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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1995 Feb;49(1):65–69. doi: 10.1136/jech.49.1.65

Lung cancer: is there an association with socioeconomic status in The Netherlands?

A J van Loon 1, R A Goldbohm 1, P A van den Brandt 1
PMCID: PMC1060077  PMID: 7707009

Abstract

STUDY OBJECTIVE--To evaluate if there are differences in lung cancer incidence between socioeconomic groups in the Netherlands and if so, if smoking habits and other lifestyle characteristics could explain these differences. DESIGN--Prospective cohort study. Baseline measurement included information on socioeconomic status, smoking habits, and other covariates by means of a self-administered questionnaire. Follow up was established by computerised record linkage to cancer registries and a pathology register. SETTING--Population originating from 204 municipalities in The Netherlands. PARTICIPANTS--58,279 men aged 55-69 years in September 1986. After 3.3 years of follow up 490 microscopically confirmed incident lung cancer cases were detected. MAIN RESULTS--An inverse association between lung cancer risk and highest level of education was found, which persisted after adjustment for age, smoking, dietary intake of vitamin C, beta-carotene and retinol (rate ratio (RR) highest/lowest level of education = 0.52, 95% CI 0.33, 0.82, trend p < 0.001). Men with a lower white collar profession had a significantly lower relative rate of lung cancer compared with blue collar workers (RR = 0.66, 95% CI 0.47, 0.96), but after adjustment for smoking habits this difference was reduced (RR = 0.73, 95% CI 0.51, 1.08). CONCLUSIONS--There is an inverse association between highest level of education and lung cancer, which is still apparent after adjustment for age, smoking, dietary intake of vitamin C, beta-carotene and retinol. The significantly lower lung cancer risk of lower white collar workers compared with the risk of blue collar workers could be partially explained by smoking habits.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baquet C. R., Horm J. W., Gibbs T., Greenwald P. Socioeconomic factors and cancer incidence among blacks and whites. J Natl Cancer Inst. 1991 Apr 17;83(8):551–557. doi: 10.1093/jnci/83.8.551. [DOI] [PubMed] [Google Scholar]
  2. Byers T. E., Graham S., Haughey B. P., Marshall J. R., Swanson M. K. Diet and lung cancer risk: findings from the Western New York Diet Study. Am J Epidemiol. 1987 Mar;125(3):351–363. doi: 10.1093/oxfordjournals.aje.a114542. [DOI] [PubMed] [Google Scholar]
  3. Fox A. J., Adelstein A. M. Occupational mortality: work or way of life? J Epidemiol Community Health. 1978 Jun;32(2):73–78. doi: 10.1136/jech.32.2.73. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Goldbohm R. A., van den Brandt P. A., Brants H. A., van't Veer P., Al M., Sturmans F., Hermus R. J. Validation of a dietary questionnaire used in a large-scale prospective cohort study on diet and cancer. Eur J Clin Nutr. 1994 Apr;48(4):253–265. [PubMed] [Google Scholar]
  5. Graham S. Epidemiology of retinoids and cancer. J Natl Cancer Inst. 1984 Dec;73(6):1423–1428. [PubMed] [Google Scholar]
  6. Hein H. O., Suadicani P., Gyntelberg F. Lung cancer risk and social class. The Copenhagen Male Study--17-year follow up. Dan Med Bull. 1992 Apr;39(2):173–176. [PubMed] [Google Scholar]
  7. Jöckel K. H., Ahrens W., Wichmann H. E., Becher H., Bolm-Audorff U., Jahn I., Molik B., Greiser E., Timm J. Occupational and environmental hazards associated with lung cancer. Int J Epidemiol. 1992 Apr;21(2):202–213. doi: 10.1093/ije/21.2.202. [DOI] [PubMed] [Google Scholar]
