Income Dynamics and Incident Esophageal Cancer: A Retrospective Cohort Study
Menée à partir de données portant sur 3 361 091 Coréens ayant réalisé un examen de santé en 2012 (durée de suivi : 9,3 ans), cette étude analyse l'association entre la trajectoire des revenus et l'incidence du cancer de l'oesophage (1 943 cas)
Background: Although socioeconomic status is a recognized risk factor for esophageal cancer (EC), most studies have examined socioeconomic status at a single time point. We investigated the association between income dynamics and incident EC.
Methods: We analyzed 3,361,091 Korean adults aged 30–65 years who underwent health screening in 2012. Income dynamics from 2008 to 2012, derived from National Health Insurance premium data, were characterized as i) income variability (year-to-year percentage change standard deviations), ii) cumulative years in the lowest or highest income group, and iii) directional income change. Incident EC was identified using ICD-10 codes from 2013 to 2022.
Results: During follow-up of 9.3 years, 1,943 EC cases occurred. Compared to the highest income group, the lowest income group (Medical Aid + quartile 1) had a higher EC risk (adjusted hazard ratios [aHR]Q4 vs. MA+Q1 1.22; 95% confidence interval [CI], 1.07–1.38; p for trend <0.001). Greater income variability (aHRQ4 vs. Q1 1.21; 95% CI, 1.06–1.37; p for trend=0.003), longer cumulative low-income duration (aHR5 vs.0 years 1.21; 95% CI, 1.03–1.42; p for trend=0.001), and a decline from high- to low-income status (aHR 1.39; 95% CI, 1.05–1.83) were also associated with increased risk. Sustained high-income status was inversely associated with EC risk (aHR5 vs.0 years 0.83; 95% CI 0.73–0.93; p for trend=0.002).
Conclusions: Higher income variability, persistently low income, and income decline over the 5-year income assessment period were independently associated with increased EC risk.
Impact: Incorporating income trajectories may help EC risk stratification and preventive strategies.
Cancer Epidemiology, Biomarkers & Prevention , résumé, 2026