SS 16.00-17.30 Special sessions

CANCER RISK BY SOCIAL CLASS AND OCCUPATION

Cancer risks by social class and occupation for all main cancer sites among working-aged Finnish men and women were systematically produced in a huge record linkage study of 109,000 cancer cases. The study was based on the nationwide population-based Finnish Cancer Registry and the 1970 Population Census including social class and occupational data from a time-point 1-15 years prior to the cancer diagnosis.

Overall cancer incidence among men in the lowest social class (IV) was some 30% higher overall than in the highest one. In women the trend was opposite. Cancers of the lip, oesophagus, stomach, larynx and nose, and multiple myeloma were associated with low social class in both sexes, cancers of cervix uteri and vagina in women and lung cancer in men. Cancers of the colon, breast, testis and soft tissue, and skin melanoma in the trunk and limbs were most common in high social classes throughout the whole observation period, whereas for cancers of the corpus uteri, kidney and nervous system as well for non-Hodgkin's lymphoma the positive social class association disappeared by the early 1980s. In lung cancer among women there was an extremely rapid change from a disease of a high social class to a disease of a low one in about five years.

Much of the largest social class differences, i.e., of those in cancers of the lung and larynx, can be accounted for by smoking. More than one-fifth of all cancer cases among men would be prevented if the incidence of these two cancers in the whole population would be reduced to the level of social class 1. Other important factors behind social class variation are dietary factors (colon, stomach, oesophagus) and reproductive factors (breast, uterus). If it would be possible for all social classes to maintain a way of life similar to that of the social class with the lowest incidence, every year some 1,600 cancer cases of the total of 6,300 among working-aged Finns would be avoided.

Social class explained a lot of the occupational variation of many cancers, but there were many occupations with a total cancer incidence of more than 50% above the average incidence of their own social class, such as asphalt roofers, insulators, tobacco industry workers, glass and ceramics decorators, miners and hairdressers. The risk was low, e.g., among sport coaches, priests and male medical workers. Occupations can indirectly create a protective environment against cancer: it is not suitable for a primary school teacher, dentist or priest to smoke at work (or elsewhere), which is reflected in a low incidence of smoking-related cancers.

Smoke Free Europe Conference Abstracts - 19 SEP 1996

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