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

van Boeckel, Petra G. A.; Boshuizen, Hendriek C.; Siersema, Peter D.; Vrieling, Alina; Kunst, Anton E.; Ye, Weimin; Sund, Malin; Michaud, Dominique S.; Gallo, Valentina and Spencer, Elizabeth A., et al. (2010) In Cancer Epidemiology2009-01-01+01:00 34(6). p.696-701
Abstract
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... (More)
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. (Less)
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@article{9df20c37-52b4-4ec0-a461-971a88275525,
  abstract     = {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 &lt;= (60) (years) = 0.85, 95% CI 0.44-1.64, adjusted RII&gt; 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.},
  author       = {van Boeckel, Petra G. A. and Boshuizen, Hendriek C. and Siersema, Peter D. and Vrieling, Alina and Kunst, Anton E. and Ye, Weimin and Sund, Malin and Michaud, Dominique S. and Gallo, Valentina and Spencer, Elizabeth A. and Trichopoulou, Antonia and Benetou, Vasiliki and Orfanos, Philippos and Cirera, Lluis and Duell, Eric J. and Rohrmann, Sabine and Hemann, Silke and Masala, Giovanni and Manjer, Jonas and Mattiello, Amalia and Lindkvist, Bjorn and Sanchez, Maria-Jose and Pala, Valeria and Peeters, Petra H. M. and Braaten, Tonje and Tjonneland, Anne and Dalton, Susanne Oksbjerg and Larranaga, Nerea and Dorronsoro, Miren and Overvad, Kim and Illner, Anne-Kathrin and Ardanaz, Eva and Marron, M. and Straif, K. and Riboli, E. and Bueno-de-Mesquita, B.},
  issn         = {1877-7821},
  keyword      = {Educational level,Socioeconomic status,Epidemiology,Pancreatic cancer incidence},
  language     = {eng},
  number       = {6},
  pages        = {696--701},
  publisher    = {Elsevier},
  series       = {Cancer Epidemiology2009-01-01+01:00},
  title        = {No association between educational level and pancreatic cancer incidence in the European Prospective Investigation into Cancer and Nutrition},
  url          = {http://dx.doi.org/10.1016/j.canep.2010.08.004},
  volume       = {34},
  year         = {2010},
}