Background The impact of societal factors on the occurrence of head and neck cancers (HNCs) remains understudied, especially in the Nordic countries. Methods To quantify the association between socio-economic status (SES) and the occurrence of HNCs, this cohort study uses data from the Nordic Occupational Cancer project that combine occupational and cancer registry data from 1961 to 2005 of 14.9 million individuals aged between 30 and 64 years. Occupational categories were combined into seven socio-economic categories. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for the entire national study populations used as reference rates. Results Altogether, 83 997 HNCs—72% in men and 28% in women—were recorded. Among men, a gradient of risk associated with SES was observed for cancers of the tongue, other oral cavity subsites, pharynx, oropharynx and larynx in groups with lower SES. Managers showed decreased SIRs of 0.50 to –0.90 also for cancers of the lip, tongue, other oral cavity subsites, oropharynx, nasopharynx, nose and larynx. In contrast, excess risks of tongue, other oral cavity subsites, pharyngeal, oropharyngeal and laryngeal cancers were observed among clerical (SIRs 1.05–1.16), skilled workers (1.04–1.14), unskilled workers (1.16–1.26) and economically inactive men (1.38–1.87). Among women, no risk gradient similar to that in men was revealed. Conclusions The current study underscores the influence of SES on the incidence of HNCs and highlights the need for targeted interventions, including tobacco and alcohol control policies, and improved access to healthcare services, particularly for socio-economically disadvantaged populations.

中文翻译：

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北欧国家的社会经济状况和头颈癌发病率


背景 社会因素对头颈癌 (HNC) 发生的影响仍未得到充分研究，特别是在北欧国家。方法 为了量化社会经济地位 (SES) 与 HNC 发生之间的关联，这项队列研究使用了北欧职业癌症项目的数据，该项目结合了 1961 年至 2005 年 1490 万年龄在 30 至 64 岁之间的个人的职业和癌症登记数据年。职业类别被合并为七个社会经济类别。以整个国家研究人群的癌症发病率作为参考率进行标准化发病率（SIR）分析。结果 总共记录了 83 997 名 HNC，其中 72% 为男性，28% 为女性。在男性中，在 SES 较低的群体中，观察到舌癌、其他口腔亚部位、咽癌、口咽癌和喉癌与 SES 相关的风险梯度。管理人员发现，唇癌、舌癌、其他口腔亚部位癌、口咽癌、鼻咽癌、鼻癌和喉癌的 SIR 也降低了 0.50 至 –0.90。相比之下，在文员（SIR 1.05-1.16）、技术工人（1.04-1.14）、非技术工人（1.16-1.26）和经济不活跃的男性中观察到舌癌、其他口腔亚部位、咽癌、口咽癌和喉癌的风险过高（ 1.38–1.87）。在女性中，没有发现与男性相似的风险梯度。结论 目前的研究强调了社会经济地位对 HNC 发病率的影响，并强调需要采取有针对性的干预措施，包括烟草和酒精控制政策，以及改善获得医疗保健服务的机会，特别是对于社会经济弱势群体。