Individual and joint associations of socioeconomic inequalities and unhealthy lifestyle with incident gastric cancer: A prospective cohort study

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2025-04-25 DOI:10.1016/j.puhe.2025.105730

Xiang Wang , Shangxin Zhang , Yuqiang Zhao , Shiyin Meng , Jing Wang , Zhuoyi Wu , Jing Ni

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引用次数: 0

Abstract

Objectives

Gastric cancer (GC) remains a significant public health challenge, with accumulating evidence indicating an association between socioeconomic status (SES) and GC risk. This study aimed to examine the independent and synergistic effects of SES and lifestyle on GC incidence within a large prospective cohort.

Study design

Prospective cohort study.

Methods

Data were analysed from 349,908 UK Biobank participants using latent class analysis to determine SES (household income, education, employment). Lifestyle was assessed based on smoking status, alcohol consumption, physical activity, body mass index and diet. Multivariable Cox regression tested associations between SES, lifestyle and GC, with mediation and interaction analyses used to explore their relationships.

Results

SES was significantly associated with GC risk (hazard ratio [HR] = 1.35, 95 % confidence interval [CI], 1.20–1.52). An unhealthy lifestyle was also linked to increased GC risk (HR = 1.48, 95 % CI, 1.30–1.68). Individuals with low SES and an unhealthy lifestyle had a 195 % higher risk of GC compared to those with high SES and a healthy lifestyle (HR = 2.95, 95 % CI, 2.11–4.11). Mediation analysis indicated that 5.26 % of the SES-GC risk association was mediated by lifestyle factors. No significant interaction between SES and lifestyle was observed.

Conclusions

Low SES was related to an increased risk of GC, some of which may be mediated by unhealthy lifestyle. Public health initiatives should focus on addressing socioeconomic disparities and improving lifestyle factors to reduce GC incidence.

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社会经济不平等和不健康生活方式与胃癌发病率的个体和联合关联：一项前瞻性队列研究

胃癌（GC）仍然是一个重大的公共卫生挑战，越来越多的证据表明社会经济地位（SES）与胃癌风险之间存在关联。本研究旨在通过一个大型前瞻性队列研究社会经济地位和生活方式对胃癌发病率的独立和协同影响。研究设计前瞻性队列研究。方法对349,908名英国生物银行参与者的数据进行分析，采用潜在类别分析确定SES（家庭收入、教育、就业）。生活方式的评估基于吸烟状况、饮酒、身体活动、体重指数和饮食。多变量Cox回归测试了社会地位、生活方式和GC之间的关系，并使用中介和交互分析来探索它们之间的关系。结果ses与GC风险显著相关（风险比[HR] = 1.35, 95%可信区间[CI]， 1.20-1.52）。不健康的生活方式也与胃癌风险增加有关（HR = 1.48, 95% CI, 1.30-1.68）。低社会经济地位和不健康生活方式的个体发生GC的风险比高社会经济地位和健康生活方式的个体高195% （HR = 2.95, 95% CI, 2.11-4.11）。中介分析显示5.26%的SES-GC风险关联是由生活方式因素介导的。社会经济地位和生活方式之间没有明显的相互作用。结论低SES与GC风险增加有关，可能与不健康的生活方式有关。公共卫生倡议应侧重于解决社会经济差距和改善生活方式因素，以减少胃癌发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.