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Socioeconomic Effect of Education on Pancreatic Cancer Risk in Western Europe : An Update on the EPIC Cohorts Study

Cirera, Lluís ; Huerta, José María ; Chirlaque, María Dolores ; Overvad, Kim ; Lindström, Martin LU ; Regnér, Sara LU orcid ; Tjønneland, Anne ; Boutron-Ruault, Marie-Christine ; Rebours, Vinciane and Fagherazzi, Guy , et al. (2019) In Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 28(6). p.1089-1092
Abstract

BACKGROUND: To analyze the potential effect of social inequality on pancreatic cancer risk in Western Europe, by reassessing the association within the European Prospective Investigation into Cancer and Nutrition (EPIC) Study, including a larger number of cases and an extended follow-up.

METHODS: Data on highest education attained were gathered for 459,170 participants (70% women) from 10 European countries. A relative index of inequality (RII) based on adult education was calculated for comparability across countries and generations. Cox regression models were applied to estimate relative inequality in pancreatic cancer risk, stratifying by age, gender, and center, and adjusting for known pancreatic cancer risk... (More)

BACKGROUND: To analyze the potential effect of social inequality on pancreatic cancer risk in Western Europe, by reassessing the association within the European Prospective Investigation into Cancer and Nutrition (EPIC) Study, including a larger number of cases and an extended follow-up.

METHODS: Data on highest education attained were gathered for 459,170 participants (70% women) from 10 European countries. A relative index of inequality (RII) based on adult education was calculated for comparability across countries and generations. Cox regression models were applied to estimate relative inequality in pancreatic cancer risk, stratifying by age, gender, and center, and adjusting for known pancreatic cancer risk factors.

RESULTS: A total of 1,223 incident pancreatic cancer cases were included after a mean follow-up of 13.9 (±4.0) years. An inverse social trend was found in models adjusted for age, sex, and center for both sexes [HR of RII, 1.27; 95% confidence interval (CI), 1.02-1.59], which was also significant among women (HR, 1.42; 95% CI, 1.05-1.92). Further adjusting by smoking intensity, alcohol consumption, body mass index, prevalent diabetes, and physical activity led to an attenuation of the RII risk and loss of statistical significance.

CONCLUSIONS: The present reanalysis does not sustain the existence of an independent social inequality influence on pancreatic cancer risk in Western European women and men, using an index based on adult education, the most relevant social indicator linked to individual lifestyles, in a context of very low pancreatic cancer survival from (quasi) universal public health systems.

IMPACT: The results do not support an association between education and risk of pancreatic cancer.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
volume
28
issue
6
pages
4 pages
publisher
American Association for Cancer Research
external identifiers
  • pmid:31160392
  • scopus:85067195833
ISSN
1538-7755
DOI
10.1158/1055-9965.EPI-18-1153
language
English
LU publication?
yes
additional info
©2019 American Association for Cancer Research.
id
d2d328b8-43e7-4d5c-9861-0e28618e1e8a
date added to LUP
2019-06-24 09:15:48
date last changed
2024-04-16 13:04:49
@article{d2d328b8-43e7-4d5c-9861-0e28618e1e8a,
  abstract     = {{<p>BACKGROUND: To analyze the potential effect of social inequality on pancreatic cancer risk in Western Europe, by reassessing the association within the European Prospective Investigation into Cancer and Nutrition (EPIC) Study, including a larger number of cases and an extended follow-up.</p><p>METHODS: Data on highest education attained were gathered for 459,170 participants (70% women) from 10 European countries. A relative index of inequality (RII) based on adult education was calculated for comparability across countries and generations. Cox regression models were applied to estimate relative inequality in pancreatic cancer risk, stratifying by age, gender, and center, and adjusting for known pancreatic cancer risk factors.</p><p>RESULTS: A total of 1,223 incident pancreatic cancer cases were included after a mean follow-up of 13.9 (±4.0) years. An inverse social trend was found in models adjusted for age, sex, and center for both sexes [HR of RII, 1.27; 95% confidence interval (CI), 1.02-1.59], which was also significant among women (HR, 1.42; 95% CI, 1.05-1.92). Further adjusting by smoking intensity, alcohol consumption, body mass index, prevalent diabetes, and physical activity led to an attenuation of the RII risk and loss of statistical significance.</p><p>CONCLUSIONS: The present reanalysis does not sustain the existence of an independent social inequality influence on pancreatic cancer risk in Western European women and men, using an index based on adult education, the most relevant social indicator linked to individual lifestyles, in a context of very low pancreatic cancer survival from (quasi) universal public health systems.</p><p>IMPACT: The results do not support an association between education and risk of pancreatic cancer.</p>}},
  author       = {{Cirera, Lluís and Huerta, José María and Chirlaque, María Dolores and Overvad, Kim and Lindström, Martin and Regnér, Sara and Tjønneland, Anne and Boutron-Ruault, Marie-Christine and Rebours, Vinciane and Fagherazzi, Guy and Katzke, Verena A and Boeing, Heiner and Peppa, Eleni and Trichopoulou, Antonia and Valanou, Elissavet and Palli, Domenico and Grioni, Sara and Panico, Salvatore and Tumino, Rosario and Ricceri, Fulvio and van Gils, Carla and Vermeulen, Roel C H and Skeie, Guri and Braaten, Tonje and Weiderpass, Elisabete and Merino, Susana and Sánchez, María José and Larrañaga, Nerea and Ardanaz, Eva and Sund, Malin and Khaw, Kay-Tee and Key, Timothy J and Jenab, Mazda and Naudin, Sabine and Murphy, Neil and Aune, Dagfinn and Ward, Heather and Riboli, Elio and Bueno-de-Mesquita, Bas and Navarro, Carmen and Duell, Eric J}},
  issn         = {{1538-7755}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1089--1092}},
  publisher    = {{American Association for Cancer Research}},
  series       = {{Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology}},
  title        = {{Socioeconomic Effect of Education on Pancreatic Cancer Risk in Western Europe : An Update on the EPIC Cohorts Study}},
  url          = {{http://dx.doi.org/10.1158/1055-9965.EPI-18-1153}},
  doi          = {{10.1158/1055-9965.EPI-18-1153}},
  volume       = {{28}},
  year         = {{2019}},
}