Social class differences in lung cancer mortality: risk factor explanations using two Scottish cohort studies

Area of Science:

• Public Health
• Epidemiology
• Social Medicine

Background:

• Investigated disparities in lung cancer mortality risk across different social classes.
• Highlighted the association between socioeconomic status and lung cancer outcomes.

Purpose of the Study:

• To quantify the difference in lung cancer mortality risk between manual and non-manual social classes.
• To determine the contribution of smoking, lung function, phlegm, and deprivation to these differences.

Main Methods:

• Analyzed 20-year mortality follow-up data from general population and collaborative studies.
• Included 7052 men and 8354 women from Renfrew/Paisley and 4021 working men from the Collaborative study.
• Adjusted for age, smoking, lung function, phlegm, deprivation, and socioeconomic variables.

Main Results:

• Manual social classes exhibited higher rates of smoking, phlegm, poorer lung function, and lived in more deprived areas.
• Lung cancer mortality rates were elevated in manual compared to non-manual men and women.
• Adjusting for smoking reduced risk, while further adjustments for lung function, phlegm, and deprivation attenuated risks, with socioeconomic variables eliminating the difference.

Conclusions:

• Lung cancer risk differs between social classes beyond smoking, influenced by lifelong lung health, deprivation, and socioeconomic conditions.
• Reducing socioeconomic inequalities and targeting individuals with poor lung function for smoking cessation are crucial.
• Interventions should address both smoking cessation and socioeconomic determinants to reduce lung cancer incidence and mortality.