BACKGROUND: A higher burden of head and neck cancer has been reported to affect deprived populations. This study assessed the association between socioeconomic status and head and neck cancer, aiming to explore how this association is related to differences of tobacco and alcohol consumption across socioeconomic strata. METHODS: We conducted a case-control study in São Paulo, Brazil (1998-2006), including 1017 incident cases of oral, pharyngeal and laryngeal cancer, and 951 sex- and age-matched controls. Education and occupation were distal determinants in the hierarchical approach; cumulative exposure to tobacco and alcohol were proximal risk factors. Outcomes of the hierarchical model were compared with fully adjusted ORs. RESULTS: Individuals with lower education (OR 2.27; 95% CI 1.61 to 3.19) and those performing manual labour (OR 1.55; 95% CI 1.26 to 1.92) had a higher risk of disease. However, 54% of the association with lower education and 45% of the association with manual labour were explained by proximal lifestyle exposures, and socioeconomic status remained significantly associated with disease when adjusted for smoking and alcohol consumption. CONCLUSIONS: Socioeconomic differences in head and neck cancer are partially attributable to the distribution of tobacco smoking and alcohol consumption across socioeconomic strata. Additional mediating factors may explain the remaining variation of socioeconomic status on head and neck cancer.
BACKGROUND: A higher burden of head and neck cancer has been reported to affect deprived populations. This study assessed the association between socioeconomic status and head and neck cancer, aiming to explore how this association is related to differences of tobacco and alcohol consumption across socioeconomic strata. METHODS: We conducted a case-control study in São Paulo, Brazil (1998-2006), including 1017 incident cases of oral, pharyngeal and laryngeal cancer, and 951 sex- and age-matched controls. Education and occupation were distal determinants in the hierarchical approach; cumulative exposure to tobacco and alcohol were proximal risk factors. Outcomes of the hierarchical model were compared with fully adjusted ORs. RESULTS: Individuals with lower education (OR 2.27; 95% CI 1.61 to 3.19) and those performing manual labour (OR 1.55; 95% CI 1.26 to 1.92) had a higher risk of disease. However, 54% of the association with lower education and 45% of the association with manual labour were explained by proximal lifestyle exposures, and socioeconomic status remained significantly associated with disease when adjusted for smoking and alcohol consumption. CONCLUSIONS: Socioeconomic differences in head and neck cancer are partially attributable to the distribution of tobacco smoking and alcohol consumption across socioeconomic strata. Additional mediating factors may explain the remaining variation of socioeconomic status on head and neck cancer.
Authors: Gioia Di Credico; Valeria Edefonti; Jerry Polesel; Francesco Pauli; Nicola Torelli; Diego Serraino; Eva Negri; Daniele Luce; Isabelle Stucker; Keitaro Matsuo; Paul Brennan; Marta Vilensky; Leticia Fernandez; Maria Paula Curado; Ana Menezes; Alexander W Daudt; Rosalina Koifman; Victor Wunsch-Filho; Ivana Holcatova; Wolfgang Ahrens; Pagona Lagiou; Lorenzo Simonato; Lorenzo Richiardi; Claire Healy; Kristina Kjaerheim; David I Conway; Tatiana V Macfarlane; Peter Thomson; Antonio Agudo; Ariana Znaor; Leonardo F Boaventura Rios; Tatiana N Toporcov; Silvia Franceschi; Rolando Herrero; Joshua Muscat; Andrew F Olshan; Jose P Zevallos; Carlo La Vecchia; Deborah M Winn; Erich M Sturgis; Guojun Li; Eleonora Fabianova; Jolanda Lissowska; Dana Mates; Peter Rudnai; Oxana Shangina; Beata Swiatkowska; Kirsten Moysich; Zuo-Feng Zhang; Hal Morgenstern; Fabio Levi; Elaine Smith; Philip Lazarus; Cristina Bosetti; Werner Garavello; Karl Kelsey; Michael McClean; Heribert Ramroth; Chu Chen; Stephen M Schwartz; Thomas L Vaughan; Tongzhang Zheng; Gwenn Menvielle; Stefania Boccia; Gabriella Cadoni; Richard B Hayes; Mark Purdue; Maura Gillison; Stimson Schantz; Guo-Pei Yu; Hermann Brenner; Gypsyamber D'Souza; Neil D Gross; Shu-Chun Chuang; Paolo Boffetta; Mia Hashibe; Yuan-Chin Amy Lee; Luigino Dal Maso Journal: Oral Oncol Date: 2019-05-17 Impact factor: 5.337
