Shared social mechanisms underlying the risk of nine cancers: A life course study

Int J Cancer. 2019 Jan 1;144(1):59-67. doi: 10.1002/ijc.31719. Epub 2018 Oct 26.


Identifying life periods during which social conditions have the highest impact on risk of common cancers in a population may help to reveal their underlying shared social mechanisms. We used the life course framework to estimate the extent to which life course SEP is associated with risk of nine cancers. In addition, we tested whether these associations conform to a critical period or cumulative life course model. Data were from a population-based case-control study of occupational exposures and cancer conducted in Montreal, Canada. Participants were males aged 35-70 years (n = 2,547) residing in the Montreal metropolitan area with primary, histologically confirmed cancers diagnosed between 1979 and 1985. Population controls (n = 512) were sampled from electoral lists. SEP was measured at three different periods of life based on respondent's report: during childhood, young adulthood and mid-life. We used a structured modeling approach using a series of unconditional logistic regressions to test which models best fit the data. Life course SEP increased the risk of all cancers. SEP in childhood was identified as a critical period for prostate and all gastrointestinal tract cancers except for esophagus cancer. In addition, the accumulation model best explained the data for melanoma and lung squamous cell carcinoma. Our findings suggest that childhood social circumstances are a common risk factor for several cancers among men; our results provide insights into the mechanisms involved in the etiology of nine cancers.

Keywords: Canada; cancer; case-control study; life course; socioeconomic position.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Canada / epidemiology
  • Case-Control Studies
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Neoplasms / classification
  • Neoplasms / diagnosis*
  • Neoplasms / epidemiology
  • Risk Assessment / methods*
  • Risk Assessment / statistics & numerical data
  • Risk Factors
  • Social Class*
  • Socioeconomic Factors*
  • Surveys and Questionnaires