This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jansson, C. Articles by Lagergren, J. Search for Related Content PubMed PubMed Citation Articles by Jansson, C. Articles by Lagergren, J.

Socioeconomic Factors and Risk of Esophageal Adenocarcinoma: A Nationwide Swedish Case-Control Study

Departments of ¹ Medical Epidemiology and Biostatistics and ² Surgical Sciences, Karolinska Institutet, Stockholm, Sweden

Requests for reprints: Catarina Jansson, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O. Box 281, SE-171 77 Stockholm, Sweden. Phone: 46-8-524-86005. E-mail: catarina.jansson{at}meb.ki.se

Background: The increase in esophageal adenocarcinoma incidence in developed countries remains unexplained. Although low socioeconomic status (SES) is linked to an increased risk of esophageal squamous cell carcinoma (SCC), the relation with adenocarcinoma is uncertain.

Methods: We addressed the importance of various socioeconomic factors in a Swedish population-based case-control study, where 189 and 262 cases of esophageal adenocarcinoma and the gastric cardia, respectively, 167 cases of esophageal SCC, and 820 control participants underwent personal interviews. Our classification of SES was derived from occupational histories. Relative risks were estimated by odds ratios with 95% confidence intervals (95% CI), derived from conditional logistic regression, in crude and adjusted models.

Results: The risk of both esophageal adenocarcinoma and SCC increased with decreasing SES; unskilled workers had 3.7-fold (95% CI, 1.7-7.7) and 2.1-fold (95% CI, 1.0-4.7) increased risks, respectively, compared with age- and sex-comparable professionals. Adjustment for reflux symptoms, body mass, and tobacco smoking attenuated the excess risk for esophageal adenocarcinoma, whereas adjustment for Helicobacter pylori infection in a subset of the interviewed participants did not influence the results. Life without a partner was associated with a >2-fold increased risk of both histologic types of esophageal cancer, associations that remained even after multiple adjustments.

Conclusions: Esophageal adenocarcinoma and SCC are both linked to low SES and a life without a partner. These associations are only partly explained by established risk factors.

This article has been cited by other articles:

				G. Nagel, J. Linseisen, H. C Boshuizen, G. Pera, G. Del Giudice, G. P Westert, H B. Bueno-de-Mesquita, N. E Allen, T. J Key, M. E Numans, 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., March 12, 2007; (2007) dyl275v2. [Abstract] [Full Text] [PDF]

				J. Lagergren, P. Viklund, and C. Jansson Carbonated soft drinks and risk of esophageal adenocarcinoma: a population-based case-control study. J Natl Cancer Inst, August 16, 2006; 98(16): 1158 - 1161. [Abstract] [Full Text] [PDF]