Socioeconomic status, smoking, and lung cancer: mediation and bias analysis in the SYNERGY study
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00209805%3A_____%2F25%3A00079994" target="_blank" >RIV/00209805:_____/25:00079994 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11110/25:10501984
Result on the web
<a href="https://journals.lww.com/epidem/abstract/2025/03000/socioeconomic_status,_smoking,_and_lung_cancer_.13.aspx" target="_blank" >https://journals.lww.com/epidem/abstract/2025/03000/socioeconomic_status,_smoking,_and_lung_cancer_.13.aspx</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1097/EDE.0000000000001807" target="_blank" >10.1097/EDE.0000000000001807</a>
Alternative languages
Result language
angličtina
Original language name
Socioeconomic status, smoking, and lung cancer: mediation and bias analysis in the SYNERGY study
Original language description
BACKGROUND: Increased lung-cancer risks for low socioeconomic status (SES) groups are only partially attributable to smoking habits. Little effort has been made to investigate the persistent risks related to low SES by quantification of potential biases. METHODS: Based on 12 case-control studies, including 18 centers of the international SYNERGY project (16,550 cases, 20,147 controls), we estimated controlled direct effects (CDE) of SES on lung cancer via multiple logistic regression, adjusted for age, study center, and smoking habits, and stratified by sex. We conducted mediation analysis by inverse odds ratio weighting to estimate natural direct effects (NDE) and natural indirect effects via smoking habits. We considered misclassification of smoking status, selection bias, and unmeasured mediator-outcome confounding by genetic risk, both separately as well as by multiple quantitative bias analysis, using bootstrap to create 95% simulation intervals (SI). RESULTS: Mediation analysis of lung-cancer risks for SES estimated mean proportions of 43% in men and 33% in women attributable to smoking. Bias analyses decreased direct effects of SES on lung cancer, with selection bias showing the strongest reduction in lung-cancer risk in the multiple bias analysis. Lung-cancer risks remained increased for lower SES groups, with higher risks in men [4th versus 1st (highest) SES quartile: CDE 1.50 (SI 1.32-1.69)] than women [CDE 1.20 (SI 1.01-1.45)]. NDE were similar to CDE, particularly in men. CONCLUSIONS: Bias adjustment lowered direct lung-cancer risk estimates of lower SES groups. However, risks for low SES remained elevated, likely attributable to occupational hazards or other environmental exposures.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30204 - Oncology
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2025
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Epidemiology
ISSN
1044-3983
e-ISSN
1531-5487
Volume of the periodical
36
Issue of the periodical within the volume
2
Country of publishing house
US - UNITED STATES
Number of pages
8
Pages from-to
245-252
UT code for WoS article
001414213300011
EID of the result in the Scopus database
2-s2.0-85208233950