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Multicenter Study
. 2016 Jul 7:16:395.
doi: 10.1186/s12885-016-2432-9.

Occupational prestige, social mobility and the association with lung cancer in men

Thomas Behrens  1 , Isabelle Groß  2 , Jack Siemiatycki  3 , David I Conway  4 , Ann Olsson  5   6 , Isabelle Stücker  7   8 , Florence Guida  7   8 , Karl-Heinz Jöckel  9 , Hermann Pohlabeln  10 , Wolfgang Ahrens  10   11 , Irene Brüske  12 , Heinz-Erich Wichmann  12   13 , Per Gustavsson  6 , Dario Consonni  14 , Franco Merletti  15 , Lorenzo Richiardi  15 , Lorenzo Simonato  16 , Cristina Fortes  17 , Marie-Elise Parent  18 , John McLaughlin  19 , Paul Demers  19 , Maria Teresa Landi  20 , Neil Caporaso  20 , David Zaridze  21 , Neonila Szeszenia-Dabrowska  22 , Peter Rudnai  23 , Jolanta Lissowska  24 , Eleonora Fabianova  25 , Adonina Tardón  26 , John K Field  27   28 , Rodica Stanescu Dumitru  29 , Vladimir Bencko  30 , Lenka Foretova  31 , Vladimir Janout  32   33 , Hans Kromhout  34 , Roel Vermeulen  34 , Paolo Boffetta  35 , Kurt Straif  5 , Joachim Schüz  5 , Jan Hovanec  2 , Benjamin Kendzia  2 , Beate Pesch  2 , Thomas Brüning  2
Affiliations
Multicenter Study

Occupational prestige, social mobility and the association with lung cancer in men

Thomas Behrens et al. BMC Cancer. .

Abstract

Background: The nature of the association between occupational social prestige, social mobility, and risk of lung cancer remains uncertain. Using data from the international pooled SYNERGY case-control study, we studied the association between lung cancer and the level of time-weighted average occupational social prestige as well as its lifetime trajectory.

Methods: We included 11,433 male cases and 14,147 male control subjects. Each job was translated into an occupational social prestige score by applying Treiman's Standard International Occupational Prestige Scale (SIOPS). SIOPS scores were categorized as low, medium, and high prestige (reference). We calculated odds ratios (OR) with 95 % confidence intervals (CI), adjusting for study center, age, smoking, ever employment in a job with known lung carcinogen exposure, and education. Trajectories in SIOPS categories from first to last and first to longest job were defined as consistent, downward, or upward. We conducted several subgroup and sensitivity analyses to assess the robustness of our results.

Results: We observed increased lung cancer risk estimates for men with medium (OR = 1.23; 95 % CI 1.13-1.33) and low occupational prestige (OR = 1.44; 95 % CI 1.32-1.57). Although adjustment for smoking and education reduced the associations between occupational prestige and lung cancer, they did not explain the association entirely. Traditional occupational exposures reduced the associations only slightly. We observed small associations with downward prestige trajectories, with ORs of 1.13, 95 % CI 0.88-1.46 for high to low, and 1.24; 95 % CI 1.08-1.41 for medium to low trajectories.

Conclusions: Our results indicate that occupational prestige is independently associated with lung cancer among men.

Keywords: Life course; Occupational history; SYNERGY; Social prestige; Socio-economic status; Transitions.

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Figures

Fig. 1
Fig. 1
Estimated exposure-response association for time-weighted average occupational social prestige and lung cancer risk with restricted cubic spline function with 4 knots located at the 5th, 25th, 75th and 95th percentiles of the distribution of TWASP adjusted for study center, log(age), smoking status with time since quitting, log(pack-years + 1), ever working in List A occupation and education (model 4). Reference value is 40, the median of time-weighted average social prestige in the control population. The dashed lines are the lower and upper 95 % confidence limits. Tests for overall association and also for non-linear association were significant with p-values <0.0001
Fig. 2
Fig. 2
Unadjusted time course of mean occupational social prestige with 95 % confidence intervals for working durations from 0 to 50 years (by intervals of 5 years) for cases and controls (class limits based on tertiles of the distribution of TWA-prestige among controls)
Fig. 3
Fig. 3
Unadjusted time course of mean occupational social prestige with 95 % confidence intervals for age (by intervals of 5 years) for cases and controls (class limits based on tertiles of the distribution of TWA-prestige among controls)
See this image and copyright information in PMC

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