Social inequality and incidence of and survival from cancer of the female genital organs in a population-based study in Denmark, 1994–2003

Jensen, Kirsten Egebjerg; Hannibal, Charlotte Gerd; Nielsen, Ann; Jensen, Allan; Nøhr, Bugge; Munk, Christian; Kjær, Susanne K.

doi:10.1016/j.ejca.2008.06.014

Cited by 65 publications

(65 citation statements)

References 11 publications

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“…In line with other studies, we found that age was associated with advanced-stage disease and a prognostic factor [4,[23][24][25] and that the risk for death increases with increasing comorbidity [5,[26][27][28]. The possibility of surgery and tolerance of oncological treatment might be reduced in patients with severe comorbidity, however, adjustment for comorbidity did not change the association between educational level and overall survival.…”

Section: Education and Survival After Endometrial Cancersupporting

confidence: 77%

“…The number has been increasing due to the ageing of the population [4]. The association between socioeconomic position and endometrial cancer outcomes has been investigated in a few studies, and social inequality in incidence has been observed [5][6][7][8]. Two nationwide register-based studies conducted in Denmark and Sweden found decreased mortality with increasing level of education after adjustment for age and period of diagnosis, but neither study included information on stage or treatment [5,6].…”

Section: Original Articlementioning

confidence: 99%

“…The association between socioeconomic position and endometrial cancer outcomes has been investigated in a few studies, and social inequality in incidence has been observed [5][6][7][8]. Two nationwide register-based studies conducted in Denmark and Sweden found decreased mortality with increasing level of education after adjustment for age and period of diagnosis, but neither study included information on stage or treatment [5,6]. In two studies in the USA showing disparities in survival after endometrial cancer, area-based measures of socioeconomic position or race were used as proxies for socioeconomic position [7,8].…”

Section: Original Articlementioning

confidence: 99%

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Does stage of cancer, comorbidity or lifestyle factors explain educational differences in survival after endometrial cancer? A cohort study among Danish women diagnosed 2005–2009

et al. 2016

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Background: Several studies have documented an association between socioeconomic position and survival from gynaecological cancer, but the mechanisms are unclear. Objective: The aim of this study was to examine the association between level of education and survival after endometrial cancer among Danish women; and whether differences in stage at diagnosis and comorbidity contribute to the educational differences in survival. Methods: Women with endometrial cancer diagnosed between 2005 and 2009 were identified in the Danish Gynaecological Cancer Database, with information on clinical characteristics, surgery, body mass index (BMI) and smoking status. Information on highest attained education, cohabitation and comorbidity was obtained from nationwide administrative registries. Logistic regression models were used to determine the association between level of education and cancer stage and Cox proportional hazards model for analyses of overall survival. Results: Of the 3638 patients identified during the study period, 787 had died by the end of 2011. The group of patients with short education had a higher odds ratio (OR) for advanced stage at diagnosis, but this was not statistically significant (adjusted OR 1.20; 95% CI 0.97-1.49). The age-adjusted hazard ratio (HR) for dying of patients with short education was 1.47 (CI 95% 1.17-1.80). Adjustment for cohabitation status, BMI, smoking and comorbidity did not change HRs, but further adjustment for cancer stage yielded a HR of 1.36 (1.11-1.67). Conclusion: Early detection in all educational groups might reduce social inequalities in survival, however, the unexplained increased risk for death after adjustment for prognostic factors, warrants increased attention to patients with short education in all age groups throughout treatment and rehabilitation.

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Section: Education and Survival After Endometrial Cancersupporting

confidence: 77%

Section: Original Articlementioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

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Does stage of cancer, comorbidity or lifestyle factors explain educational differences in survival after endometrial cancer? A cohort study among Danish women diagnosed 2005–2009

et al. 2016

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“…Cancer of the cervix is the sixth commonest cancer among women in Denmark (1), with about 380 cases diagnosed each year (2). In 2008, a Danish nationwide population-based cohort study revealed that relatively fewer women with lower social position, as measured by education or income, survived after cervical cancer than women with higher social position; however, this study did not take factors such as stage of cancer into consideration (3,4). As the timing of diagnosis is closely related to survival from cervical cancer (5), the relations between social factors and cancer stage must be studied to determine factors relevant to disparities in cancer survival.…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic Position and Stage of Cervical Cancer in Danish Women Diagnosed 2005 to 2009

Ibfelt

Kjær

Johansen

et al. 2012

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: To reduce social disparities in cervical cancer survival, it is important to understand the mechanisms by which social position influence cancer prognosis. We investigated the relations between socioeconomic factors, comorbidity, time since last Papanicolau smear, and stage at diagnosis in Danish women with cervical cancer. Results: The risk for advanced (stage II-IV) compared with early-stage cancer (stage I) was increased for women with short and medium education (OR ¼ 2.40; 1.67-3.45 and 1.76; 1.44-2.16), women living without a partner (OR ¼ 1.31; 1.10-1.55), and older women (OR ¼ 1.07; 1.06-1.08 increase per year). The relations between socioeconomic factors and cancer stage were partly mediated by time since last Pap smear test and to a lesser extent by comorbidity.Conclusions: Shorter education, living alone, and older age were related to advanced stage cervical cancer, due partly to Pap smear testing and less to comorbidity.Impact: It is relevant to further investigate how to decrease delay in cervical cancer diagnosis among disadvantaged groups. Cancer Epidemiol Biomarkers Prev; 21(5); 835-42. Ó2012 AACR.

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“…Cervical cancer incidence and mortality rates are higher in ethnic minorities (1)(2)(3)(4)(5)(6) and in individuals with low socioeconomic status, low education levels, and living in areas with high poverty (2,(7)(8)(9)(10)(11)(12). An important contributor to these inequalities is the differential participation and follow-up in cervical screening programs, either because of differences in health seeking behavior or because of screening and treatment access barriers (3,(13)(14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Changing Inequalities in Cervical Cancer: Modeling the Impact of Vaccine Uptake, Vaccine Herd Effects, and Cervical Cancer Screening in the Post-Vaccination Era

Malagón

Drolet

Boily

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Inequalities in cervical cancer may be increased following mass vaccination against the human papillomavirus (HPV) if girls with low vaccine uptake also have low future participation in cervical cancer screening. We evaluated how vaccine uptake distribution affects inequalities in squamous cell carcinoma (SCC) incidence between groups with different screening participation.Methods: We used an individual-based transmission dynamic model of HPV infection and disease (HPV-ADVISE). Females were stratified by routine screening frequency. We modeled the impact of vaccination on SCC incidence rate differences (absolute inequality) and incidence rate ratios (relative inequality) between women who have routine screening intervals of <5 years (frequently screened), !5 years (underscreened), and who are never screened. We compared simulations with uniform vaccine uptake with scenarios with unequal vaccine uptake, in which never and underscreened

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Social inequality and incidence of and survival from cancer of the female genital organs in a population-based study in Denmark, 1994–2003

Cited by 65 publications

References 11 publications

Does stage of cancer, comorbidity or lifestyle factors explain educational differences in survival after endometrial cancer? A cohort study among Danish women diagnosed 2005–2009

Does stage of cancer, comorbidity or lifestyle factors explain educational differences in survival after endometrial cancer? A cohort study among Danish women diagnosed 2005–2009

Socioeconomic Position and Stage of Cervical Cancer in Danish Women Diagnosed 2005 to 2009

Changing Inequalities in Cervical Cancer: Modeling the Impact of Vaccine Uptake, Vaccine Herd Effects, and Cervical Cancer Screening in the Post-Vaccination Era

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