Socio-economic status and lung cancer risk including histologic subtyping - A longitudinal study

We investigated prospectively the risk of lung cancer in relation to socioeconomic status (SES) in 22387 middle-aged individuals who attended a screening program in the city of Malmo, Sweden between 1974 and 1992. We also examined the relationship between SES and histologic subtype in smokers. By 2003, a total of 550 lung cancer cases had been identified. Relative risks (RR) were calculated with adjustment for age, current smoking, inhalation habits and marital status at baseline in the low SES group compared to high SES group. Among smokers, the RR (95% confidence interval (Cl)) for lung cancer in the tow SES group of men was 1.39 (1.11-1.73), and women 1.56 (1.04-2.34). Also among smokers, low SES was associated with an increased risk of squamous cell carcinoma in men; RR 1.89 (1.16-2.81) and women; RR 7.10 (1.63-30.86), and with an increased risk of mesothelioma in men RR 9.97 (1.29-76.96). We conclude that Low SES groups run an increased risk of lung cancer despite accounting for smoking habits. Furthermore, tow SES was positively associated with squamous cell carcinoma and mesothelioma. Our results suggest that the association between low SES and lung cancer could be mediated by unaccounted for smoking exposure, Lifestyle or occupational hazards. (C) 2005 Elsevier Ireland Ltd. All rights reserved.