title: Socioeconomic status and esophageal squamous cell carcinoma risk in Kashmir, India.
abstract: Studies have persistently associated esophageal squamous cell carcinoma (ESCC) risk with low socioeconomic status (SES), but this association is unexplored in Kashmir, an area with a high incidence of ESCC in the northernmost part of India. We carried out a case-control study to assess the association of multiple indicators of SES and ESCC risk in the Kashmir valley. A total number of 703 histologically confirmed ESCC cases and 1664 controls matched to the cases for age, sex, and district of residence were recruited from October 2008 to January 2012. Conditional logistic regression models were used to calculate unadjusted and adjusted odds ratios and 95% confidence intervals. Composite wealth scores were constructed based on the ownership of several appliances using multiple correspondence analyses. Higher education, living in a kiln brick or concrete house, use of liquefied petroleum gas and electricity for cooking, and higher wealth scores all showed an inverse association with ESCC risk. Compared to farmers, individuals who had government jobs or worked in the business sector were at lower risk of ESCC, but this association disappeared in fully adjusted models. Occupational strenuous physical activity was strongly associated with ESCC risk. In summary, we found a strong relationship of low SES and ESCC in Kashmir. The findings need to be studied further to understand the mechanisms through which such SES parameters increase ESCC risk.
authors.affiliation: Department of Biochemistry, University of Kashmir, Srinagar, India. nazirramzan@gmail.com
authors.forename: Nazir A
authors.initials: NA
authors.lastname: Dar
authors.forename: Idrees A
authors.initials: IA
authors.lastname: Shah
authors.forename: Gulzar A
authors.initials: GA
authors.lastname: Bhat
authors.forename: Muzamil A
authors.initials: MA
authors.lastname: Makhdoomi
authors.forename: Beenish
authors.initials: B
authors.lastname: Iqbal
authors.forename: Rumaisa
authors.initials: R
authors.lastname: Rafiq
authors.forename: Iqra
authors.initials: I
authors.lastname: Nisar
authors.forename: Arshid B
authors.initials: AB
authors.lastname: Bhat
authors.forename: Sumaiya
authors.initials: S
authors.lastname: Nabi
authors.forename: Akbar
authors.initials: A
authors.lastname: Masood
authors.forename: Sajad A
authors.initials: SA
authors.lastname: Shah
authors.forename: Mohd M
authors.initials: MM
authors.lastname: Lone
authors.forename: Showkat A
authors.initials: SA
authors.lastname: Zargar
authors.forename: Farhad
authors.initials: F
authors.lastname: Islami
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000191:economics* / Q000453:epidemiology*; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000191:economics* / Q000453:epidemiology*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012306:Risk; D012923:Social Class; D012959:Socioeconomic Factors