The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer: A pooled analysis of 18 case-control studies
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Author
Præstegaard, Camilla
Kjaer, Susanne K.
Nielsen, Thor S.S.
Jensen, Signe M.
Webb, Penelope M.
Nagle, Christina M.
Høgdall, Estrid
Risch, Harvey A.
Rossing, Mary Anne
Doherty, Jennifer A.
Wicklund, Kristine G.
Goodman, Marc T.
Modugno, Francesmary
Moysich, Kirsten
Ness, Roberta B.
Edwards, Robert P.
Goode, Ellen L.
Winham, Stacey J.
Fridley, Brooke L.
Schildkraut, Joellen M.
Berchuck, Andrew
Bandera, Elisa V.
Paddock, Lisa
Kiemeney, Lambertus A.
Massuger, Leon F.
Wentzensen, Nicolas
Pharoah, Paul
Song, Honglin
Whittemore, Alice S.
McGuire, Valerie
Sieh, Weiva
Rothstein, Joseph
Anton-Culver, Hoda
Ziogas, Argyrios
Menon, Usha
Gayther, Simon A.
Ramus, Susan J.
Gentry-Maharaj, Aleksandra
Wu, Anna H.
Pearce, Celeste L.
Pike, Malcolm C.
Lee, Alice W.
Chang-Claude, Jenny
Jensen, Allan
Note: Order does not necessarily reflect citation order of authors.
Published Version
https://doi.org/10.1016/j.canep.2016.01.012Metadata
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Præstegaard, Camilla, Susanne K. Kjaer, Thor S.S. Nielsen, Signe M. Jensen, Penelope M. Webb, Christina M. Nagle, Estrid Høgdall, et al. 2016. “The Association Between Socioeconomic Status and Tumour Stage at Diagnosis of Ovarian Cancer: A Pooled Analysis of 18 Case-Control Studies.” Cancer Epidemiology 41 (April): 71–79. doi:10.1016/j.canep.2016.01.012.Abstract
PURPOSE:Socioeconomic 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.
METHODS:
From 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.
RESULTS:
Overall, 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.
CONCLUSION:
Lower 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.
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993452/Terms of Use
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http://nrs.harvard.edu/urn-3:HUL.InstRepos:33464191
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