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 - Præstegaard, Camilla

AU - Kjær, Susanne Krüger

AU - Nielsen, Thor Schütt Svane

AU - Jensen, Signe Marie

AU - Webb, Penelope M.

AU - Nagle, Christina M

AU - Høgdall, Estrid Vilma Solyom

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

N1 - Copyright © 2016 Elsevier Ltd. All rights reserved.

PY - 2016/4

Y1 - 2016/4

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.

U2 - 10.1016/j.canep.2016.01.012

DO - 10.1016/j.canep.2016.01.012

M3 - Journal article

C2 - 26851750

VL - 41

SP - 71

EP - 79

JO - Cancer Epidemiology

JF - Cancer Epidemiology

SN - 1877-7821

ER -