE, Vineis P, Dalton SO, Bergmann MM, et al. Occupational exposures contribute to educational inequalities in lung cancer incidence among men: Evidence from the EPIC prospective cohort study. Int J Cancer. 2010;126(8):1928–1935. PubMed PMC

Shavers VL. Measurement of socioeconomic status in health disparities research. J Natl Med Assoc. 2007;99(9):1013–1023. PubMed PMC

Smith GD. Life-course approaches to inequalities in adult chronic disease risk. Proc Nutr Soc. 2007;66(2):216–236. doi: 10.1017/S0029665107005460. PubMed DOI

Braveman PA, Cubbin C, Egerter S, Chidea S, Marchi K, Metzler M, et al. Socioeconomic status in health research: one size does not fit all. JAMA. 2005;294(22):2879–2888. doi: 10.1001/jama.294.22.2879. PubMed DOI

Hart CL, Hole DJ, Gillis CR, Smith DG, Watts GC, Hawthorne VM. Social class differences in lung cancer mortality: risk factor explanations using two Scottish cohort studies. Int J Epidemiol. 2001;30(2):268–274. doi: 10.1093/ije/30.2.268. PubMed DOI

Nkosi TM, Parent M, Siemiatycki J, Rousseau MC. Socioeconomic position and lung cancer risk: how important is the modeling of smoking? Epidemiology. 2012;23(3):377–385. doi: 10.1097/EDE.0b013e31824d0548. PubMed DOI

Ekberg-Aronsson M, Nilsson PM, Nilsson J, Pehrsson K, Löfdahl CG. Socio-economic status and lung cancer risk including histologic subtyping--a longitudinal study. Lung Cancer. 2006;51(1):21–29. doi: 10.1016/j.lungcan.2005.08.014. PubMed DOI

Arheart KL, Lee DJ, Fleming LE, LeBlanc WG, Dietz NA, McCollister KE, et al. Accuracy of self-reported smoking and secondhand smoke exposure in the US workforce: the National Health and Nutrition Examination Surveys. J Occup Environ Med. 2008;50(12):1414–1420. doi: 10.1097/JOM.0b013e318188b90a. PubMed DOI

Thun MJ. The evolving relationship of social class to tobacco smoking and lung cancer. J Natl Cancer Inst. 2009;101(5):285–287. doi: 10.1093/jnci/djp005. PubMed DOI

Mackenbach JP, Huisman M, Andersen O, Bopp M, Borgan JK, Borrell C, et al. Inequalities in lung cancer mortality by the educational level in 10 European populations. Eur J Cancer. 2004;40(1):126–135. doi: 10.1016/j.ejca.2003.10.018. PubMed DOI

Mackenbach JP, Stirbu I, Roskam AJ, Schaap MM, Menvielle G, Leinsalu M, et al. Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008;358(23):2468–2481. doi: 10.1056/NEJMsa0707519. PubMed DOI

Dahl E. Social mobility and health: cause or effect? BMJ. 1996;313(7055):435–436. doi: 10.1136/bmj.313.7055.435. PubMed DOI PMC

Pearlin LI, Lieberman MA, Menaghan EG, Mullan JT. The stress process. J Health Soc Behav. 1981;22(4):337–356. doi: 10.2307/2136676. PubMed DOI

Occupational socioeconomic risk associations for head and neck cancer in Europe and South America: individual participant data analysis of pooled case-control studies within the INHANCE Consortium

Lung cancer and socioeconomic status in a pooled analysis of case-control studies