Occupational disparities in survival in Korean women with cancer: a nationwide registry linkage study

Abstract

ObjectivesWe sought to examine occupational disparities in survival among Korean women diagnosed with cancer.DesignPopulation-based, registry-linkage study.SettingSouth Korea.ParticipantsOur study population comprised female workers registered in the Korean national employment insurance programme during 1995–2000 and diagnosed with cancer between 1995 and 2008. A total of 61 110 women with cancer diagnoses was included in analysis. The occupation was categorised into four groups: (1) managers, professionals and technical workers, (2) clerks, (3) service/sales workers and (4) blue-collar workers.Primary and secondary outcome measureStudy population were linked to the national death registry until 2009. HRs for mortality adjusting for age and year of diagnosis were calculated in the study sample and subgroups with 10 specific cancer sites including thyroid, breast, stomach, cervix, colon or lung cancer using managers, professionals and technical workers as the reference.ResultsWomen in service/sales (HR 1.25, 95% CI 1.15 to 1.35) and blue-collar occupations (HR 1.34, 95% CI 1.25 to 1.44) had poorer survival for all cancer sites combined, while blue-collar workers showed poorer survival for lung (HR 1.41, 95% CI 1.14 to 1.77), breast (HR 1.28, 95% CI 1.06 to 1.54), cervical cancer (HR 1.42, 95% CI 1.02 to 2.06) and non-Hodgkin’s lymphoma (HR 1.69, 95% CI 1.09 to 2.77) compared with women in professional and managerial positions.ConclusionWe found substantial and significant inequalities in overall survival by the occupational group among Korean women with cancer, even in the context of universal access to cancer screening and treatment.

Occupational disparities in tumor grade and cytosolic HMGB1 expression in renal cell cancer

“…Hence, further studies should address occupational backgrounds in histological characteristics, trying to use data linkage approaches. 18,33 In conclusion, occupational disparities in RCC tumor grades appeared to exist in Japan. Further integrated perspectives of clinical pathology, occupational medicine, and social epidemiology are warranted to elucidate the determinants of occupational differences in RCC carcinogenesis.…”

“…Additionally, in a recent study, cancer patients of manual workers had 1.25 times higher odds for advanced cancer stage, 28 which also suggests the existence of socioeconomic disparities in health behaviors including delayed diagnosis with non‐cancer screening in Japan. Hence, further studies should address occupational backgrounds in histological characteristics, trying to use data linkage approaches 18,33 . In conclusion, occupational disparities in RCC tumor grades appeared to exist in Japan.…”