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<title lang=en>Quantifying the mediating effects of smoking and occupational exposures in the relation between education and lung cancer: the ICARE study</title>
<creator>Menvielle, Gwenn</creator>
<creator>Franck, Jeanna-Eve</creator>
<creator>Radoï, Loredana</creator>
<creator>Sanchez, Marie</creator>
<creator>Févotte, Joëlle</creator>
<creator>Guizard, Anne-Valérie</creator>
<creator>Stücker, Isabelle</creator>
<creator>Luce, Danièle</creator>
<contributor>Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP) ; Université Pierre et Marie Curie - Paris 6 (UPMC) - Institut National de la Santé et de la Recherche Médicale (INSERM)</contributor>
<contributor>Centre de recherche en épidémiologie et santé des populations (CESP) ; Université de Versailles Saint-Quentin-en-Yvelines (UVSQ) - Université Paris-Sud - Paris 11 (UP11) - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - Institut National de la Santé et de la Recherche Médicale (INSERM)</contributor>
<contributor>Université Paris Descartes - Paris 5 (UPD5)</contributor>
<contributor>Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR T9405) ; Université Claude Bernard Lyon 1 (UCBL) - Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR) - Université de Lyon</contributor>
<contributor>Registre des cancers du Calvados ; Registre des cancers du Calvados</contributor>
<contributor>Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; Université d'Angers (UA) - Université des Antilles et de la Guyane (UAG) - Université de Rennes 1 (UR1) - École des Hautes Études en Santé Publique [EHESP] (EHESP) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )</contributor>
<description>International audience</description>
<source>ISSN: 0393-2990</source>
<source>EISSN: 1573-7284</source>
<source>European Journal of Epidemiology</source>
<publisher>Springer Verlag</publisher>
<identifier>hal-01360240</identifier>
<identifier>http://hal.upmc.fr/hal-01360240</identifier>
<identifier>http://hal.upmc.fr/hal-01360240/document</identifier>
<identifier>http://hal.upmc.fr/hal-01360240/file/Menvielle_2016_Quantifying_the.pdf</identifier>
<source>http://hal.upmc.fr/hal-01360240</source>
<source>European Journal of Epidemiology, Springer Verlag, 2016, 31 (12), pp.1213-1221. 〈10.1007/s10654-016-0182-2〉</source>
<identifier>PUBMED : 27417979</identifier>
<relation>info:eu-repo/semantics/altIdentifier/pmid/27417979</relation>
<identifier>DOI : 10.1007/s10654-016-0182-2</identifier>
<relation>info:eu-repo/semantics/altIdentifier/doi/10.1007/s10654-016-0182-2</relation>
<language>en</language>
<subject lang=en>France</subject>
<subject lang=en>Lung cancer</subject>
<subject lang=en>incidence</subject>
<subject lang=en>occupational exposure</subject>
<subject lang=en>men</subject>
<subject lang=en>smoking</subject>
<subject>[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie</subject>
<type>info:eu-repo/semantics/article</type>
<type>Journal articles</type>
<description lang=en>Smoking only partly explains the higher lung cancer incidence observed among socially deprived people. Occupational exposures may account for part of these inequalities, but this issue has been little investigated. We investigated the extent to which smoking and occupational exposures to asbestos, silica and diesel motor exhaust mediated the association between education and lung cancer incidence in men. We analyzed data from a large French population-based case–control study (1976 lung cancers, 2648 controls). Detailed information on lifelong tobacco consumption and occupational exposures to various carcinogens was collected. We conducted inverse probability-weighted marginal structural models. A strong association was observed between education and lung cancer. The indirect effect through smoking varied by educational level, with the strongest indirect effect observed for those with the lowest education (OR = 1.34 (1.14–1.57)). The indirect effect through occupational exposures was substantial among men with primary (OR = 1.22 (1.15–1.30) for asbestos and silica) or vocational secondary education (OR = 1.18 (1.12–1.25)). The contribution of smoking to educational differences in lung cancer incidence ranged from 22 % (10–34) for men with primary education to 31 % (−3 to 84) for men with a high school degree. The contribution of occupational exposures to asbestos and silica ranged from 15 % (10–20) for men with a high school degree to 20 % (13–28) for men with vocational secondary education. Our results highlight the urgent need for public health policies that aim at decreasing exposure to carcinogens at work, in addition to tobacco control policies, if we want to reduce socioeconomic inequalities in the cancer field.</description>
<date>2016</date>
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