title: Time trends in educational differences in lung and upper aero digestive tract cancer mortality in France between 1990 and 2007.
abstract: BACKGROUND
  We investigated the magnitude of educational differences in lung and upper aero digestive tract (UADT) cancer mortality in France from 1990 to 2007.
  
  
  METHODS
  The analyses were based on census data from a representative sample of the French population. Educational level was used as the indicator for socioeconomic status. Educational differences in mortality from lung and UADT cancer were calculated among people aged 30-74 and by birth cohort. Two periods were compared: 1990-1998 and 1999-2007. Mortality rates, hazard ratios and relative indices of inequality (RII) were computed.
  
  
  RESULTS
  We found higher lung and UADT cancer mortality among those with less education. Inequalities in male UADT cancer mortality remained stable over time (RII(1990-1998)=0.21 (95% confidence interval 0.15-0.29); RII(1999-2007)=0.17 (0.11-0.26)) whereas inequalities in lung cancer mortality increased among the younger men (RII(1990-1998)=0.48 (0.28-0.83); RII(1999-2007)=0.16 (0.09-0.31)). Among women, inequalities in lung cancer mortality became apparent during the second period with higher mortality among those with less education. This trend was exclusively driven by the younger women, among whom inequalities reached about the same magnitude as among younger men (RII(1999-2007)=0.21 (0.08-0.56)).
  
  
  CONCLUSIONS
  UADT cancer mortality rates strongly decreased over time for every educational level. This implies that the burden of health associated with socioeconomic inequalities in UADT cancer mortality decreased substantially. Inequalities in lung cancer mortality are increasing among the younger generation and are expected to increase even more. Differences in magnitude of inequalities among men and women may disappear in the coming decades.
authors.affiliation: Inserm U1018, Center for Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health, 16 Av. Paul Vaillant Couturier, 94800 Villejuif, France.
authors.forename: Kim P
authors.initials: KP
authors.lastname: Wagenaar
authors.forename: Michiel R
authors.initials: MR
authors.lastname: de Boer
authors.forename: Danièle
authors.initials: D
authors.lastname: Luce
authors.forename: Gwenn
authors.initials: G
authors.lastname: Menvielle
mesh_terms: D000328:Adult; D000368:Aged; D004522:Educational Status; D004938:Esophageal Neoplasms / Q000401:mortality*; D005260:Female; D005602:France / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000401:mortality*; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends