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Socioeconomic positoon and the risk of gastric and overphageal cancer in the European Prospective into Cancer and Nutrition (EPIC-EURGAST)

Nagel, Gabriele; Linseisen, Jakob; Boshuizen, Hendriek C.; Pera, Guillem; Del Giudice, Giuseppe; Westert, Gert P.; Bueno-de-Mesquita, H. Bas; Allen, Naomi E.; Key, Timothy J. and Numans, Mattijs E., et al. (2007) In International Journal of Epidemiology 36(1). p.66-76
Abstract
Objectives To evaluate the association of socioeconomic position with adenocarcinoma of the oesophagus and stomach. Methods The European Prospective Investigation into Cancer and Nutrition (EPIC) cohort comprises about 520000 participants mostly aged 35-70 years. Information on diet and lifestyle was collected at recruitment. After an average follow-up of 6.5 years, 268 cases with adenocarcinoma of the stomach and 56 of the oesophagus were confirmed. We examined the effect of socioeconomic position on cancer risk by means of educational data and a computed Relative Index of Inequality (RII). In a nested case-control study, adjustment for Helicobacter pylori (H. pylori) infection was performed. Results Higher education was significantly... (More)
Objectives To evaluate the association of socioeconomic position with adenocarcinoma of the oesophagus and stomach. Methods The European Prospective Investigation into Cancer and Nutrition (EPIC) cohort comprises about 520000 participants mostly aged 35-70 years. Information on diet and lifestyle was collected at recruitment. After an average follow-up of 6.5 years, 268 cases with adenocarcinoma of the stomach and 56 of the oesophagus were confirmed. We examined the effect of socioeconomic position on cancer risk by means of educational data and a computed Relative Index of Inequality (RII). In a nested case-control study, adjustment for Helicobacter pylori (H. pylori) infection was performed. Results Higher education was significantly associated with a reduced risk of gastric cancer [vs lowest level of education, hazard ratio (HR): 0.64, 95% Confidence intervals (CI): 0.43-0.981. This effect was more pronounced for cancer of the cardia (HR: 0.42, 95% CI: 0.20-0.89) as compared to non-cardia gastric cancer (HR: 0.66, 95% CI: 0.36-1.22). Additionally, the inverse association of educational level and gastric cancer was stronger for cases with intestinal (extreme categories, HR: 0.13, 95% CI: 0.04-0.44) rather than diffuse histological subtype (extreme categories, HR: 0.71 95% CI: 0.37-1.40). In the nested case-control study, inverse but statistically non-significant associations were found after additional adjustment for H. pylori infection [highest vs lowest level of education: Odds ratio (OR) 0.53, 95% CI: 0.24-1.18]. Educational level was non-significantly, inversely associated with carcinoma of the oesophagus. Conclusion A higher socioeconomic position was associated with a reduced risk of gastric adenocarcinoma, which was strongest for cardia cancer or intestinal histological subtype, suggesting different risk profiles according to educational level. These effects appear to be explained only partially by established risk factors. (Less)
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publication status
published
subject
keywords
Helicobacter pylori, socioeconomic position, gastric cancer, EPIC
in
International Journal of Epidemiology
volume
36
issue
1
pages
66 - 76
publisher
Oxford University Press
external identifiers
  • wos:000246966100012
  • scopus:34447331715
ISSN
1464-3685
DOI
10.1093/ije/dyl275
language
English
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yes
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fa3e0f9f-9303-41f1-9e54-a003d47dbb1e (old id 650912)
date added to LUP
2007-12-17 10:11:37
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2017-09-03 03:56:47
@article{fa3e0f9f-9303-41f1-9e54-a003d47dbb1e,
  abstract     = {Objectives To evaluate the association of socioeconomic position with adenocarcinoma of the oesophagus and stomach. Methods The European Prospective Investigation into Cancer and Nutrition (EPIC) cohort comprises about 520000 participants mostly aged 35-70 years. Information on diet and lifestyle was collected at recruitment. After an average follow-up of 6.5 years, 268 cases with adenocarcinoma of the stomach and 56 of the oesophagus were confirmed. We examined the effect of socioeconomic position on cancer risk by means of educational data and a computed Relative Index of Inequality (RII). In a nested case-control study, adjustment for Helicobacter pylori (H. pylori) infection was performed. Results Higher education was significantly associated with a reduced risk of gastric cancer [vs lowest level of education, hazard ratio (HR): 0.64, 95% Confidence intervals (CI): 0.43-0.981. This effect was more pronounced for cancer of the cardia (HR: 0.42, 95% CI: 0.20-0.89) as compared to non-cardia gastric cancer (HR: 0.66, 95% CI: 0.36-1.22). Additionally, the inverse association of educational level and gastric cancer was stronger for cases with intestinal (extreme categories, HR: 0.13, 95% CI: 0.04-0.44) rather than diffuse histological subtype (extreme categories, HR: 0.71 95% CI: 0.37-1.40). In the nested case-control study, inverse but statistically non-significant associations were found after additional adjustment for H. pylori infection [highest vs lowest level of education: Odds ratio (OR) 0.53, 95% CI: 0.24-1.18]. Educational level was non-significantly, inversely associated with carcinoma of the oesophagus. Conclusion A higher socioeconomic position was associated with a reduced risk of gastric adenocarcinoma, which was strongest for cardia cancer or intestinal histological subtype, suggesting different risk profiles according to educational level. These effects appear to be explained only partially by established risk factors.},
  author       = {Nagel, Gabriele and Linseisen, Jakob and Boshuizen, Hendriek C. and Pera, Guillem and Del Giudice, Giuseppe and Westert, Gert P. and Bueno-de-Mesquita, H. Bas and Allen, Naomi E. and Key, Timothy J. and Numans, Mattijs E. and Peeters, Petra H. M. and Sieri, Sabina and Simán, Henrik and Berglund, Göran and Hallmans, Goran and Stenling, Roger and Martinez, Carmen and Arriola, Larraitz and Barricarte, Aurelio and Chirlaque, M. Dolores and Quiros, Jose R. and Vineis, Paolo and Masala, Giovanna and Palli, Domenico and Panico, Salvatore and Tumino, Rosario and Bingham, Sheila and Boeing, Heiner and Bergmann, Manuela M. and Overvad, Kim and Boutron-Ruault, Marie-Christine and Clavel-Chapelon, Francoise and Olsen, Anja and Tjormeland, Anne and Trichopoulou, Antonia and Bamia, Christina and Soukara, Stavroula and Sabourin, Jean-Christoph and Carneiro, Fatima and Slimani, Nadia and Jenab, Mazda and Norat, Teresa and Riboli, Elio and Gonzalez, Carlos A.},
  issn         = {1464-3685},
  keyword      = {Helicobacter pylori,socioeconomic position,gastric cancer,EPIC},
  language     = {eng},
  number       = {1},
  pages        = {66--76},
  publisher    = {Oxford University Press},
  series       = {International Journal of Epidemiology},
  title        = {Socioeconomic positoon and the risk of gastric and overphageal cancer in the European Prospective into Cancer and Nutrition (EPIC-EURGAST)},
  url          = {http://dx.doi.org/10.1093/ije/dyl275},
  volume       = {36},
  year         = {2007},
}