Journal Article

DKFZ-2022-02585

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Mediating role of lifestyle behaviours in the association between education and cancer: results from the European Prospective Investigation into Cancer and Nutrition.

Macciotta, A. ; Catalano, A. ; Giraudo, M. T. ; Weiderpass, E. ; Ferrari, P. ; Freisling, H. ; Colorado-Yohar, S. M. ; Santiuste, C. ; Amiano, P. ; Heath, A. K. ; Ward, H. A. ; Christakoudi, S. ; Vineis, P. ; Singh, D. ; Vaccarella, S. ; Schulze, M. B. ; Hiensch, A. E. ; Monninkhof, E. M. ; Katzke, V.DKFZ* ; Kaaks, R.DKFZ* ; Tumino, R. ; Lazzarato, F. ; Milani, L. ; Agudo, A. ; Dahm, C. C. ; Baglietto, L. ; Perduca, V. ; Severi, G. ; Grioni, S. ; Panico, S. ; Ardanaz, E. ; Benjaminsen Borch, K. ; Benebo, F. O. ; Braaten, T. ; Sánchez, M.-J. ; Giachino, C. ; Sacerdote, C. ; Ricceri, F.

2023
AACR Philadelphia, Pa.

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Please use a persistent id in citations: doi:10.1158/1055-9965.EPI-22-0777

Abstract: Many studies have shown that socioeconomic position (SEP) is associated with the incidence of malignant tumors at different sites. This study aims to estimate the association between educational level (as proxy for SEP) and cancer incidence and to understand if the observed associations might be partially explained by lifestyle behaviors.The analyses were performed on data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, globally and by sex. We used Cox proportional hazards models together with mediation analysis to disentangle the total effect (TE) of educational level (measured through the Relative Index of Inequality (RII)) on cancer incidence into pure direct (PDE) and total indirect (TIE) effect, unexplained and explained by mediators, respectively. PDE and TIE were then combined to compute the proportions mediated (PM).After an average of 14 years of follow-up, 52,422 malignant tumors were ascertained. Low educated participants showed higher risk of developing stomach, lung, kidney (in women), and bladder (in men) cancers, and, conversely, lower risk of melanoma and breast cancer (in post-menopausal women), when compared to more educated participants. Mediation analyses showed that portions of the total effect of RII on cancer could be explained by site-specific related lifestyle behaviors for stomach, lung, and breast (in women).Cancer incidence in Europe is determined at least in part by a socioeconomically stratified distribution of risk factors.These observational findings support policies to reduce cancer occurrence by altering mediators, such as lifestyle behaviors, particularly focusing on underprivileged strata of the population.

Note: 2023 Jan 9;32(1):132-140

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Contributing Institute(s):

1. C020 Epidemiologie von Krebs (C020)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2022

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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