학술논문

The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer: A pooled analysis of 18 case-control studies
Document Type
article
Source
Subject
Biomedical and Clinical Sciences
Epidemiology
Health Services and Systems
Health Sciences
Oncology and Carcinogenesis
Cancer
Ovarian Cancer
Tobacco Smoke and Health
Rare Diseases
Tobacco
Prevention
Aged
Carcinoma
Ovarian Epithelial
Case-Control Studies
Delayed Diagnosis
Female
Humans
Logistic Models
Middle Aged
Neoplasms
Glandular and Epithelial
Odds Ratio
Ovarian Neoplasms
Social Class
Ovarian cancer
Pooled analysis
Socioeconomic status
Tumour stage
Ovarian Cancer Association Consortium
Public Health and Health Services
Oncology & Carcinogenesis
Oncology and carcinogenesis
Language
Abstract
PurposeSocioeconomic status (SES) is a known predictor of survival for several cancers and it has been suggested that SES differences affecting tumour stage at diagnosis may be the most important explanatory factor for this. However, only a limited number of studies have investigated SES differences in tumour stage at diagnosis of ovarian cancer. In a pooled analysis, we investigated whether SES as represented by level of education is predictive for advanced tumour stage at diagnosis of ovarian cancer, overall and by histotype. The effect of cigarette smoking and body mass index (BMI) on the association was also evaluated.MethodsFrom 18 case-control studies, we obtained information on 10,601 women diagnosed with epithelial ovarian cancer. Study specific odds ratios (ORs) with corresponding 95% confidence intervals (CI) were obtained from logistic regression models and combined into a pooled odds ratio (pOR) using a random effects model.ResultsOverall, women who completed ≤high school had an increased risk of advanced tumour stage at diagnosis compared with women who completed >high school (pOR 1.15; 95% CI 1.03-1.28). The risk estimates for the different histotypes of ovarian cancer resembled that observed for ovarian cancers combined but did not reach statistical significance. Our results were unchanged when we included BMI and cigarette smoking.ConclusionLower level of education was associated with an increased risk of advanced tumour stage at diagnosis of ovarian cancer. The observed socioeconomic difference in stage at diagnosis of ovarian cancer calls for further studies on how to reduce this diagnostic delay.