DOI QR코드

DOI QR Code

Cancer Incidence by Occupation in Korea: Longitudinal Analysis of a Nationwide Cohort

  • Lee, Hye-Eun (Korea Institute of Labor Safety and Health) ;
  • Zaitsu, Masayoshi (Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health) ;
  • Kim, Eun-A (Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency) ;
  • Kawachi, Ichiro (Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health)
  • Received : 2019.07.02
  • Accepted : 2019.12.10
  • Published : 2020.03.30

Abstract

Background: We performed this study to investigate the inequalities in site-specific cancer incidences among workers across different occupations in Korea. Methods: Subjects included members of the national employment insurance. Incident cancers among 8,744,603 workers were followed from 1995 to 2007. Occupational groups were classified according to the Korean Standard Occupational Classification. Age-standardized incidence rate ratios were calculated. Results: We found that men in service/sales and blue-collar occupations had elevated rates of esophageal, liver, laryngeal, and lung cancer. Among women, service/sales workers had elevated incidences of cervical cancer. Male prostate cancer, female breast, corpus uteri, and ovarian cancers, as well as male and female colorectal, kidney, and thyroid cancer showed lower incidences among workers in lower socioeconomic occupations. Conclusions: Substantial differences in cancer incidences were found depending on occupation reflecting socioeconomic position, in the Korean working population. Cancer prevention policy should focus on addressing these socioeconomic inequalities.

