TY - JOUR
T1 - No association between educational level and pancreatic cancer incidence in the European Prospective Investigation into Cancer and Nutrition
AU - van Boeckel, Petra G.A.
AU - Boshuizen, Hendriek C.
AU - Siersema, Peter D.
AU - Vrieling, Alina
AU - Kunst, Anton E.
AU - Ye, Weimin
AU - Sund, Malin
AU - Michaud, Dominique S.
AU - Gallo, Valentina
AU - Spencer, Elizabeth A.
AU - Trichopoulou, Antonia
AU - Benetou, Vasiliki
AU - Orfanos, Philippos
AU - Cirera, Lluis
AU - Duell, Eric J.
AU - Rohrmann, Sabine
AU - Hemann, Silke
AU - Masala, Giovanni
AU - Manjer, Jonas
AU - Mattiello, Amalia
AU - Lindkvist, Bjorn
AU - Sánchez, María José
AU - Pala, Valeria
AU - Peeters, Petra H.M.
AU - Braaten, Tonje
AU - Tjonneland, Anne
AU - Dalton, Susanne Oksbjerg
AU - Larranaga, Nerea
AU - Dorronsoro, Miren
AU - Overvad, Kim
AU - Illner, Anne Kathrin
AU - Ardanaz, Eva
AU - Marron, M.
AU - Straif, K.
AU - Riboli, E.
AU - Bueno-de-Mesquita, B.
PY - 2010/12/1
Y1 - 2010/12/1
N2 - 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 (RII), 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.
AB - 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 (RII), 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.
KW - Educational level
KW - Epidemiology
KW - Pancreatic cancer incidence
KW - Socioeconomic status
UR - http://www.scopus.com/inward/record.url?scp=78650170684&partnerID=8YFLogxK
U2 - 10.1016/j.canep.2010.08.004
DO - 10.1016/j.canep.2010.08.004
M3 - Article
C2 - 20829145
AN - SCOPUS:78650170684
SN - 1877-7821
VL - 34
SP - 696
EP - 701
JO - Cancer Epidemiology
JF - Cancer Epidemiology
IS - 6
ER -