Cancer Causes & Control

, Volume 16, Issue 5, pp 515–524 | Cite as

Occupational class, occupational mobility and cancer incidence among middle-aged men and women: a prospective study of the French GAZEL cohort*

  • Maria Melchior
  • Marcel Goldberg
  • Nancy Krieger
  • Ichiro Kawachi
  • Gwenn Menvielle
  • Marie Zins
  • Lisa F. Berkman



To examine the association between occupational class, occupational mobility and cancer incidence in the 1990s.


Prospective study of 14,853 men and 5493 women employed by a large French company. Incident cases (any cancer, smoking and alcohol-related, breast) were ascertained through a validated company-based cancer registry (1990–2002). Hazard ratios (HRs) by occupational class and by career-long occupational mobility were calculated adjusting for age, marital status, tobacco and alcohol consumption, weight, diet, asbestos exposure, family history of cancer, and reproductive history.


359 male cancers (107 smoking and alcohol-related) and 208 female cases (120 breast cancers) were observed. Male clerks and manual workers were at high risk, particularly of smoking and alcohol-related cancers (compared to managers, age-adjusted HRs: 2.95 95% CI 1.37–6.38 and 2.18 95% CI 1.15–4.11). Adjusting for specific health behaviors and other cancer risk factors reduced this gradient (fully-adjusted HRs respectively 1.95 95% CI 0.89–4.27 and 1.54 95% CI 0.80–2.97). The risk was also associated with occupational mobility. We found no association between women’s occupational class and cancer.


The incidence of smoking and alcohol-related cancers among French men shows a strong socioeconomic gradient. Policies addressing these social disparities are needed.


