Area and individual socioeconomic factors and cancer risk: a population cohort study in Scotland
Sharpe, K., McMahon, A.D., Raab, G., Brewster, D.H. & Conway, D.I. (2013) SHIP conference: Exploiting Existing Data for Health Research, University of St Andrews, UK, 28 - 30 August 2013 [SLS]
Background: Socioeconomic inequalities in cancer risk differ by tumour site, age and sex. Lung and upper aero-digestive tract (UADT) cancer risk contribute 90% (males) and 81% (females) to cancer risk social inequalities in Scotland and are associated with low socioeconomic circumstances. We investigate the relative association with cancer risk of country of birth, marital status, area deprivation and individual socioeconomic variables (economic activity, education level, occupational social class, car ownership, housing tenure) for lung, UADT and all cancer risk (excluding non melanoma skin cancer).
Methods: We linked Scottish Longitudinal Study, vital event registries and Scottish Cancer Registry data and followed 203 658 cohort members aged 15+ years from 1991- 2006. We calculated relative risks and 95% confidence intervals using fully adjusted Poisson regression models for each sex offset by person-years of follow-up.
Results: 21 832 first primary tumours, including 3 505 lung and 1 206 UADT tumours were diagnosed corresponding to 3.05 million person- years of follow-up. For females, car ownership and housing tenure were more strongly associated with increased risk. For males unemployment was consistently associated with increased cancer risk (except lung), while education was not associated with increased risk. For lung cancer, area deprivation remained significant even after adjustment for individual variables in both sexes, suggesting the area affect can not be fully explained by individual socioeconomic circumstances. Finally, being born in Scotland, divorced or widowed was associated with increased risk regardless of sex.
Conclusion: Different and independent socioeconomic variables are associated with different cancer risks in different sexes.