Changing socioeconomic correlates for cancers of the upper digestive tract

Background: Cancers of the upper digestive tract have long been associated with low socio-economic levels. It has however been suggested that in recen t times the social gradient for these cancers is leveling off. Patients and methods: Data from three case-control studies on oral, pharyng eal and oesophageal cancer conducted in Northern Italy during the periods 1 984-1992 and 1992-1997 were combined and re-analyzed. Cases were subjects a dmitted to the major teaching and general hospitals in the areas under stud y with incident, histologically confirmed cancer of the oral cavity and pha rynx (n = 1126) and oesophagus (n = 714). Controls were subjects admitted t o the same hospitals for a wide spectrum of acute, non-neoplastic condition s, not related to smoking or alcohol consumption (n = 4642). Results: In the 1980s a significant association was observed with low educa tion and social class level. The multivariate odds ratios for oral, pharyng eal and oesophageal cancers combined was 1.78 for the lowest versusthe high est educational level, and 1.75 for the lowest versusthe highest social cla ss. No consistent pattern of risk was observed with any of the socio-econom ic indicators considered in the studies conducted in the 1990s. Conclusions: The present study indicates that the socio-economic correlates of cancers of the upper digestive tract have changed over the last few yea rs in Italy, with a disappearance of the social gradient.