TY - JOUR
T1 - Socio-economic status and oesophageal cancer
T2 - Results from a population-based case-control study in a high-risk area
AU - Islami, Farhad
AU - Kamangar, Farin
AU - Nasrollahzadeh, Dariush
AU - Aghcheli, Karim
AU - Sotoudeh, Masoud
AU - Abedi-Ardekani, Behnoush
AU - Merat, Shahin
AU - Nasseri-Moghaddam, Siavosh
AU - Semnani, Shahryar
AU - Sepehr, Alireza
AU - Wakefield, Jon
AU - Møller, Henrik
AU - Abnet, Christian C.
AU - Dawsey, Sanford M.
AU - Boffetta, Paolo
AU - Malekzadeh, Reza
N1 - Funding Information:
Digestive Disease Research Center of Tehran University of Medical Sciences (grant number 82-603); intramural funds of the National Cancer Institute, National Institutes of Health.
PY - 2009
Y1 - 2009
N2 - Background: Cancer registries in the 1970s showed that parts of Golestan Province in Iran had the highest rate of oesophageal squamous cell carcinoma (OSCC) in the world. More recent studies have shown that while rates are still high, they are approximately half of what they were before, which might be attributable to improved socio-economic status (SES) and living conditions in this area. We examined a wide range of SES indicators to investigate the association between different SES components and risk of OSCC in the region. Methods: Data were obtained from a population-based case-control study conducted between 2003 and 2007 with 300 histologically proven OSCC cases and 571 matched neighbourhood controls. We used conditional logistic regression to compare cases and controls for individual SES indicators, for a composite wealth score constructed using multiple correspondence analysis, and for factors obtained from factors analysis. Results: We found that various dimensions of SES, such as education, wealth and being married were all inversely related to OSCC. The strongest inverse association was found with education. Compared with no education, the adjusted odds ratios (95% confidence intervals) for primary education and high school or beyond were 0.52 (0.27-0.98) and 0.20 (0.06-0.65), respectively. Conclusions: The strong association of SES with OSCC after adjustment for known risk factors implies the presence of yet unidentified risk factors that are correlated with our SES measures; identification of these factors could be the target of future studies. Our results also emphasize the importance of using multiple SES measures in epidemiological studies. Published by Oxford University Press on behalf of the International Epidemiological Association
AB - Background: Cancer registries in the 1970s showed that parts of Golestan Province in Iran had the highest rate of oesophageal squamous cell carcinoma (OSCC) in the world. More recent studies have shown that while rates are still high, they are approximately half of what they were before, which might be attributable to improved socio-economic status (SES) and living conditions in this area. We examined a wide range of SES indicators to investigate the association between different SES components and risk of OSCC in the region. Methods: Data were obtained from a population-based case-control study conducted between 2003 and 2007 with 300 histologically proven OSCC cases and 571 matched neighbourhood controls. We used conditional logistic regression to compare cases and controls for individual SES indicators, for a composite wealth score constructed using multiple correspondence analysis, and for factors obtained from factors analysis. Results: We found that various dimensions of SES, such as education, wealth and being married were all inversely related to OSCC. The strongest inverse association was found with education. Compared with no education, the adjusted odds ratios (95% confidence intervals) for primary education and high school or beyond were 0.52 (0.27-0.98) and 0.20 (0.06-0.65), respectively. Conclusions: The strong association of SES with OSCC after adjustment for known risk factors implies the presence of yet unidentified risk factors that are correlated with our SES measures; identification of these factors could be the target of future studies. Our results also emphasize the importance of using multiple SES measures in epidemiological studies. Published by Oxford University Press on behalf of the International Epidemiological Association
KW - Case-control
KW - Correspondence analysis
KW - Epidemiology
KW - Factor analysis
KW - Iran
KW - Oesophageal cancer
KW - Socio-economic status
UR - http://www.scopus.com/inward/record.url?scp=68849130185&partnerID=8YFLogxK
U2 - 10.1093/ije/dyp195
DO - 10.1093/ije/dyp195
M3 - Article
C2 - 19416955
AN - SCOPUS:68849130185
SN - 0300-5771
VL - 38
SP - 978
EP - 988
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 4
ER -