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Objectives To examine the association between neighbourhood deprivation and lung cancer risk.

Design Nested case–control study.

Setting Southern Community Cohort Study of persons residing in 12 states in the southeastern USA.

Participants 1334 cases of lung cancer and 5315 controls.

Primary outcome measure Risk of lung cancer.

Results After adjustment for smoking status and other confounders, and additional adjustment for individual-level measures of socioeconomic status (SES), there was no monotonic increase in risk with worsening deprivation score overall or within sex and race groups. There was an increase among current and shorter term former smokers (p=0.04) but not among never and longer term former smokers. There was evidence of statistically significant interaction by sex among whites, but not blacks, in which the effect of worsening deprivation on lung cancer existed in males but not in females.

Conclusions Area-level measures of SES were associated with lung cancer risk in current and shorter term former smokers only in this population.