Keywords

References

  1. Jung K-W, Won Y-J, Oh C-M, Kong H-J, Lee DH, Lee KH. Community of population-based regional cancer registries. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2014. Cancer Res Treat 2017 Apr;49(2):292-305. https://doi.org/10.4143/crt.2017.118
  2. Pukkala E, Martinsen JI, Lynge E, Gunnarsdottir HK, Sparen P, Tryggvadottir L, Weiderpass E, Kjaerheim K. Occupation and cancer - follow-up of 15 million people in five Nordic countries. Acta Oncol 2009;48(5):646-790. https://doi.org/10.1080/02841860902913546
  3. Mannetje A 't, Kromhout H. The use of occupation and industry classifications in general population studies. Int J Epidemiol 2003 Jun;32(3):419-28. https://doi.org/10.1093/ije/dyg080
  4. Sidorchuk A, Agardh EE, Aremu O, Hallqvist J, Allebeck P, Moradi T. Socioeconomic differences in lung cancer incidence: a systematic review and metaanalysis. Cancer Causes Control 2009 May;20(4):459-71. https://doi.org/10.1007/s10552-009-9300-8
  5. Uthman OA, Jadidi E, Moradi T. Socioeconomic position and incidence of gastric cancer: a systematic review and meta-analysis. J Epidemiol Community Health 2013 Oct;67(10):854-60. https://doi.org/10.1136/jech-2012-201108
  6. Kroenke C, Kawachi I. Internet. In: Socioeconomic disparities in cancer incidence and mortality, vol. 1. Oxford University Press. 2017 [cited 2019 Mar 14]. Available from: http://www.oxfordscholarship.com/view/10.1093/oso/9780190238667.001.0001/oso-9780190238667-chapter-9.
  7. Faggiano F, Partanen T, Kogevinas M, Boffetta P. Socioeconomic differences in cancer incidence and mortality. IARC Scientific Publications 1997;(138):65-176.
  8. Merletti F, Galassi C, Spadea T. The socioeconomic determinants of cancer. Environ Health 2011 Apr 5;10(Suppl. 1):S7. https://doi.org/10.1186/1476-069X-10-S1-S7
  9. Lundqvist A, Andersson E, Ahlberg I, Nilbert M, Gerdtham U. Socioeconomic inequalities in breast cancer incidence and mortality in Europe-a systematic review and meta-analysis. Eur J Public Health 2016;26(5):804-13. https://doi.org/10.1093/eurpub/ckw070
  10. Cheng I, Witte JS, McClure LA, Shema SJ, Cockburn MG, John EM, Clarke CA. Socioeconomic status and prostate cancer incidence and mortality rates among the diverse population of California. Cancer Causes Control 2009 Oct;20(8):1431-40. https://doi.org/10.1007/s10552-009-9369-0
  11. Jung-Choi K, Khang YH. Contribution of different causes of death to socioeconomic mortality inequality in Korean children aged 1-9: findings from a national mortality follow-up study. J Epidemiol Community Health 2011 Feb;65(2):124-9. https://doi.org/10.1136/jech.2008.086884
  12. Jung-Choi K, Khang YH, Cho HJ. Changes in contribution of causes of death to socioeconomic mortality inequalities in Korean adults. J Prev Med Public Health 2011 Nov;44(6):249-59. https://doi.org/10.3961/jpmph.2011.44.6.249
  13. Kim MH, Jung-Choi K, Kim H, Song YM. Educational inequality in female cancer mortality in Korea. J Korean Med Sci 2015 Jan;30(1):1-6. https://doi.org/10.3346/jkms.2015.30.1.1
  14. Lee H-E, Kim H-R, Chung YK, Kang S-K, Kim E-A. Mortality rates by occupation in Korea: a nationwide, 13-year follow-up study. Occup Environ Med 2016;73(5):329-35. https://doi.org/10.1136/oemed-2015-103192
  15. Kim C-W, Lee S-Y, Moon O-R. Inequalities in cancer incidence and mortality across income groups and policy implications in South Korea. Public Health 2008 Mar;122(3):229-36. https://doi.org/10.1016/j.puhe.2007.07.003
  16. Zaitsu M, Kaneko R, Takeuchi T, Sato Y, Kobayashi Y, Kawachi I. Occupational class and male cancer incidence: nationwide, multicenter, hospital-based case-control study in Japan. Cancer Med 2019 Jan 4.
  17. Zaitsu M, Kaneko R, Takeuchi T, Sato Y, Kobayashi Y, Kawachi I. Occupational inequalities in female cancer incidence in Japan: hospital-based matched case-control study with occupational class. SSM Popul Health 2018 Aug;5:129-37. https://doi.org/10.1016/j.ssmph.2018.06.001
  18. OECD. Poverty gap (indicator). Internet; 2019. https://doi.org/10.1787/349eb41b-en [cited 2019 Mar 14, https://data.oecd.org/inequality/povertygap.htm#indicator-chart. Available from:.
  19. Yoon TH, Moon OR, Lee SY, Jeong BG, Lee SJ, Kim NS, Jhang WK. Differences in health behaviors among the social strata in Korea. Korean J Prev Med 2000 Dec;33(4):469-76.
  20. Tanaka H, Nusselder WJ, Bopp M, Bronnum-Hansen H, Kalediene R, Lee JS, Leinsalu M, Martikainen P, Menvielle G, Kobayashi Y, Mackenbach JP. Mortality inequalities by occupational class among men in Japan, South Korea and eight European countries: a national register-based study, 1990-2015. J Epidemiol Community Health 2019 Aug;73(8):750-8.