  8. Kvåle G., Bjelke E., Gart J. J. Dietary habits and lung cancer risk. Int J Cancer. 1983 Apr 15;31(4):397–405. doi: 10.1002/ijc.2910310402. [DOI] [PubMed] [Google Scholar]
  9. Levi F., Negri E., La Vecchia C., Te V. C. Socioeconomic groups and cancer risk at death in the Swiss Canton of Vaud. Int J Epidemiol. 1988 Dec;17(4):711–717. doi: 10.1093/ije/17.4.711. [DOI] [PubMed] [Google Scholar]
  10. Liberatos P., Link B. G., Kelsey J. L. The measurement of social class in epidemiology. Epidemiol Rev. 1988;10:87–121. doi: 10.1093/oxfordjournals.epirev.a036030. [DOI] [PubMed] [Google Scholar]
  11. Notani P. N., Shah P., Jayant K., Balakrishnan V. Occupation and cancers of the lung and bladder: a case-control study in Bombay. Int J Epidemiol. 1993 Apr;22(2):185–191. doi: 10.1093/ije/22.2.185. [DOI] [PubMed] [Google Scholar]
  12. Pastorino U., Berrino F., Gervasio A., Pesenti V., Riboli E., Crosignani P. Proportion of lung cancers due to occupational exposure. Int J Cancer. 1984 Feb 15;33(2):231–237. doi: 10.1002/ijc.2910330211. [DOI] [PubMed] [Google Scholar]
  13. Pearce N. E., Howard J. K. Occupation, social class and male cancer mortality in New Zealand, 1974-78. Int J Epidemiol. 1986 Dec;15(4):456–462. doi: 10.1093/ije/15.4.456. [DOI] [PubMed] [Google Scholar]
  14. Rosén M., Hanning M., Wall S. Changing smoking habits in Sweden: towards better health, but not for all. Int J Epidemiol. 1990 Jun;19(2):316–322. doi: 10.1093/ije/19.2.316. [DOI] [PubMed] [Google Scholar]
  15. Slater C., Carlton B. Behavior, lifestyle, and socioeconomic variables as determinants of health status: implications for health policy development. Am J Prev Med. 1985 Sep-Oct;1(5):25–33. [PubMed] [Google Scholar]
  16. Sterling T. D., Weinkam J. J. Smoking patterns by occupation, industry, sex, and race. Arch Environ Health. 1978 Nov-Dec;33(6):313–317. doi: 10.1080/00039896.1978.10667354. [DOI] [PubMed] [Google Scholar]
  17. Teppo L. Cancer incidence by living area, social class and occupation. Scand J Work Environ Health. 1984 Dec;10(6 Spec No):361–366. doi: 10.5271/sjweh.2306. [DOI] [PubMed] [Google Scholar]
  18. Van den Brandt P. A., Schouten L. J., Goldbohm R. A., Dorant E., Hunen P. M. Development of a record linkage protocol for use in the Dutch Cancer Registry for Epidemiological Research. Int J Epidemiol. 1990 Sep;19(3):553–558. doi: 10.1093/ije/19.3.553. [DOI] [PubMed] [Google Scholar]
  19. Vågerö D., Persson G. Occurrence of cancer in socioeconomic groups in Sweden. An analysis based on the Swedish Cancer Environment Registry. Scand J Soc Med. 1986;14(3):151–160. doi: 10.1177/140349488601400308. [DOI] [PubMed] [Google Scholar]
  20. Williams R. R., Horm J. W. Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. J Natl Cancer Inst. 1977 Mar;58(3):525–547. doi: 10.1093/jnci/58.3.525. [DOI] [PubMed] [Google Scholar]
  21. Winkleby M. A., Jatulis D. E., Frank E., Fortmann S. P. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992 Jun;82(6):816–820. doi: 10.2105/ajph.82.6.816. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Wynder E. L., Stellman S. D. Comparative epidemiology of tobacco-related cancers. Cancer Res. 1977 Dec;37(12):4608–4622. [PubMed] [Google Scholar]
  23. Zurayk H., Halabi S., Deeb M. Measures of social class based on education for use in health studies in developing countries. J Epidemiol Community Health. 1987 Jun;41(2):173–179. doi: 10.1136/jech.41.2.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. van den Brandt P. A., van't Veer P., Goldbohm R. A., Dorant E., Volovics A., Hermus R. J., Sturmans F. A prospective cohort study on dietary fat and the risk of postmenopausal breast cancer. Cancer Res. 1993 Jan 1;53(1):75–82. [PubMed] [Google Scholar]

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