Socioeconomic position and stage of cervical cancer in Danish women diagnosed 2005 to 2009

Else Ibfelt*, Susanne K. Kjær, Christoffer Johansen, Claus Høgdall, Marianne Steding-Jessen, Kirsten Frederiksen, Birgitte Lidegaard Frederiksen, Merete Osler, Susanne Oksbjerg Dalton

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstract

    Background: To reduce social disparities in cervical cancer survival, it is important to understand the mechanisms by which social position influence cancer prognosis. We investigated the relations between socioeconomic factors, comorbidity, time since last Papanicolau smear, and stage at diagnosis in Danish women with cervical cancer. Methods: We identified 1,651 cervical cancer cases diagnosed 2005 to 2009 from the Danish Gynaecological Cancer Database. Date of diagnosis, clinical cancer stage, tumor histology, and treating hospital were retrieved; Pap smear registrations were obtained from the Danish Pathology Register; data on comorbid conditions from the Danish National Patients Register; and data on education, income, and cohabitation from Statistics Denmark. Logistic regression models were used to analyze the relations between socioeconomic factors and cancer stage in a four-step model, with stepwise inclusion of mediators. Results: The risk for advanced (stage II-IV) compared with early-stage cancer (stage I) was increased for women with short and medium education (OR = 2.40; 1.67-3.45 and 1.76; 1.44-2.16), women living without a partner (OR=1.31; 1.10-1.55), and olderwomen (OR=1.07; 1.06-1.08 increase per year). The relations between socioeconomic factors and cancer stage were partly mediated by time since last Pap smear test and to a lesser extent by comorbidity. Conclusions: Shorter education, living alone, and older age were related to advanced stage cervical cancer, due partly to Pap smear testing and less to comorbidity. Impact: It is relevant to further investigate how to decrease delay in cervical cancer diagnosis among disadvantaged groups.

    OriginalsprogEngelsk
    Sider (fra-til)835-842
    Antal sider8
    TidsskriftCancer Epidemiology Biomarkers and Prevention
    Vol/bind21
    Udgave nummer5
    DOI
    StatusUdgivet - 1 maj 2012

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