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Socioeconomic position and the risk of gastric and oesophageal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST).
Int J Epidemiol 2007; 36(1):66-76IJ

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 520 000 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): 0.43-0.98]. 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.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17227779

Citation

Nagel, Gabriele, et al. "Socioeconomic Position and the Risk of Gastric and Oesophageal Cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC-EURGAST)." International Journal of Epidemiology, vol. 36, no. 1, 2007, pp. 66-76.
Nagel G, Linseisen J, Boshuizen HC, et al. Socioeconomic position and the risk of gastric and oesophageal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). Int J Epidemiol. 2007;36(1):66-76.
Nagel, G., Linseisen, J., Boshuizen, H. C., Pera, G., Del Giudice, G., Westert, G. P., ... González, C. A. (2007). Socioeconomic position and the risk of gastric and oesophageal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). International Journal of Epidemiology, 36(1), pp. 66-76.
Nagel G, et al. Socioeconomic Position and the Risk of Gastric and Oesophageal Cancer in the European Prospective Investigation Into Cancer and Nutrition (EPIC-EURGAST). Int J Epidemiol. 2007;36(1):66-76. PubMed PMID: 17227779.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Socioeconomic position and the risk of gastric and oesophageal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). AU - Nagel,Gabriele, AU - Linseisen,Jakob, AU - Boshuizen,Hendriek C, AU - Pera,Guillem, AU - Del Giudice,Giuseppe, AU - Westert,Gert P, AU - Bueno-de-Mesquita,H Bas, AU - Allen,Naomi E, AU - Key,Timothy J, AU - Numans,Mattijs E, AU - Peeters,Petra Hm, AU - Sieri,Sabina, AU - Siman,Henrik, AU - Berglund,Goran, AU - Hallmans,Goran, AU - Stenling,Roger, AU - Martinez,Carmen, AU - Arriola,Larraitz, AU - Barricarte,Aurelio, AU - Chirlaque,M Dolores, AU - Quiros,Jose R, AU - Vineis,Paolo, AU - Masala,Giovanna, AU - Palli,Domenico, AU - Panico,Salvatore, AU - Tumino,Rosario, AU - Bingham,Sheila, AU - Boeing,Heiner, AU - Bergmann,Manuela M, AU - Overvad,Kim, AU - Boutron-Ruault,Marie-Christine, AU - Clavel-Chapelon,Francoise, AU - Olsen,Anja, AU - Tjonneland,Anne, AU - Trichopoulou,Antonia, AU - Bamia,Christina, AU - Soukara,Stavroula, AU - Sabourin,Jean-Christoph, AU - Carneiro,Fatima, AU - Slimani,Nadia, AU - Jenab,Mazda, AU - Norat,Teresa, AU - Riboli,Elio, AU - González,Carlos A, Y1 - 2007/01/16/ PY - 2007/1/18/pubmed PY - 2007/7/31/medline PY - 2007/1/18/entrez SP - 66 EP - 76 JF - International journal of epidemiology JO - Int J Epidemiol VL - 36 IS - 1 N2 - 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 520 000 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): 0.43-0.98]. 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. SN - 0300-5771 UR - https://www.unboundmedicine.com/medline/citation/17227779/Socioeconomic_position_and_the_risk_of_gastric_and_oesophageal_cancer_in_the_European_Prospective_Investigation_into_Cancer_and_Nutrition__EPIC_EURGAST__ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/dyl275 DB - PRIME DP - Unbound Medicine ER -