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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 71-79 |
| Number of pages | 9 |
| Journal | Cancer Epidemiology |
| Volume | 41 |
| DOIs | |
| State | Published - Apr 1 2016 |
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Keywords
- Epidemiology
- Ovarian cancer
- Pooled analysis
- Socioeconomic status
- Tumour stage
ASJC Scopus subject areas
- Cancer Research
- Oncology
- Epidemiology
Cite this
The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer : A pooled analysis of 18 case-control studies. / On behalf of the Australian Ovarian Cancer Study Group; on behalf of the Ovarian Cancer Association Consortium.
In: Cancer Epidemiology, Vol. 41, 01.04.2016, p. 71-79.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer
T2 - A pooled analysis of 18 case-control studies
AU - On behalf of the Australian Ovarian Cancer Study Group
AU - on behalf of the Ovarian Cancer Association Consortium
AU - Præstegaard, Camilla
AU - Kjaer, Susanne K.
AU - Nielsen, Thor S S
AU - Jensen, Signe M.
AU - Webb, Penelope M.
AU - Nagle, Christina M.
AU - Høgdall, Estrid
AU - Risch, Harvey A.
AU - Rossing, Mary Anne
AU - Doherty, Jennifer A.
AU - Wicklund, Kristine G.
AU - Goodman, Marc T.
AU - Modugno, Francesmary
AU - Moysich, Kirsten
AU - Ness, Roberta B.
AU - Edwards, Robert P.
AU - Goode, Ellen L
AU - Winham, Stacey J
AU - Fridley, Brooke L.
AU - Cramer, Daniel W.
AU - Terry, Kathryn L.
AU - Schildkraut, Joellen M.
AU - Berchuck, Andrew
AU - Bandera, Elisa V.
AU - Paddock, Lisa
AU - Kiemeney, Lambertus A.
AU - Massuger, Leon F.
AU - Wentzensen, Nicolas
AU - Pharoah, Paul
AU - Song, Honglin
AU - Whittemore, Alice S.
AU - McGuire, Valerie
AU - Sieh, Weiva
AU - Rothstein, Joseph
AU - Anton-Culver, Hoda
AU - Ziogas, Argyrios
AU - Menon, Usha
AU - Gayther, Simon A.
AU - Ramus, Susan J.
AU - Gentry-Maharaj, Aleksandra
AU - Wu, Anna H.
AU - Pearce, Celeste L.
AU - Pike, Malcolm C.
AU - Lee, Alice W.
AU - Chang-Claude, Jenny
AU - Jensen, Allan
PY - 2016/4/1
Y1 - 2016/4/1
N2 - 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.
AB - 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.
KW - Epidemiology
KW - Ovarian cancer
KW - Pooled analysis
KW - Socioeconomic status
KW - Tumour stage
UR - http://www.scopus.com/inward/record.url?scp=84961267068&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84961267068&partnerID=8YFLogxK
U2 - 10.1016/j.canep.2016.01.012
DO - 10.1016/j.canep.2016.01.012
M3 - Article
C2 - 26851750
AN - SCOPUS:84961267068
VL - 41
SP - 71
EP - 79
JO - Cancer Epidemiology
JF - Cancer Epidemiology
SN - 1877-7821
ER -