  21. Ministry of Employment and Labor. Survey on labor conditions by employment type 2005; 2007.. http://kosis.kr/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01?menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01&parentId=B#SelectStatsBoxDiv. [Accessed 1 October 2019].
  22. Chang Y, Kang H-Y, Lim D, Cho H-J, Khang Y-H. Long-term trends in smoking prevalence and its socioeconomic inequalities in Korea, 1992-2016. Int J Equity Health 2019 Sep 18;18(1):148.
  23. Jang T-W, Kim H-R, Choi SE, Yim H-W, Lee H-E, Myong J-P, Koo J-W. Smoking rate trends in Korean occupational groups: analysis of KNHANES 1998-2009 data. J Occup Health 2012;54(6):452-8. https://doi.org/10.1539/joh.12-0148-OA
  24. Lee S, Lee K, Holden C. Creating demand for foreign brands in a "home run" market: tobacco company tactics in South Korea following market liberalisation. Tob Control 2014 May;23(3):e8. https://doi.org/10.1136/tobaccocontrol-2012-050534
  25. Kim E-A, Lee H-E, Kang S-K. Occupational burden of cancer in Korea. Saf Health Work. 1(1):61-68.
  26. Yim JY, Kim N, Choi SH, Kim YS, Cho KR, Kim SS, Seo GS, Kim HU, Baik GH, Sin CS, Cho SH, Oh BH. Seroprevalence of Helicobacter pylori in South Korea. Helicobacter 2007 Aug;12(4):333-40. https://doi.org/10.1111/j.1523-5378.2007.00504.x
  27. Hong JW, Noh JH, Kim D-J. Factors associated with high sodium intake based on estimated 24-hour urinary sodium excretion: the 2009-2011 Korea national health and nutrition examination survey. Medicine (Baltimore) 2016 Mar;95(9) e2864. https://doi.org/10.1097/md.0000000000002864
  28. Kim J-Y, Kang H-T. Association between socioeconomic status and cancer screening in Koreans over 40 Years in age based on the 2010-2012 Korean national health and nutrition examination survey. Korean J Fam Med 2016 Sep;37(5):287-92. https://doi.org/10.4082/kjfm.2016.37.5.287
  29. Choe SA, Yoo S, JeKarl J, Kim KK. Recent trend and associated factors of harmful alcohol use based on age and gender in Korea. J Korean Med Sci 2018 Jan 22;33(4):e23. https://doi.org/10.3346/jkms.2018.33.e23
  30. Park B, Choi KS, Lee H-Y, Jun JK, Park E-C. Socioeconomic inequalities in completion of hepatitis B vaccine series among Korean women: results from a nationwide interview survey. Vaccine 2012 Aug 31;30(40):5844-8. https://doi.org/10.1016/j.vaccine.2012.07.022
  31. Shin A, Cho ER, Kim J, Sung J, Park KW, Lim M-K, Shin H-R. Factors associated with awareness of infection status among chronic hepatitis B and C carriers in Korea. Cancer Epidemiol Biomarkers Prev 2009 Jun;18(6):1894-8. https://doi.org/10.1158/1055-9965.EPI-08-1228
  32. Cogliano VJ, Baan R, Straif K, Grosse Y, Lauby-Secretan B, El Ghissassi F, Bouvard V, Benbrahim-Tallaa L, Guha N, Freeman C, Galichet L, Wild CP. Preventable exposures associated with human cancers. J Natl Cancer Inst 2011 Dec 21;103(24):1827-39. https://doi.org/10.1093/jnci/djr483
  33. Jung K-W, Park S, Kong H-J, Won Y-J, Lee JY, Seo HG, Lee J-S. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2009. Cancer Res Treat 2012 Mar;44(1):11-24. https://doi.org/10.4143/crt.2012.44.1.11
  34. Kim E, Coelho D, Blachier F. Review of the association between meat consumption and risk of colorectal cancer. Nutr Res 2013 Dec;33(12):983-94. https://doi.org/10.1016/j.nutres.2013.07.018
  35. Manser CN, Bauerfeind P. Impact of socioeconomic status on incidence, mortality, and survival of colorectal cancer patients: a systematic review. Gastrointest Endosc 2014 Jul;80(1):42-60 e9. https://doi.org/10.1016/j.gie.2014.03.011
  36. Kim Y. Food and nutrient consumption patterns of Korean adults by socioeconomic status. Korean J Community Nutr. 6(4):645-656.
  37. Hong SA, Kim K, Kim MK. Educational attainment and differences in fruit and vegetable consumption among middle-aged adults in the Korean National Health and Nutrition Examination Survey IV. Nutr Res Pract 2012 Jun;6(3):263-9. https://doi.org/10.4162/nrp.2012.6.3.263
  38. Suh M, Choi KS, Lee H-Y, Hahm M-I, Lee YY, Jun JK, Park E-C. Socioeconomic disparities in colorectal cancer screening in Korea: a nationwide crosssectional study. Medicine (Baltimore) 2015 Sep;94(39):e1368. https://doi.org/10.1097/MD.0000000000001368
  39. Kerr J, Anderson C, Lippman SM. Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence. Lancet Oncol 2017;18(8):e457-71. https://doi.org/10.1016/S1470-2045(17)30411-4
