Abstract：
BACKGROUND: The impact of societal factors on the occurrence of head and neck cancers (HNCs) remains understudied, especially in the Nordic countries.
METHODS: To quantify the association between socio-economic status (SES) and the occurrence of HNCs, this cohort study uses data from the Nordic Occupational Cancer project that combine occupational and cancer registry data from 1961 to 2005 of 14.9 million individuals aged between 30 and 64 years. Occupational categories were combined into seven socio-economic categories. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for the entire national study populations used as reference rates.
RESULTS: Altogether, 83 997 HNCs-72% in men and 28% in women-were recorded. Among men, a gradient of risk associated with SES was observed for cancers of the tongue, other oral cavity subsites, pharynx, oropharynx and larynx in groups with lower SES. Managers showed decreased SIRs of 0.50 to -0.90 also for cancers of the lip, tongue, other oral cavity subsites, oropharynx, nasopharynx, nose and larynx. In contrast, excess risks of tongue, other oral cavity subsites, pharyngeal, oropharyngeal and laryngeal cancers were observed among clerical (SIRs 1.05-1.16), skilled workers (1.04-1.14), unskilled workers (1.16-1.26) and economically inactive men (1.38-1.87). Among women, no risk gradient similar to that in men was revealed.
CONCLUSIONS: The current study underscores the influence of SES on the incidence of HNCs and highlights the need for targeted interventions, including tobacco and alcohol control policies, and improved access to healthcare services, particularly for socio-economically disadvantaged populations.
METHODS: To quantify the association between socio-economic status (SES) and the occurrence of HNCs, this cohort study uses data from the Nordic Occupational Cancer project that combine occupational and cancer registry data from 1961 to 2005 of 14.9 million individuals aged between 30 and 64 years. Occupational categories were combined into seven socio-economic categories. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for the entire national study populations used as reference rates.
RESULTS: Altogether, 83 997 HNCs-72% in men and 28% in women-were recorded. Among men, a gradient of risk associated with SES was observed for cancers of the tongue, other oral cavity subsites, pharynx, oropharynx and larynx in groups with lower SES. Managers showed decreased SIRs of 0.50 to -0.90 also for cancers of the lip, tongue, other oral cavity subsites, oropharynx, nasopharynx, nose and larynx. In contrast, excess risks of tongue, other oral cavity subsites, pharyngeal, oropharyngeal and laryngeal cancers were observed among clerical (SIRs 1.05-1.16), skilled workers (1.04-1.14), unskilled workers (1.16-1.26) and economically inactive men (1.38-1.87). Among women, no risk gradient similar to that in men was revealed.
CONCLUSIONS: The current study underscores the influence of SES on the incidence of HNCs and highlights the need for targeted interventions, including tobacco and alcohol control policies, and improved access to healthcare services, particularly for socio-economically disadvantaged populations.
摘要：
背景：社会因素对头颈癌（HNC）发生的影响仍未得到充分研究，尤其是在北欧国家。
方法：为了量化社会经济地位（SES）与HNC发生之间的关联，这项队列研究使用了北欧职业性癌症项目的数据,该项目结合了1961~2005年1,490万年龄在30~64岁之间的个体的职业和癌症登记数据.职业类别被合并为七个社会经济类别。使用整个国家研究人群的癌症发病率作为参考率进行标准化发病率（SIR）分析。
结果：总之，记录了83997例HNC，男性为72％，女性为28％。在男性中,在舌癌中观察到与SES相关的风险梯度，其他口腔亚位点，咽部,SES较低的组的口咽和喉。经理显示，唇癌的SIR也降低了0.50至-0.90，舌头,其他口腔亚位点，口咽,鼻咽部,鼻子和喉.相比之下,舌头的过度风险，其他口腔亚位点，咽部,在文书中观察到口咽和喉癌（SIRs1.05-1.16），熟练工人（1.04-1.14），非熟练工人（1.16-1.26）和不从事经济活动的男性（1.38-1.87）。在女性中,没有发现与男性相似的风险梯度.
结论：当前的研究强调了SES对HNC发病率的影响，并强调了对针对性干预措施的必要性。包括烟草和酒精控制政策，改善获得医疗保健服务的机会，特别是社会经济弱势群体。
方法：为了量化社会经济地位（SES）与HNC发生之间的关联，这项队列研究使用了北欧职业性癌症项目的数据,该项目结合了1961~2005年1,490万年龄在30~64岁之间的个体的职业和癌症登记数据.职业类别被合并为七个社会经济类别。使用整个国家研究人群的癌症发病率作为参考率进行标准化发病率（SIR）分析。
结果：总之，记录了83997例HNC，男性为72％，女性为28％。在男性中,在舌癌中观察到与SES相关的风险梯度，其他口腔亚位点，咽部,SES较低的组的口咽和喉。经理显示，唇癌的SIR也降低了0.50至-0.90，舌头,其他口腔亚位点，口咽,鼻咽部,鼻子和喉.相比之下,舌头的过度风险，其他口腔亚位点，咽部,在文书中观察到口咽和喉癌（SIRs1.05-1.16），熟练工人（1.04-1.14），非熟练工人（1.16-1.26）和不从事经济活动的男性（1.38-1.87）。在女性中,没有发现与男性相似的风险梯度.
结论：当前的研究强调了SES对HNC发病率的影响，并强调了对针对性干预措施的必要性。包括烟草和酒精控制政策，改善获得医疗保健服务的机会，特别是社会经济弱势群体。
