Educational attainment and longevity are strongly related. Large population studies covering long periods to provide evidence of trends in educational inequalities regarding life expectancy are scarce though, especially prior to the 1980s. Our objective was to document changes in life expectancy by education in Norway in the period 1961-2009, and to determine whether the patterns differ between sexes. This is a register-based population study of all Norwegian residents over 34 years, with data from the National Central Population Registry and the National Education Database. For each calendar year during 1961-2009, death rates by 1 year age groups were calculated separately for each sex and three educational categories (primary, secondary and tertiary). Annual life tables were used to calculate life expectancy at age 35 (e ( 35 )) and survival probability for the three age-intervals 35-44, 45-64, and 65-90. All education groups increased their e ( 35 ) over time, but inequalities in e ( 35 ) between tertiary and primary educational categories widened 5.3 years for men and 3.2 years for women during the study period. The probability for women with primary education to survive to age 64 did not improve from 1961 to 2009. The gain in life expectancy lagged about 10 years in lower compared to higher education groups which might suggest that improvements in life sustaining factors reach different segments of the population at different times. The widening of the gap seems to have partly tapered off over the last two decades, and the changes in life expectancy should be followed carefully in the future to document the development.
An increase in the number of older adults may raise the demand for health and care services, whereas decreasing prevalence of disability and functional limitations among them might counteract this demographic effect. However, the trends in health are inconsistent between studies and countries. In this article, we estimated the trends in mild disability and functional limitations among older Norwegians and analyzed whether they differ between socio-demographic groups. Data were obtained from repeated cross-sectional surveys conducted in 1987, 1991, 1995, 2002, 2005, and 2008, in total 4,036 non-institutionalized persons aged 67 years or older. We analyzed trends using multivariate logistic regression. On average, the age-adjusted trend in functional limitations was −3.3% per year, and in disability 3.4% per year. The risk for functional limitations or disability was elevated for women compared to men, for married compared to non-married, and was inversely associated with educational level The trends were significantly weaker with increasing age for disabilities, whereas none of the trends differed significantly between subgroups of sexes, educational level or marital status. Both functional limitations free and disability-free life expectancy appeared to have increased more than total life expectancy at age 67 during this period. The analysis suggests downward trends in the prevalence of mild disability and functional limitations among older Norwegians between 1987 and 2008 and a compression of lifetime in such health states. The reduced numbers of older people with disability and functional limitations may have restrained the demand for health and care services caused by the increase in the number of older adults.
Education matters regarding remaining life expectancy also for the oldest old in Norway. Life expectancy at these ages is low, so a growth of 0.5 years in the life expectancy differential is sizeable.
BackgroundThe vast majority of deaths occur in older adults. Paradoxically, knowledge on long-term trends in mortality inequalities among the aged, and particularly for those aged 80 years and over, is sparse. The historical trends in size and impact of socioeconomic inequalities on old age mortality are important to monitor because they may give an indication on future burden of inequalities. We investigated trends in absolute and relative educational inequalities in old age mortality in Norway between 1961 and 2009.MethodsWe did a register-based population study covering the entire Norwegian population aged 65-94 in the years 1961−2009 (1,534,513 deaths and 29,312,351 person years at risk). By examining 1-year mortality rates by gender, age and educational level we estimated trends in mortality rate ratios and rate differences.ResultsOn average, age-standardised absolute inequalities increased by 0.17 deaths per 1000 person-years per year in men (P<0.001), and declined by 0.07 deaths per 1000 person-years per year in women (P<0.001). Trends in rate differences were largest in men aged 75−84 years, but differed in direction by age group in women. The corresponding mean increase in age-standardised relative inequalities was 0.4% and 0.1% per year in men and women, respectively (P<0.001). Trends in rate ratios were largest in the youngest age groups for both genders and negligible among women aged 85−94 years.ConclusionsWhile relative educational inequalities in old age mortality increased for both genders, absolute educational inequalities increased only temporarily in men and changed little among women. Our study show the importance of including absolute measures in inequality research in order to present a more complete picture of the burden of inequalities to policy makers. As even in older ages, inequalities represent an unexploited potential to public health, old age inequalities will become increasingly important as many countries are facing aging populations.
Background ROS1 fusion is an infrequent, but attractive target for therapy in patients with metastatic non- small-cell lung cancer. In studies on mainly late-stage disease, the prevalence of ROS1 fusions is about 1–3%. In early-stage lung cancer ROS1 might also provide a fruitful target for neoadjuvant or adjuvant therapy. In the present study, we investigated the prevalence of ROS1 fusion in a Norwegian cohort of early-stage lung cancer. We also explored whether positive ROS1 immunohistochemical (IHC) stain was associated with certain mutations, clinical characteristics and outcomes. Methods The study was performed using biobank material from 921 lung cancer patients including 542 patients with adenocarcinoma surgically resected during 2006–2018. Initially, we screened the samples with two different IHC clones (D4D6 and SP384) targeting ROS1. All samples that showed more than weak or focal staining, as well as a subgroup of negative samples, were analyzed with ROS1 fluorescence in situ hybridization (FISH) and next-generation sequencing (NGS) with a comprehensive NGS DNA and RNA panel. Positive ROS1-fusion was defined as those samples positive in at least two of the three methods (IHC, FISH, NGS). Results Fifty cases were IHC positive. Of these, three samples were both NGS and FISH-positive and considered positive for ROS1 fusion. Two more samples were FISH positive only, and whilst IHC and NGS were negative. These were also negative with Reverse Transcription quantitative real time Polymerase Chain Reaction (RT-qPCR). The prevalence of ROS1 fusion in adenocarcinomas was 0.6%. All cases with ROS1 fusion had TP53 mutations. IHC-positivity was associated with adenocarcinoma. Among SP384-IHC positive cases we also found an association with never smoking status. There was no association between positive IHC and overall survival, time to relapse, age, stage, sex or pack-year of smoking. Conclusions ROS1 seems to be less frequent in early-stage disease than in advanced stages. IHC is a sensitive, but less specific method and the results need to be confirmed with another method like FISH or NGS.
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