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

Research output: Contribution to journalArticle

8 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)71-79
Number of pages9
JournalCancer Epidemiology
Volume41
DOIs
StatePublished - Apr 1 2016

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Social Class
Ovarian Neoplasms
Case-Control Studies
Neoplasms
Odds Ratio
Body Mass Index
Logistic Models
Smoking
Confidence Intervals
Education
Survival

Keywords

  • Epidemiology
  • Ovarian cancer
  • Pooled analysis
  • Socioeconomic status
  • Tumour stage

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Epidemiology

Cite this

On behalf of the Australian Ovarian Cancer Study Group, & on behalf of the Ovarian Cancer Association Consortium (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, 71-79. https://doi.org/10.1016/j.canep.2016.01.012

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 journalArticle

On behalf of the Australian Ovarian Cancer Study Group & on behalf of the Ovarian Cancer Association Consortium 2016, 'The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer: A pooled analysis of 18 case-control studies', Cancer Epidemiology, vol. 41, pp. 71-79. https://doi.org/10.1016/j.canep.2016.01.012
On behalf of the Australian Ovarian Cancer Study Group, on behalf of the Ovarian Cancer Association Consortium. The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer: A pooled analysis of 18 case-control studies. Cancer Epidemiology. 2016 Apr 1;41:71-79. https://doi.org/10.1016/j.canep.2016.01.012
On behalf of the Australian Ovarian Cancer Study Group ; on behalf of the Ovarian Cancer Association Consortium. / The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer : A pooled analysis of 18 case-control studies. In: Cancer Epidemiology. 2016 ; Vol. 41. pp. 71-79.
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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.",
keywords = "Epidemiology, Ovarian cancer, Pooled analysis, Socioeconomic status, Tumour stage",
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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

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