cancer incidence France/epidemiology socioeconomic position smoking 


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  1. 1.
    Chevalier, A, Leclerc, A, Blanc, C, Goldberg, M 1987Disparités sociales et professionnelles de la mortalité des travailleurs d’Electricité et Gaz de FrancePopulation6863880Google Scholar
  2. 2.
    Kogevinas, M, Pearce, N, Susser, M, Boffetta, P 1997Social Inequalities and CancerIARC/WHOLyonGoogle Scholar
  3. 3.
    Hart, CL, Davey Smith, G, Blane, D 1998Social mobility and 21 year mortality in a cohort of Scottish menSoc Sci Med4711211130PubMedGoogle Scholar
  4. 4.
    Mackenbach, JP, Huisman, M, Andersen, O,  et al. 2004Inequalities in lung cancer mortality by the educational level in 10 European populationsEur J Cancer40126135PubMedGoogle Scholar
  5. 5.
    Faggiano F, Partanen T, Kogevinas M, Boffetta P. Socioeconomic differences in cancer incidence and mortality. Kogevinas, M, Pearce, N, Susser, M, and Boffetta, Paolo. Social inequalities and cancer. 138, 65–176. 1997. Lyon, IARC. IARC Scientific Publications.Google Scholar
  6. 6.
    Haut Comité pour la Santé Publique (2002) La santé en France. Paris: La documentation française, p. 167.Google Scholar
  7. 7.
    Chérié-Challine, L, Paty, A-C, Uhry, Z 2003La mortalité prématurée par cancer: une spécificité française?Bul Epidémiol Hébd30–31146149Google Scholar
  8. 8.
    Hein, HO, Suadicani, P, Gyntelberg, F 1992Lung cancer risk and social class. The Copenhagen Male Study – 17-year follow upDan Med Bull.39173176PubMedGoogle Scholar
  9. 9.
    Loon, AJ, Goldbohm, RA, Brandt, PA 1995Lung cancer: is there an association with socioeconomic status in The Netherlands?J Epidemiol Community Health496569PubMedGoogle Scholar
  10. 10.
    Marshall, B, Chevalier, A, Garillon, C, Coing, F 1999Socio-economic status, social mobility and cancer occurrence during working life: a case-control study among French electricity and gas workersCancer Causes Control10495502PubMedGoogle Scholar
  11. 11.
    Berrino, F, Richiardi, L, Boffetta, P,  et al. 2003Occupation and larynx and hypopharynx cancer: a job-exposure matrix approach in an international case-control study in France, Italy, Spain and SwitzerlandCancer Causes Control14213223PubMedGoogle Scholar
  12. 12.
    Menvielle, G, Luce, D, Goldberg, P, Leclerc, A 2004Smoking, alcohol drinking, occupational exposures and social inequalities in hypopharyngeal and laryngeal cancerInt J Epidemiol33799806PubMedGoogle Scholar
  13. 13.
    Kogevinas, M, Mannetje, A, Cordier, S,  et al. 2003Occupation and bladder cancer among men in Western EuropeCancer Causes Control14907914PubMedGoogle Scholar
  14. 14.
    Mackenbach, JP, Bos, V, Andersen, O,  et al. 2003Widening socioeconomic inequalities in mortality in six Western European countriesInt J Epidemiol32830837PubMedGoogle Scholar
  15. 15.
    Singh, GK, Miller, BA, Hankey, BF, Edwards, BK 2003Area Socioeconomic Variations in U.S. Cancer Incidence, Mortality, Stage, Treatment, and Survival, 1975–1999. NCI Cancer Surveillance Monograph Series, Number 4National Cancer InstituteBethesda, MD(NIH Pub. No. 03–5417).Google Scholar
  16. 16.
    Dano, H, Andersen, O, Ewertz, M, Holm Petersen, J, Lynge, E 2003Socioeconomic status and breast cancer in DenmarkInt J Epidemiol32218224CrossRefPubMedGoogle Scholar
  17. 17.
    Krieger, N, Queensberry, C,Jr, Peng, T,  et al. 1999Social class, race/ethnicity, and incidence of breast, cervix, colon, lung, and prostate cancer among Asian, black, and white residents of the San Fransisco Bay Area, 1988–1992 (United States)Cancer Causes Control10525537CrossRefPubMedGoogle Scholar
  18. 18.
    Krieger, N 2002Is breast cancer a disease of affluence, or poverty, or both? The case of African American womenAm J Public Health92611613PubMedGoogle Scholar
  19. 19.
    Martikainen, P, Valkonen, T 2000Diminishing educational differences in breast cancer mortality among Finnish women: a register-based 25-year follow-upAm J Public Health90277280PubMedGoogle Scholar
  20. 20.
    Goldberg, M, Chastang, J-F, Leclerc, A, Zins, M, Bonenfant, S, Bugel, I 2001Socioeconomic, demographic, occupational and health factors associated with participation in a long-term epidemiological survey. A prospective study of the French Gazel cohort and its target populationAm J Epidemiol154373384CrossRefPubMedGoogle Scholar
  21. 21.
    Goldberg, M, Leclerc, A, Chastang, J, Morcet, J, Marne, M, Luce, D 1990Mise en place d’une cohorte épidémiologique à Electricité de France - Gaz de France: principales caractéristiques de l’échantillonRev Epidémio Santé Publique38378380Google Scholar
  22. 22.
    INSEE (2002). France, Portrait Social. Paris.Google Scholar
  23. 23.
    Leclerc, A, Zins, M, Bugel, I,  et al. 1994Consommation de boissons alcoolisées et situation professionnelle dans la cohorte GAZEL (EDF-GDF)Arch Maladies Prof55509517Google Scholar
  24. 24.
    Imbernon, E, Goldberg, M, Bonenfant, S,  et al. 1995Occupational respiratory cancer and exposure to asbestos: a case-control study in a cohort of workers in the Electricity and Gas industryAm J Industrial Med28339352Google Scholar
  25. 25.
    Chevalier, A, Goldberg, M, Godard, C,  et al. 1996Incidence des cancers dans la population masculine des salariés en activité à Electricité de France et Gaz de FranceRev Epidémiol Santé Publique442536PubMedGoogle Scholar
