title: Socioeconomic inequalities in alcohol related cancer mortality among men: to what extent do they differ between Western European populations?
abstract: We aim to study socioeconomic inequalities in alcohol related cancers mortality [upper aerodigestive tract (UADT) (oral cavity, pharynx, larynx, oesophagus and liver)] in men and to investigate whether the contribution of these cancers to socioeconomic inequalities in cancer mortality differs within Western Europe. We used longitudinal mortality datasets, including causes of death. Data were collected during the 1990s among men aged 30-74 years in 13 European populations [Madrid, the Basque region, Barcelona, Turin, Switzerland (German and Latin part), France, Belgium (Walloon and Flemish part, Brussels), Norway, Sweden, Finland]. Socioeconomic status was measured using the educational level declared at the census at the beginning of the follow-up period. We conducted Poisson regression analyses and used both relative [Relative index of inequality (RII)] and absolute (mortality rates difference) measures of inequality. For UADT cancers, the RII's were above 3.5 in France, Switzerland (both parts) and Turin whereas for liver cancer they were the highest (around 2.5) in Madrid, France and Turin. The contribution of alcohol related cancer to socioeconomic inequalities in cancer mortality was 29-36% in France and the Spanish populations, 17-23% in Switzerland and Turin, and 5-15% in Belgium and the Nordic countries. We did not observe any correlation between mortality rates differences for lung and UADT cancers, confirming that the pattern found for UADT cancers is not only due to smoking. This study suggests that alcohol use substantially influences socioeconomic inequalities in male cancer mortality in France, Spain and Switzerland but not in the Nordic countries and nor in Belgium.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. g.menvielle@eramusmc.nl
authors.forename: Gwenn
authors.initials: G
authors.lastname: Menvielle
authors.forename: Anton E
authors.initials: AE
authors.lastname: Kunst
authors.forename: Irina
authors.initials: I
authors.lastname: Stirbu
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
authors.forename: Matthias
authors.initials: M
authors.lastname: Bopp
authors.forename: Enrique
authors.initials: E
authors.lastname: Regidor
authors.forename: Bjørn
authors.initials: B
authors.lastname: Heine Strand
authors.forename: Patrick
authors.initials: P
authors.lastname: Deboosere
authors.forename: Olle
authors.initials: O
authors.lastname: Lundberg
authors.forename: Annette
authors.initials: A
authors.lastname: Leclerc
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costa
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Chastang
authors.forename: Santiago
authors.initials: S
authors.lastname: Esnaola
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D004067:Digestive System Neoplasms / Q000453:epidemiology; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology; D008175:Lung Neoplasms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D012142:Respiratory Tract Neoplasms; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors