Impact Factor:4.9
DOI number:10.1136/jech-2024-222158
Journal:Journal of Epidemiology and Community Health
Key Words:ECONOMICS; EDUCATION; Health inequalities; MELANOMA.
Abstract:Background: Previous studies on the associations between socioeconomic status (SES) and cutaneous malignant melanoma (CMM) failed to distinguish the effects of different SES factors under an individual-data-based prospective study design. Methods: Based on UK Biobank (UKB) and China Kadoorie Biobank (CKB), we estimated the effects of four SES factors on transitions from baseline to CMM in situ, subsequently to invasive CMM and further CMM mortality by applying multistate models. We further explored to which extent the associations between SES and CMM incidence could be explained by potential mediators including sun exposure, lifestyle and ageing in UKB. Results: In multistate analyses, good household income was independently associated with an increased risk of CMM in situ (HR=1.38, 95% CI: 1.21 to 1.58) and invasive CMM (HR=1.34, 95% CI: 1.22 to 1.48) in UKB. These findings were partly validated in CKB. Especially in UKB, we observed an increased risk of CMM in situ and invasive CMM among participants with good type of house; only good education was independently associated with lower risk of evolving to invasive CMM among patients with CMM in situ (HR=0.69, 95% CI: 0.52 to 0.92); only good household income was independently associated with lower risk of CMM mortality among patients with CMM (HR=0.65, 95% CI: 0.45 to 0.95). In mediation analysis, the proportions attributable to the mediating effect were <6% for all selected variables, including self-reported sun exposure-related factors. Conclusion: SES factors have different effects on the incidence and progression of CMM. The association between SES and incident CMM is neither causal nor well explained by selected mediators.
Co-author:Yi Xiao, Danrong Jing, Hong Liu
First Author:Songchun Yang
Indexed by:Journal paper
Correspondence Author:Juan Su, Minxue Shen, Xiang Chen
Document Code:PMID: 38977296
Discipline:Medicine
First-Level Discipline:Public Health and Preventive Medicine
Document Type:J
Page Number:Online first
ISSN No.:0143-005X
Translation or Not:no
Included Journals:SCI
Links to published journals:https://jech.bmj.com/content/early/2024/07/08/jech-2024-222158.long