Association of socioeconomic status with risk of esophageal cancer: a meta-analysis

Aim Esophageal cancer is divided into two main histological types; esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). Previous studies have described associations between socioeconomic status (SES) and cancer. In this study, we performed a meta-analysis on previously reported studies to assess the relationship between socioeconomic status and esophageal cancer. Methods We performed a systematic search through MEDLINE, PubMed, EMBASE and Cochrane libraries and identified relevant articles published before 1
^st
October, 2019. We then tested heterogeneity using Revman 5.3 and chi-square test, and quantified its degree using the I
²
statistic. Results Our results revealed presence of heterogeneity among the studies (I
²
=98, P< 0.00001), and indicated a significant negative relationship between levels of education and esophageal cancer (P<0.00001). In addition, we found a significant increase in the risk of esophageal adenocarcinoma and esophageal squamous cell carcinoma among patients with low education levels, with a pooled OR of 1.48, 95% CI (1.38-1.59) and 1.65, 95% CI (1.55-1.76). Moreover, patients who had low wealth status exhibited a significant increase in the risk of esophageal squamous cell carcinoma, with a pooled OR of 1.50, 95% CI (1.41,1.59). Conclusions Overall, our findings indicated that low SES is associated with increased risk of esophageal cancer.