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Rigshospitalet - en del af Københavns Universitetshospital
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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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  • Camilla Præstegaard
  • Susanne K Kjaer
  • Thor S S Nielsen
  • Signe M Jensen
  • Penelope M Webb
  • Christina M Nagle
  • Estrid Vilma Solyom Høgdall
  • Harvey A Risch
  • Mary Anne Rossing
  • Jennifer A Doherty
  • Kristine G Wicklund
  • Marc T Goodman
  • Francesmary Modugno
  • Kirsten Moysich
  • Roberta B Ness
  • Robert P Edwards
  • Ellen L Goode
  • Stacey J Winham
  • Brooke L Fridley
  • Daniel W Cramer
  • Kathryn L Terry
  • Joellen M Schildkraut
  • Andrew Berchuck
  • Elisa V Bandera
  • Lisa Paddock
  • Lambertus A Kiemeney
  • Leon F Massuger
  • Nicolas Wentzensen
  • Paul Pharoah
  • Honglin Song
  • Alice S Whittemore
  • Valerie McGuire
  • Weiva Sieh
  • Joseph Rothstein
  • Hoda Anton-Culver
  • Argyrios Ziogas
  • Usha Menon
  • Simon A Gayther
  • Susan J Ramus
  • Aleksandra Gentry-Maharaj
  • Anna H Wu
  • Celeste L Pearce
  • Malcolm C Pike
  • Alice W Lee
  • Jenny Chang-Claude
  • Allan Jensen
  • Ovarian Cancer Association Consortium
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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.

OriginalsprogEngelsk
TidsskriftCancer epidemiology
Vol/bind41
Sider (fra-til)71-9
Antal sider9
ISSN1877-7821
DOI
StatusUdgivet - apr. 2016

ID: 49570160