Cancer Research in Switzerland - Krebsliga Schweiz

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Findings of the INHANCE study also suggested that the
risks of HNC for beer and liquor are comparable. A greater
than multiplicative effect between ever tobacco and alcohol
use was observed for HNC risk. The population attributable
risk for tobacco or alcohol was 72 % for HNC,
of which 4 % was due to alcohol alone, 33 % was due to
tobacco alone and 35 % was due to tobacco and alcohol
combined. Quitting tobacco smoking resulted in a HNC
risk reduction in the short term. For alcohol use, a beneficial
effect on the risk of HNC was only observed after
≥ 20 years of quitting.
Additional and more detailed collaborative analyses within
the INHANCE consortium were conducted on: a) total exposure
and exposure rate effects of alcohol and smoking
and risk of HNC; b) cessation of alcohol drinking, tobacco
smoking and the reversal of HNC; and c) interaction between
tobacco and alcohol use and risk of HNC.
The major results of the research are published to increase
the project impact on various aspects of public health and
prevention and, in particular, the assessment of the individual
risks and their public health implications.
Project coordinator
Prof. Dr Fabio Levi
Unité d’épidémiologie du cancer et
Registres vaudois et neuchâtelois des tumeurs
Institut universitaire de médecine sociale et
préventive
Centre hospitalier universitaire vaudois (CHUV)
Chemin des Falaises 1
CH-1011 Lausanne
Phone +41 (0)21 314 73 11
fabio.levi@chuv.ch
Zwahlen Marcel | Risk of childhood leukemia varies
little by familial socio-economic status – while survival
time after a brain tumor diagnosis varied considerably
by familial socio-economic status
(OCS 1869-02-2006)
Research on origins and determinants of childhood cancer
is still important, because the aetiology of childhood cancer
remains poorly understood. Whether diseases are
occurring more frequently in persons with lower socioeconomic
status (SES) is a question that is regularly asked.
In a nationwide study of the SCCR and the Swiss National
Cohort (SNC) using data of the 1990 and 2000 census,
we examined, first, the association of SES level and the
risk of leukaemia and, second, the association of SES level
and mortality in childhood cancer patients.
In the case-control study part we found weak evidence
for a positive association of childhood leukaemia with
higher education of mother but no evidence of an association
with other family indicators of SES. The odds ratio
for leukaemia and SES, comparing the highest SES category
with the lowest SES category, was 1.37 (1.00–1.89)
for mother’s education, 0.95 (95 % CI: 0.71–1.26) for
father’s education and 0.96 (95 % CI: 0.74–1.25) for
number of rooms per person. This might imply that childhood
leukaemia risk is positively associated with a specific
exposure linked to higher education of the mother.
When analyzing survival after a cancer diagnosis, SES differentials
were virtually absent for leukaemia patients but
existed for other childhood cancers, especially for patients
with a tumour of the central nervous system. Mortality
was lower in higher SES groups compared to lower SES
groups. Depending on the SES measure used, hazard
ratios ranged from 0.48 (95 % CI: 0.28–0.81) to 0.71
(95 % CI: 0.44–1.15) when comparing the highest with
the lowest SES group. This might imply an association of
SES with access to health care and treatment decisions,
which in turn would be associated with treatment outcome.
To improve health conditions and care in all socioeconomic
groups in high-income countries with mandatory
health insurance like Switzerland, it is important to understand
the causes of childhood cancer and the mechanisms
that are responsible for differences in survival after a cancer
diagnosis in children.
Project coordinator
Prof. Dr. Marcel Zwahlen
Institut für Sozial- und Präventivmedizin
Universität Bern
Finkenhubelweg 11
CH-3000 Bern
Phone +41 (0)31 631 35 11
zwahlen@ispm.unibe.ch