Socioeconomic disparity in the natural history of cutaneous melanoma: evidence from two large prospective cohorts
- 点击次数：
- 影响因子：4.9
- DOI码：10.1136/jech-2024-222158
- 发表刊物：Journal of Epidemiology and Community Health
- 关键字：ECONOMICS; EDUCATION; Health inequalities; MELANOMA.
- 摘要：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.
- 合写作者：Yi Xiao, Danrong Jing, Hong Liu
- 第一作者：Songchun Yang
- 论文类型：期刊论文
- 通讯作者：Juan Su, Minxue Shen, Xiang Chen
- 论文编号：PMID: 38977296
- 学科门类：医学
- 一级学科：公共卫生与预防医学
- 文献类型：J
- 页面范围：Online first
- ISSN号：0143-005X
- 是否译文：否
- 发表时间：2024-07-08
- 收录刊物：SCI
- 发布期刊链接：https://jech.bmj.com/content/early/2024/07/08/jech-2024-222158.long
