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Wiley Open Access, Cancer Science, 9(104), p. 1231-1236, 2013

DOI: 10.1111/cas.12210

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Socioeconomic status and esophageal squamous cell carcinoma risk in Kashmir, India

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Data provided by SHERPA/RoMEO

Abstract

Studies have persistently associated esophageal squamous cell carcinoma (ESCC) risk with low socioeconomic status (SES), but this association is unexplored in Kashmir, an area with a high incidence of ESCC in the northernmost part of India. We conducted a case-control study to assess the association of multiple indicators of SES and ESCC risk in Kashmir valley. A total number of 703 histologically confirmed ESCC cases and 1664 controls matched to the cases for age, sex, and district of residence were recruited from October, 2008 to January, 2012. Conditional logistic regression models were used to calculate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs). Composite wealth scores were constructed based on the ownership of several appliances using multiple correspondence analysis. Higher education, living in the kiln brick or concrete house, use of liquefied petroleum gas and electricity for cooking, and higher wealth scores all showed an inverse association with ESCC risk. Compared to farmers, the individuals who had government jobs and worked in the business sector were at lower risk of ESCC, but this association disappeared in fully adjusted models. Occupational strenuous physical activity was strongly associated with ESCC risk. In summary, we found a strong relationship of low SES and ESCC in Kashmir. The findings need to be studied further to understand the mechanisms through which such SES parameters increase ESCC risk. This article is protected by copyright. All rights reserved.