The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer: a pooled analysis of 18 case-control studies

Details

• Alternative Title:
  Cancer Epidemiol
• Personal Author:
  Præstegaard, Camilla ; Kjaer, Susanne K. ; Nielsen, Thor S.S. ; Jensen, Signe M. ; Webb, Penelope M. ; Nagle, Christina M. ; Høgdall, Estrid ; Risch, Harvey A. ; Rossing, Mary Anne ; Doherty, Jennifer A. ; Wicklund, Kristine G. ; Goodman, Marc T. ; Modugno, Francesmary ; Moysich, Kirsten ; Ness, Roberta B. ; Edwards, Robert P. ; Goode, Ellen L. ; Winham, Stacey J. ; Fridley, Brooke L. ; Cramer, Daniel W. ; Terry, Kathryn L. ; Schildkraut, Joellen M. ; Berchuck, Andrew ; Bandera, Elisa V. ; Paddock, Lisa ; Kiemeney, Lambertus A. ; Massuger, Leon F. ; Wentzensen, Nicolas ; Pharoah, Paul ; Song, Honglin ; Whittemore, Alice S. ; McGuire, Valerie ; Sieh, Weiva ; Rothstein, Joseph ; Anton-Culver, Hoda ; Ziogas, Argyrios ; Menon, Usha ; Gayther, Simon A. ; Ramus, Susan J. ; Gentry-Maharaj, Aleksandra ; Wu, Anna H. ; Pearce, Celeste L. ; Pike, Malcolm C. ; Lee, Alice W. ; Chang-Claude, Jenny ; Jensen, Allan
• Corporate Authors:
  on behalf of the Australian Ovarian Cancer Study Group ; on behalf of the Ovarian Cancer Association Consortium
• Description:
  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.
  
  
• Subjects:
  Aged Case-Control Studies Delayed Diagnosis Female Humans Logistic Models Middle Aged Neoplasms, Glandular And Epithelial Odds Ratio Ovarian Neoplasms Social Class

  More +
• Source:
  Cancer Epidemiol. 41:71-79.
• Pubmed ID:
  26851750
• Pubmed Central ID:
  PMC4993452
• Document Type:
  Journal Article
• Funding:
  U58 DP003931/DP/NCCDPHP CDC HHS/United States ; R01 CA83918/CA/NCI NIH HHS/United States ; U01 CA069417/CA/NCI NIH HHS/United States ; N01 PC 67001/PC/NCI NIH HHS/United States ; N01 PC067010/PC/NCI NIH HHS/United States ; P50 CA159981/CA/NCI NIH HHS/United States ; P30 CA016056/CA/NCI NIH HHS/United States ; R01 CA087538/CA/NCI NIH HHS/United States ; U01 CA69417/CA/NCI NIH HHS/United States ; M01 RR000056/RR/NCRR NIH HHS/United States ; P30 CA072720/CA/NCI NIH HHS/United States ; R01 CA61107/CA/NCI NIH HHS/United States ; MO1-RR000056/RR/NCRR NIH HHS/United States ; R01 CA87538/CA/NCI NIH HHS/United States ; R03 CA113148/CA/NCI NIH HHS/United States ; R01 CA058598/CA/NCI NIH HHS/United States ; K22 CA138563/CA/NCI NIH HHS/United States ; R01 CA058860/CA/NCI NIH HHS/United States ; R01 CA61132/CA/NCI NIH HHS/United States ; R01 CA080742/CA/NCI NIH HHS/United States ; R01 CA76016/CA/NCI NIH HHS/United States ; R01 CA54419/CA/NCI NIH HHS/United States ; R01 CA074850/CA/NCI NIH HHS/United States ; K07 CA092044/CA/NCI NIH HHS/United States ; R01 CA16056/CA/NCI NIH HHS/United States ; P50 CA105009/CA/NCI NIH HHS/United States ; K07 CA080668/CA/NCI NIH HHS/United States ; P30 CA008748/CA/NCI NIH HHS/United States ; P30 CA014089/CA/NCI NIH HHS/United States ; R01 CA083918/CA/NCI NIH HHS/United States ; R03 CA115195/CA/NCI NIH HHS/United States ; N01CN55424/CN/NCI NIH HHS/United States ; R01 CA054419/CA/NCI NIH HHS/United States ; HHSN261201300021C/CA/NCI NIH HHS/United States ; R01 CA122443/CA/NCI NIH HHS/United States ; P30 CA015083/CA/NCI NIH HHS/United States ; R01 CA076016/CA/NCI NIH HHS/United States ; R01 CA092044/CA/NCI NIH HHS/United States ; K07 CA143047/CA/NCI NIH HHS/United States ; T32 ES013678/ES/NIEHS NIH HHS/United States ; P30 CA14089/CA/NCI NIH HHS/United States ; P01 CA017054/CA/NCI NIH HHS/United States ; N01 CN025403/CA/NCI NIH HHS/United States ; N01 PC67010/PC/NCI NIH HHS/United States ; 10119/Cancer Research UK/United Kingdom ; P30 CA15083/CA/NCI NIH HHS/United States ; R01 CA58598/CA/NCI NIH HHS/United States ; K07 CA095666/CA/NCI NIH HHS/United States ; R01 CA112523/CA/NCI NIH HHS/United States ; P50 CA136393/CA/NCI NIH HHS/United States ; U01 CA71966/CA/NCI NIH HHS/United States ; 10124/Cancer Research UK/United Kingdom
• Volume:
  41
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:559d348181d2b0f25bb671f2bc8334c50be0d38ec4ccfee5b2eb73c12ddea5dd
• Download URL:
  https://stacks.cdc.gov/view/cdc/42151/cdc_42151_DS1.pdf
• File Type:
  [PDF - 739.04 KB ]