title: Socio-economic class, rurality and risk of cutaneous melanoma by site and gender in Sweden.
abstract: BACKGROUND
  Cutaneous melanoma (CM) is a cancer usually associated with high socio-economic level in the literature. Few studies have, however, assessed this relationship by gender and site or the association between CM and rurality.
  
  
  METHODS
  A major-sized historical occupational Swedish cohort comprising 2,992,166 workers was used to estimate relative risk of cutaneous melanoma, broken down by gender and anatomical site, for occupational sectors (as a proxy of socio-economic class) and rurality. To this end, Poisson models were fitted for each site in men and women, including occupational sector and town size, with adjustment for age, period of diagnosis and geographical area as possible confounding factors.
  
  
  RESULTS
  White collar workers presented a marked increased of risk in men in all melanoma cases, as well as in trunk, upper and lower limbs. This pattern was less clear for women, in which some heterogeneity appeared, as low risks in lower socioeconomic sectors in trunk, or risk excesses in white collar workers in lower limbs did not achieve statistical significance. Males also showed significant differences in risk by rural/urban distribution, but in women this association was limited to CM of lower limb. Risk of CM of head/neck did not vary by occupational sector or town size, thus depicting a specific epidemiological profile, which proved common to both sexes.
  
  
  CONCLUSIONS
  While differences in risk between men and women could suggest greater homogeneity in UV-exposure behaviour among women, the uniform risk pattern in head and neck melanoma, present in both sexes, might support the coexistence of different aetiological pathways, related to anatomical site.
authors.affiliation: Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain. bperez@isciii.es
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pérez-Gómez
authors.forename: Nuria
authors.initials: N
authors.lastname: Aragonés
authors.forename: Per
authors.initials: P
authors.lastname: Gustavsson
authors.forename: Virginia
authors.initials: V
authors.lastname: Lope
authors.forename: Gonzalo
authors.initials: G
authors.lastname: López-Abente
authors.forename: Marina
authors.initials: M
authors.lastname: Pollán
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D009790:Occupations; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D012923:Social Class; D013548:Sweden / Q000453:epidemiology