Authors: David I Conway; Darren R Brenner; Alex D McMahon; Lorna M D Macpherson; Antonio Agudo; Wolfgang Ahrens; Cristina Bosetti; Hermann Brenner; Xavier Castellsague; Chu Chen; Maria Paula Curado; Otávio A Curioni; Luigino Dal Maso; Alexander W Daudt; José F de Gois Filho; Gypsyamber D'Souza; Valeria Edefonti; Eleonora Fabianova; Leticia Fernandez; Silvia Franceschi; Maura Gillison; Richard B Hayes; Claire M Healy; Rolando Herrero; Ivana Holcatova; Vijayvel Jayaprakash; Karl Kelsey; Kristina Kjaerheim; Sergio Koifman; Carlo La Vecchia; Pagona Lagiou; Philip Lazarus; Fabio Levi; Jolanta Lissowska; Daniele Luce; Tatiana V Macfarlane; Dana Mates; Elena Matos; Michael McClean; Ana M Menezes; Gwenn Menvielle; Franco Merletti; Hal Morgenstern; Kirsten Moysich; Heiko Müller; Joshua Muscat; Andrew F Olshan; Mark P Purdue; Heribert Ramroth; Lorenzo Richiardi; Peter Rudnai; Stimson Schantz; Stephen M Schwartz; Oxana Shangina; Lorenzo Simonato; Elaine Smith; Isabelle Stucker; Erich M Sturgis; Neonila Szeszenia-Dabrowska; Renato Talamini; Peter Thomson; Thomas L Vaughan; Qingyi Wei; Deborah M Winn; Victor Wunsch-Filho; Guo-Pei Yu; Zuo-Feng Zhang; Tongzhang Zheng; Ariana Znaor; Paolo Boffetta; Shu-Chun Chuang; Marianoosh Ghodrat; Yuan-Chin Amy Lee; Mia Hashibe; Paul Brennan Journal: Int J Cancer Date: 2014-08-23 Impact factor: 7.396
Authors: Devasena Anantharaman; Behnoush Abedi-Ardekani; Daniel C Beachler; Tarik Gheit; Andrew F Olshan; Kathy Wisniewski; Victor Wunsch-Filho; Tatiana N Toporcov; Eloiza H Tajara; José Eduardo Levi; Raquel A Moyses; Stefania Boccia; Gabriella Cadoni; Guido Rindi; Wolfgang Ahrens; Franco Merletti; David I Conway; Sylvia Wright; Christine Carreira; Helene Renard; Priscilia Chopard; Sandrine McKay-Chopin; Ghislaine Scelo; Massimo Tommasino; Paul Brennan; Gypsyamber D'Souza Journal: Int J Cancer Date: 2017-02-14 Impact factor: 7.396
Authors: Tatiana Natasha Toporcov; Ariana Znaor; Zuo-Feng Zhang; Guo-Pei Yu; Deborah M Winn; Qingyi Wei; Marta Vilensky; Thomas Vaughan; Peter Thomson; Renato Talamini; Neonila Szeszenia-Dabrowska; Erich M Sturgis; Elaine Smith; Oxana Shangina; Stephen M Schwartz; Stimson Schantz; Peter Rudnai; Lorenzo Richiardi; Heribert Ramroth; Mark P Purdue; Andrew F Olshan; José Eluf-Neto; Joshua Muscat; Raquel Ajub Moyses; Hal Morgenstern; Ana Menezes; Michael McClean; Keitaro Matsuo; Dana Mates; Tatiana V Macfarlane; Jolanta Lissowska; Fabio Levi; Philip Lazarus; Carlo La Vecchia; Pagona Lagiou; Sergio Koifman; Kristina Kjaerheim; Karl Kelsey; Ivana Holcatova; Rolando Herrero; Claire Healy; Richard B Hayes; Silvia Franceschi; Leticia Fernandez; Eleonora Fabianova; Alexander W Daudt; Otávio Alberto Curioni; Luigino Dal Maso; Maria Paula Curado; David I Conway; Chu Chen; Xavier Castellsague; Cristina Canova; Gabriella Cadoni; Paul Brennan; Stefania Boccia; José Leopoldo Ferreira Antunes; Wolfgang Ahrens; Antonio Agudo; Paolo Boffetta; Mia Hashibe; Yuan-Chin Amy Lee; Victor Wünsch Filho Journal: Int J Epidemiol Date: 2015-01-22 Impact factor: 7.196
Authors: David I Conway; Jan Hovanec; Wolfgang Ahrens; Alastair Ross; Ivana Holcatova; Pagona Lagiou; Diego Serraino; Cristina Canova; Lorenzo Richiardi; Claire Healy; Kristina Kjaerheim; Gary J Macfarlane; Peter Thomson; Antonio Agudo; Ariana Znaor; Paul Brennan; Danièle Luce; Gwenn Menvielle; Isabelle Stucker; Simone Benhamou; Heribert Ramroth; Paolo Boffetta; Marta Vilensky; Leticia Fernandez; Maria Paula Curado; Ana Menezes; Alexander Daudt; Rosalina Koifman; Victor Wunsch-Filho; Amy Lee Yuan-Chin; Mia Hashibe; Thomas Behrens; Alex D McMahon Journal: J Epidemiol Community Health Date: 2021-02-23 Impact factor: 3.710