  26. 26.
    World Health Organization1992International Classification of Diseases: Tenth RevisionWorld Health OrganizationGenevaGoogle Scholar
  27. 27.
    Schottenfeld, D, Fraumeni, JF,Jr 1996Cancer Epidemiology and PreventionOxford University PressNew York, NYGoogle Scholar
  28. 28.
    SAS Institute1997SAS/STAT Software: Changes and Enhancements Through Release 6.12SAS InstituteCary: NCGoogle Scholar
  29. 29.
    Comité français pour l’éducation à la santé (1997) Baromètre santé adulte 95/96. Baudier F and Arènes J, eds. Paris: CFES.Google Scholar
  30. 30.
    Comité français pour l’éducation à la santé. (2001) Baromètre santé 2000 – Résultats. Guilbert P, Baudier, F and Gautier, A, eds. Vanves: CFESGoogle Scholar
  31. 31.
    Lynge, E 1997Unemployment and cancer: a literature reviewKogevinas, MPearce, NSusser, MBoffetta, P eds. Social Inequalities and Cancer.IARCLyon343352Google Scholar
  32. 32.
    Boffetta, P, Richiardi, L, Berrino, F,  et al. 2003Occupation and larynx and hypopharynx cancer: an international case-control study in France, Italy, Spain and SwitzerlandCancer Causes Control14203212PubMedGoogle Scholar
  33. 33.
    Ribet, C, Zins, M, Guéguen, A,  et al. 2003Occupational mobility and cardiovascular risk factors in working men: selection, causality, or both? Results from the GAZEL studyJ Epidemiol Community Health57901906CrossRefPubMedGoogle Scholar
  34. 34.
    Brisson, C, Larocque, B, Moisan, J, Vezina, M, Dagenais, G 2000Psychosocial factors at work, smoking, sedentary behavior, and body mass index: a prevalence study among 6995 white collar workersJ Occup Environ Med424046PubMedGoogle Scholar
  35. 35.
    Head, J, Stansfeld, SA, Siegrist, J 2004The psychosocial work environment and alcohol dependence: a prospective studyOccup Environ Med61219224CrossRefPubMedGoogle Scholar
  36. 36.
    Hallqvist, J, Lynch, JW, Bartley, M, Lang, T, Blane, D 2004Can we disantangle life course processes of accumulation, critical period and social mobility? An analysis of disadvantaged socio-economic positions and myocardial infarction in the Stockholm Heart Epidemiology Program (SHEEP)Social Science Medicine5815551562CrossRefPubMedGoogle Scholar
  37. 37.
    Lang, T, Ducimetière, P, Arveiler, D,  et al. 1997Incidence, case fatality, risk factors of acute coronary heart disease and occupational categories in men aged 30–59 in FranceInt J Epidemiol264757CrossRefPubMedGoogle Scholar
  38. 38.
    Lang, T, Ducimetière, P 1995Premature cardiovascular mortality in France: divergent evolution between social categories from 1970 to 1990Int J Epidemiol24331339PubMedGoogle Scholar
  39. 39.
    Seys, B 1996L’évolution sociale de la population activeINSEE Première43414Google Scholar
  40. 40.
    Hart, CL, Hole, DJ, Gillis, CR, Davey Smith, G, Watt, GC, Hawthorne, VM 2001Social class differences in lung cancer mortality: risk factor explanations using two Scottish cohort studiesInt J Epidemiol30268274CrossRefPubMedGoogle Scholar
  41. 41.
    Mao, Y, Hu, J, Ugnat, AM, Semeciw, R, Fincham, S 2001Socioeconomic status and lung cancer risk in CanadaInt J Epidemiol30809817PubMedGoogle Scholar
  42. 42.
    Niedhammer, I, Bugel, I, Bonenfant, S, Goldberg, M, Leclerc, A 2000Validity of self-reported weight and height in the French GAZEL cohortInt J Obesity2411111118Google Scholar
  43. 43.
    Haldorsen, T, Andersen, A, Boffetta, P 2004Smoking-adjusted incidence of lung cancer by occupation among Norwegian menCancer Causes Control15139147PubMedGoogle Scholar
  44. 44.
    Guénel, P, Nicolau, J, Imbernon, E, Chevalier, A, Goldberg, M 1996Exposure to 50-Hz electric field and incidence of leukemia, brain tumors, and other cancers among French electric utility workersAm J Epidemiol14411071121PubMedGoogle Scholar
  45. 45.
    Martin, JC, Imbernon, E, Goldberg, M, Chevalier, A, Bonenfant, S 2000Occupational risk factors for lung cancer in the French electricity and gas industry: a case-control survey nested in a cohort of active employeesAm J Epidemiol151902912PubMedGoogle Scholar
  46. 46.
    Guenel, P, Imbernon, E, Chevalier, A, Crinquand-Calastreng, A, Goldberg, M 2002Leukemia in relation to occupational exposures to benzene and other agents: a case-control study nested in a cohort of gas and electric utility workersAm J Ind Med428797PubMedGoogle Scholar
  47. 47.
    Garillon, C, Chevalier, A, Marshall, B,  et al. 1997Incidence des cancers chez les salariées en activité d’Eléctricité de France-Gaz de FranceBull Cancer8410251031PubMedGoogle Scholar
  48. 48.
    Krieger, N 1991Women and social class: a methodological study comparing individual, household, and census measures as predictors of black/white differences in reproductive historyJ Epidemiol Community Health453542PubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Maria Melchior
    • 1
  • Marcel Goldberg
    • 1
  • Nancy Krieger
    • 2
  • Ichiro Kawachi
    • 2
  • Gwenn Menvielle
    • 1
  • Marie Zins
    • 3
  • Lisa F. Berkman
    • 2
  1. 1.INSERM U88-IFR69Saint-MauriceFrance
  2. 2.Harvard School of Public HealthDepartment of Society, Human Development and HealthUSA
  3. 3.Cetaf-INSERM U88Saint-MauriceFrance

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