No association between educational level and pancreatic cancer incidence in the European Prospective Investigation into Cancer and Nutrition

被引:12
作者
van Boeckel, Petra G. A. [1 ,2 ]
Boshuizen, Hendriek C. [2 ]
Siersema, Peter D. [1 ]
Vrieling, Alina [2 ]
Kunst, Anton E. [3 ]
Ye, Weimin [4 ]
Sund, Malin [4 ]
Michaud, Dominique S. [5 ]
Gallo, Valentina [5 ]
Spencer, Elizabeth A. [6 ]
Trichopoulou, Antonia [7 ]
Benetou, Vasiliki [7 ]
Orfanos, Philippos [8 ]
Cirera, Lluis [8 ]
Duell, Eric J. [9 ]
Rohrmann, Sabine [10 ]
Hemann, Silke [10 ]
Masala, Giovanni [11 ]
Manjer, Jonas [12 ]
Mattiello, Amalia [13 ]
Lindkvist, Bjorn [14 ]
Sanchez, Maria-Jose [9 ,15 ]
Pala, Valeria [16 ]
Peeters, Petra H. M. [17 ]
Braaten, Tonje [18 ]
Tjonneland, Anne [19 ]
Dalton, Susanne Oksbjerg [19 ]
Larranaga, Nerea
Dorronsoro, Miren
Overvad, Kim [20 ]
Illner, Anne-Kathrin [21 ]
Ardanaz, Eva [22 ]
Marron, M. [23 ]
Straif, K. [23 ]
Riboli, E. [5 ]
Bueno-de-Mesquita, B. [1 ,2 ]
机构
[1] Univ Med Ctr Utrecht, Dept Gastroenterol & Hepatol, NL-3584 CX Utrecht, Netherlands
[2] Natl Inst Publ Hlth & Environm RIVM, Bilthoven, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Dept Publ Hlth, NL-1105 AZ Amsterdam, Netherlands
[4] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden
[5] Univ London Imperial Coll Sci Technol & Med, Div Epidemiol Publ Hlth & Primary Care, London, England
[6] Univ Oxford, Canc Epidemiol Unit, Oxford, England
[7] Univ Athens, Sch Med, WHO Collaborating Ctr Food & Nutr Policies, Dept Hyg Epidemiol & Med Stat, GR-10679 Athens, Greece
[8] Murcia Reg Hlth Authority, Dept Epidemiol, Murcia, Spain
[9] Catalan Inst Oncol, Unit Nutr Environm & Canc, Barcelona, Spain
[10] German Canc Res Ctr, Div Canc Epidemiol, D-6900 Heidelberg, Germany
[11] Canc Res & Prevent Inst ISPO, Mol & Nutr Epidemiol Unit, Florence, Italy
[12] Lund Univ, Malmo Univ Hosp, Dept Surg, Malmo, Sweden
[13] Univ Naples Federico II, Dept Clin & Expt Med, Naples, Italy
[14] Sahlgrens Univ Hosp, Dept Med, Gothenburg, Sweden
[15] Andalusian Sch Publ Hlth, Granada, Spain
[16] Fdn IRCCS, Inst Nazl Tumori, Nutr Epidemiol Unit, Dept Prevent & Predect Med, Milan, Italy
[17] UMC Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
[18] Univ Tromso, Inst Community Med, Tromso, Norway
[19] Danish Canc Soc, Inst Canc Epidemiol, Copenhagen, Denmark
[20] Aarhus Univ, Sch Publ Hlth, Dept Epidemiol, Aarhus, Denmark
[21] German Inst Human Nutr Potsdam Rehbrucke, Dept Epidemiol, Nuthetal, Germany
[22] Publ Healt Inst Navarra, Paploma, Spain
[23] Int Agcy Res Canc, Lifestyle & Canc Grp, F-69372 Lyon, France
基金
英国医学研究理事会; 英国惠康基金;
关键词
Pancreatic cancer incidence; Epidemiology; Socioeconomic status; Educational level; SOCIOECONOMIC-STATUS; PHYSICAL-ACTIVITY; RISK-FACTORS; COHORT; DETERMINANTS; INEQUALITIES; POPULATIONS; MORTALITY; SURVIVAL; STOMACH;
D O I
10.1016/j.canep.2010.08.004
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction: Until now, studies examining the relationship between socioeconomic status and pancreatic cancer incidence have been inconclusive. Aim: To prospectively investigate to what extent pancreatic cancer incidence varies according to educational level within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: In the EPIC study, socioeconomic status at baseline was measured using the highest level of education attained. Hazard ratios by educational level and a summary index, the relative indices of inequality (Rh), were estimated using Cox regression models stratified by age, gender, and center and adjusted for known risk factors. In addition, we conducted separate analyses by age, gender and geographical region. Results: Within the source population of 407, 944 individuals at baseline, 490 first incident primary pancreatic adenocarcinoma cases were identified in 9 European countries. The crude difference in risk of pancreatic cancer according to level of education was small and not statistically significant (RII = 1.14, 95% CI 0.80-1.62). Adjustment for known risk factors reduced the inequality estimates to only a small extent. In addition, no statistically significant associations were observed for age groups (adjusted RII <= (60) (years) = 0.85, 95% CI 0.44-1.64, adjusted RII> 60 years = 1.18, 95% CI 0.73-1.90), gender (adjusted RIImale = 1.20, 95% CI 0.68-2.10, adjusted RIIfemale = 0.96, 95% CI 0.56-1.62) or geographical region (adjusted RIINorthern Europe = 1.14, 95% CI 0.81-1.61, adjusted RIIMiddle (Europe) = 1.72, 95% CI 0.93-3.19, adjusted RIISouthern Europe = 0.75, 95% CI 0.32-1.80). Conclusion: Despite large educational inequalities in many risk factors within the EPIC study, we found no evidence for an association between educational level and the risk of developing pancreatic cancer in this European cohort. (C) 2010 Elsevier Ltd. All rights reserved.
引用
收藏
页码:696 / 701
页数:6
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