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


Authors: Præstegaard, C.; Kjaer, S. K.; Nielsen, T. S. S.; Jensen, S. M.; Webb, P. M.; on behalf of the Australian Ovarian Cancer Study Group; Nagle, C. M.; Høgdall, E.; Risch, H. A.; Rossing, M. A.; Doherty, J. A.; Wicklund, K. G.; Goodman, M. T.; Modugno, F.; Moysich, K.; Ness, R. B.; Edwards, R. P.; Goode, E. L.; Winham, S. J.; Fridley, B. L.; Cramer, D. W.; Terry, K. L.; Schildkraut, J. M.; Berchuck, A.; Bandera, E. V.; Paddock, L.; Kiemeney, L. A.; Massuger, L. F.; Wentzensen, N.; Pharoah, P.; Song, H.; Whittemore, A. S.; McGuire, V.; Sieh, W.; Rothstein, J.; Anton-Culver, H.; Ziogas, A.; Menon, U.; Gayther, S. A.; Ramus, S. J.; Gentry-Maharaj, A.; Wu, A. H.; Pearce, C. L.; Pike, M. C.; Lee, A. W.; Chang-Claude, J.; Jensen, A.; on behalf of the Ovarian Cancer Association Consortium
Article Title: The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer: A pooled analysis of 18 case-control studies
Abstract: 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. © 2016 Elsevier Ltd.
Keywords: ovarian cancer; epidemiology; pooled analysis; socioeconomic status; tumour stage
Journal Title: Cancer Epidemiology
Volume: 41
ISSN: 1877-7821
Publisher: Elsevier Inc.  
Date Published: 2016-04-01
Start Page: 71
End Page: 79
Language: English
DOI: 10.1016/j.canep.2016.01.012
PROVIDER: scopus
PUBMED: 26851750
PMCID: PMC4993452
DOI/URL:
Notes: Article -- Export Date: 4 April 2016 -- Source: Scopus
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  1. Malcolm Pike
    167 Pike