Socioeconomic differences in cancer survival: The Norwegian Women and Cancer Study

<p>Abstract</p> <p>Background</p> <p>Cancer survival has been observed to be poorer in low socioeconomic groups, but the knowledge about the underlying causal factors is limited. The purpose of this study was to examine how cancer survival varies by socioeconomic status...

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Main Authors: Braaten Tonje, Weiderpass Elisabete, Lund Eiliv
Format: Article
Language:English
Published: BMC 2009-06-01
Series:BMC Public Health
Online Access:http://www.biomedcentral.com/1471-2458/9/178
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author Braaten Tonje
Weiderpass Elisabete
Lund Eiliv
author_facet Braaten Tonje
Weiderpass Elisabete
Lund Eiliv
author_sort Braaten Tonje
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Cancer survival has been observed to be poorer in low socioeconomic groups, but the knowledge about the underlying causal factors is limited. The purpose of this study was to examine how cancer survival varies by socioeconomic status (SES) among women in Norway, and to identify factors that explain this variation. SES was measured by years of education and gross household income, respectively.</p> <p>Methods</p> <p>We used data from The Norwegian Women and Cancer Study, a prospective cohort study including 91 814 women who responded to an extensive questionnaire between 1996 and 1998. A total of 3 899 incident cancer cases were diagnosed during follow-up, of whom 1 089 women died, 919 of them from cancer. Cox Proportional Hazards Model was used to calculate relative risks (RR) of mortality and 95% confidence intervals.</p> <p>Results</p> <p>We observed an overall negative socioeconomic gradient in cancer survival, which was most evident in the site specific analyses for survival of ovarian cancer by years of education. For colorectal cancer, mortality increased with years of education, but not with income. After adjustment for household size, marital status, disease stage, and smoking status the SES variation in cancer survival became non-significant. We found that the unequal socioeconomic distribution of smoking status prior to diagnosis contributed considerably to the poorer survival in low SES groups.</p> <p>Conclusion</p> <p>We found an overall negative socioeconomic gradient in cancer survival when SES is measured as years of education or gross household income. Smoking status prior to diagnosis was an important predictive factor for socioeconomic variation in survival.</p>
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spelling doaj.art-e418385b0bd6471199ea6cb5229477782022-12-22T03:29:10ZengBMCBMC Public Health1471-24582009-06-019117810.1186/1471-2458-9-178Socioeconomic differences in cancer survival: The Norwegian Women and Cancer StudyBraaten TonjeWeiderpass ElisabeteLund Eiliv<p>Abstract</p> <p>Background</p> <p>Cancer survival has been observed to be poorer in low socioeconomic groups, but the knowledge about the underlying causal factors is limited. The purpose of this study was to examine how cancer survival varies by socioeconomic status (SES) among women in Norway, and to identify factors that explain this variation. SES was measured by years of education and gross household income, respectively.</p> <p>Methods</p> <p>We used data from The Norwegian Women and Cancer Study, a prospective cohort study including 91 814 women who responded to an extensive questionnaire between 1996 and 1998. A total of 3 899 incident cancer cases were diagnosed during follow-up, of whom 1 089 women died, 919 of them from cancer. Cox Proportional Hazards Model was used to calculate relative risks (RR) of mortality and 95% confidence intervals.</p> <p>Results</p> <p>We observed an overall negative socioeconomic gradient in cancer survival, which was most evident in the site specific analyses for survival of ovarian cancer by years of education. For colorectal cancer, mortality increased with years of education, but not with income. After adjustment for household size, marital status, disease stage, and smoking status the SES variation in cancer survival became non-significant. We found that the unequal socioeconomic distribution of smoking status prior to diagnosis contributed considerably to the poorer survival in low SES groups.</p> <p>Conclusion</p> <p>We found an overall negative socioeconomic gradient in cancer survival when SES is measured as years of education or gross household income. Smoking status prior to diagnosis was an important predictive factor for socioeconomic variation in survival.</p>http://www.biomedcentral.com/1471-2458/9/178
spellingShingle Braaten Tonje
Weiderpass Elisabete
Lund Eiliv
Socioeconomic differences in cancer survival: The Norwegian Women and Cancer Study
BMC Public Health
title Socioeconomic differences in cancer survival: The Norwegian Women and Cancer Study
title_full Socioeconomic differences in cancer survival: The Norwegian Women and Cancer Study
title_fullStr Socioeconomic differences in cancer survival: The Norwegian Women and Cancer Study
title_full_unstemmed Socioeconomic differences in cancer survival: The Norwegian Women and Cancer Study
title_short Socioeconomic differences in cancer survival: The Norwegian Women and Cancer Study
title_sort socioeconomic differences in cancer survival the norwegian women and cancer study
url http://www.biomedcentral.com/1471-2458/9/178
work_keys_str_mv AT braatentonje socioeconomicdifferencesincancersurvivalthenorwegianwomenandcancerstudy
AT weiderpasselisabete socioeconomicdifferencesincancersurvivalthenorwegianwomenandcancerstudy
AT lundeiliv socioeconomicdifferencesincancersurvivalthenorwegianwomenandcancerstudy