Quantifying the mediating effects of smoking and occupational exposures in the relation between education and lung cancer: the ICARE study - Sorbonne Université Accéder directement au contenu
Article Dans Une Revue European Journal of Epidemiology Année : 2016

Quantifying the mediating effects of smoking and occupational exposures in the relation between education and lung cancer: the ICARE study

Résumé

Smoking only partly explains the higher lung cancer incidence observed among socially deprived people. Occupational exposures may account for part of these inequalities, but this issue has been little investigated. We investigated the extent to which smoking and occupational exposures to asbestos, silica and diesel motor exhaust mediated the association between education and lung cancer incidence in men. We analyzed data from a large French population-based case–control study (1976 lung cancers, 2648 controls). Detailed information on lifelong tobacco consumption and occupational exposures to various carcinogens was collected. We conducted inverse probability-weighted marginal structural models. A strong association was observed between education and lung cancer. The indirect effect through smoking varied by educational level, with the strongest indirect effect observed for those with the lowest education (OR = 1.34 (1.14–1.57)). The indirect effect through occupational exposures was substantial among men with primary (OR = 1.22 (1.15–1.30) for asbestos and silica) or vocational secondary education (OR = 1.18 (1.12–1.25)). The contribution of smoking to educational differences in lung cancer incidence ranged from 22 % (10–34) for men with primary education to 31 % (−3 to 84) for men with a high school degree. The contribution of occupational exposures to asbestos and silica ranged from 15 % (10–20) for men with a high school degree to 20 % (13–28) for men with vocational secondary education. Our results highlight the urgent need for public health policies that aim at decreasing exposure to carcinogens at work, in addition to tobacco control policies, if we want to reduce socioeconomic inequalities in the cancer field.
Fichier principal
Vignette du fichier
Menvielle_2016_Quantifying_the.pdf (512.49 Ko) Télécharger le fichier
Menvielle_mediation lung cancer_Eur J Epidemiol_Supplementary material_revised.pdf (443.14 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)
Origine : Fichiers produits par l'(les) auteur(s)
Loading...

Dates et versions

hal-01360240 , version 1 (05-09-2016)

Identifiants

Citer

Gwenn Menvielle, Jeanna-Eve Franck, Loredana Radoï, Marie Sanchez, Joëlle Févotte, et al.. Quantifying the mediating effects of smoking and occupational exposures in the relation between education and lung cancer: the ICARE study. European Journal of Epidemiology, 2016, 31 (12), pp.1213-1221. ⟨10.1007/s10654-016-0182-2⟩. ⟨hal-01360240⟩
579 Consultations
521 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More