  40. Boyle T, Fritschi L, Heyworth J, Bull F. Long-term sedentary work and the risk of subsite-specific colorectal cancer. Am J Epidemiol 2011 May 15;173(10):1183-91. https://doi.org/10.1093/aje/kwq513
  41. Liu L, Cozen W, Bernstein L, Ross RK, Deapen D. Changing relationship between socioeconomic status and prostate cancer incidence. J Natl Cancer Inst 2001 May 2;93(9):705-9. https://doi.org/10.1093/jnci/93.9.705
  42. Wu C-C, Lin C-H, Chiang H-S, Tang M-J. A population-based study of the influence of socioeconomic status on prostate cancer diagnosis in Taiwan. Int J Equity Health 2018 15;17(1):79. https://doi.org/10.1186/s12939-018-0792-2
  43. Hayes JH, Barry MJ. Screening for prostate cancer with the prostate-specific antigen test: a review of current evidence. JAMA 2014 Mar 19;311(11):1143-9. https://doi.org/10.1001/jama.2014.2085
  44. Lim JW. The changing trends in live birth statistics in Korea, 1970 to 2010. Korean J Pediatr 2011 Nov;54(11):429-35. https://doi.org/10.3345/kjp.2011.54.11.429
  45. Monk-Turner E, Turner CG. Sex differentials in earnings in the South Korean labor market. Feminist Econ 2001 Jan 1;7(1):63-78. https://doi.org/10.1080/13545700010028374
  46. Kullberg C, Selander J, Albin M, Borgquist S, Manjer J, Gustavsson P. Female white-collar workers remain at higher risk of breast cancer after adjustments for individual risk factors related to reproduction and lifestyle. Occup Environ Med 2017;74(9):652-8. https://doi.org/10.1136/oemed-2016-104043
  47. Choi E, Lee YY, Suh M, Lee EY, Mai TTX, Ki M, Oh JK, Cho H, Park B, Jun JK, Kim Y, Choi KS. Socioeconomic inequalities in cervical and breast cancer screening among women in Korea, 2005-2015. Yonsei Med J 2018 Nov;59(9):1026-33. https://doi.org/10.3349/ymj.2018.59.9.1026
  48. Kweon S-S, Kim M-G, Kang M-R, Shin M-H, Choi J-S. Difference of stage at cancer diagnosis by socioeconomic status for four target cancers of the National Cancer Screening Program in Korea: results from the Gwangju and Jeonnam cancer registries. J Epidemiol 2017 Jul;27(7):299-304. https://doi.org/10.1016/j.je.2016.07.004
  49. Singh GK, Miller BA, Hankey BF, Edwards BK. Persistent area socioeconomic disparities in U.S. incidence of cervical cancer, mortality, stage, and survival, 1975-2000. Cancer 2004 Sep 1;101(5):1051-7. https://doi.org/10.1002/cncr.20467
  50. Onstad MA, Schmandt RE, Lu KH. Addressing the role of obesity in endometrial cancer risk, prevention, and treatment. J Clin Oncol 2016 10;34(35):4225-30. https://doi.org/10.1200/JCO.2016.69.4638
  51. Schonfeld SJ, Hartge P, Pfeiffer RM, Freedman DM, Greenlee RT, Linet MS, Park Y, Schairer C, Visvanathan K, Lacey JV. An aggregated analysis of hormonal factors and endometrial cancer risk by parity. Cancer 2013 Apr 1;119(7):1393-401. https://doi.org/10.1002/cncr.27909
  52. Kim J, Sharma SV, Park SK. Association between socioeconomic status and obesity in adults: evidence from the 2001 to 2009 Korea national health and nutrition examination survey. J Prev Med Public Health 2014 Mar;47(2):94-103. https://doi.org/10.3961/jpmph.2014.47.2.94
  53. Chiaffarino F, Pelucchi C, Parazzini F, Negri E, Franceschi S, Talamini R, Conti E, Montella M, La Vecchia C. Reproductive and hormonal factors and ovarian cancer. Ann Oncol 2001 Mar;12(3):337-41. https://doi.org/10.1023/A:1011128408146
  54. Zaitsu M, Cuevas AG, Trudel-Fitzgerald C, Takeuchi T, Kobayashi Y, Kawachi I. Occupational class and risk of renal cell cancer. Health Sci Rep 2018 Jun;1(6):e49. https://doi.org/10.1002/hsr2.49
  55. Bae J-M. Epidemiological evidences on overdiagnosis of prostate and kidney cancers in Korean. Epidemiol Health 2015;37 e2015015. https://doi.org/10.4178/epih/e2015015
  56. Ahn HS, Kim HJ, Welch HG. Korea's thyroid-cancer "epidemic"-screening and overdiagnosis. N Engl J Med 2014 Nov 6;371(19):1765-7. https://doi.org/10.1056/NEJMp1409841
  57. Park S, Oh C-M, Cho H, Lee JY, Jung K-W, Jun JK, Won Y-J, Kong H-J, Choi KS, Lee YJ, Lee JS. Association between screening and the thyroid cancer "epidemic" in South Korea: evidence from a nationwide study. BMJ 2016 Nov 30;355:i5745.
  58. Statistics Korea. Economically active population survey. Internet; 2017 [cited 2019 Jun 4]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1DA7002&vw_cd=MT_ZTITLE&list_id=B11&seqNo=&lang_mode=ko&language=kor&obj_var_id=&itm_id=&conn_path=E1.

Cited by

  1. Cancer risk in road transportation workers: a national representative cohort study with 600,000 person-years of follow-up vol.10, 2020, https://doi.org/10.1038/s41598-020-68242-5