北欧国家的社会经济状况和头颈癌发病率。
Socio-economic status and head and neck cancer incidence in the Nordic countries.
发表日期:2024 Jun 12
作者:
Rayan Nikkilä, Timo Carpén, Johnni Hansen, Sanna Heikkinen, Elsebeth Lynge, Jan Ivar Martinsen, Jenny Selander, Ingrid Sivesind Mehlum, Jóhanna Eyrún Torfadóttir, Antti Mäkitie, Eero Pukkala
来源:
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
摘要:
社会因素对头颈癌 (HNC) 发生的影响仍未得到充分研究,特别是在北欧国家。为了量化社会经济地位 (SES) 与 HNC 发生之间的关联,本队列研究使用了来自北欧职业癌症项目结合了 1961 年至 2005 年 1490 万名年龄在 30 至 64 岁之间的个人的职业和癌症登记数据。职业类别被合并为七个社会经济类别。以整个国家研究人群的癌症发病率作为参考率进行标准化发病率 (SIR) 分析。总共记录了 83 997 个 HNC(男性 72%,女性 28%)。在男性中,在 SES 较低的群体中,观察到舌癌、其他口腔亚部位、咽癌、口咽癌和喉癌与 SES 相关的风险梯度。管理人员发现,唇癌、舌癌、其他口腔亚部位癌、口咽癌、鼻咽癌、鼻癌和喉癌的 SIR 也降低了 0.50 至 -0.90。相比之下,在文员(SIR 1.05-1.16)、技术工人(1.04-1.14)、非技术工人(1.16-1.26)和经济不活跃男性中观察到舌癌、其他口腔亚部位、咽癌、口咽癌和喉癌的风险过高( 1.38-1.87)。在女性中,没有发现与男性相似的风险梯度。当前的研究强调了 SES 对 HNC 发病率的影响,并强调需要采取有针对性的干预措施,包括烟草和酒精控制政策,以及改善获得医疗服务的机会,特别是面向社会经济弱势群体。© 作者 2024;版权所有。由牛津大学出版社代表国际流行病学协会出版。
The impact of societal factors on the occurrence of head and neck cancers (HNCs) remains understudied, especially in the Nordic countries.To quantify the association between socio-economic status (SES) and the occurrence of HNCs, this cohort study uses data from the Nordic Occupational Cancer project that combine occupational and cancer registry data from 1961 to 2005 of 14.9 million individuals aged between 30 and 64 years. Occupational categories were combined into seven socio-economic categories. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for the entire national study populations used as reference rates.Altogether, 83 997 HNCs-72% in men and 28% in women-were recorded. Among men, a gradient of risk associated with SES was observed for cancers of the tongue, other oral cavity subsites, pharynx, oropharynx and larynx in groups with lower SES. Managers showed decreased SIRs of 0.50 to -0.90 also for cancers of the lip, tongue, other oral cavity subsites, oropharynx, nasopharynx, nose and larynx. In contrast, excess risks of tongue, other oral cavity subsites, pharyngeal, oropharyngeal and laryngeal cancers were observed among clerical (SIRs 1.05-1.16), skilled workers (1.04-1.14), unskilled workers (1.16-1.26) and economically inactive men (1.38-1.87). Among women, no risk gradient similar to that in men was revealed.The current study underscores the influence of SES on the incidence of HNCs and highlights the need for targeted interventions, including tobacco and alcohol control policies, and improved access to healthcare services, particularly for socio-economically disadvantaged populations.© The Author(s) 2024; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.