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

Camilla Præstegaard; Susanne K Kjaer; Thor S.S Nielsen; Signe M Jensen; Penelope M Webb; Christina M Nagle; Estrid Høgdall; Harvey A Risch; Mary Anne Rossing; Jennifer A Doherty; Kristine G Wicklund; Marc T Goodman; Francesmary Modugno; Kirsten Moysich; Roberta B Ness; Robert P Edwards; Ellen L Goode; Stacey J Winham; Brooke L Fridley; Daniel W Cramer; Kathryn L Terry; Joellen M Schildkraut; Andrew Berchuck; Elisa V Bandera; Lisa Paddock; Lambertus A Kiemeney; Leon F Massuger; Nicolas Wentzensen; Paul Pharoah; Honglin Song; Alice S Whittemore; Valerie McGuire; Weiva Sieh; Joseph Rothstein; Hoda Anton-Culver; Argyrios Ziogas; Usha Menon; Simon A Gayther; Susan J Ramus; Aleksandra Gentry-Maharaj; Anna H Wu; Celeste L Pearce; Malcolm C Pike; Alice W Lee; Jenny Chang-Claude; Allan Jensen; Ovarian Cancer Association Consortium

doi:10.1016/j.canep.2016.01.012

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

Journal article

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

Camilla Præstegaard, Susanne K Kjaer, Thor S.S Nielsen, Signe M Jensen, Penelope M Webb, Christina M Nagle, Estrid Høgdall, Harvey A Risch, Mary Anne Rossing, Jennifer A Doherty, …

Cancer epidemiology, Vol.41, pp.71-79

04/2016

DOI: https://doi.org/10.1016/j.canep.2016.01.012

PMCID: PMC4993452

PMID: 26851750

Abstract

Epidemiology

Ovarian cancer

Pooled analysis

Socioeconomic status

Tumour stage

•The association between socioeconomic status (level of education) and tumour stage at diagnosis of ovarian cancer was investigated.•Data were obtained from 18 case-control studies that provided individual level measures of level of education.•Lower level of education was associated with an increased risk of advanced tumour stage at diagnosis.•The results persisted when taking BMI and smoking status into account.•The results calls for further studies on how to reduce this diagnostic delay. 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. 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. 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. 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.

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Title: The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer: A pooled analysis of 18 case-control studies
Creators: Camilla Præstegaard - Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
Susanne K Kjaer - Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
Thor S.S Nielsen - Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
Signe M Jensen - Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
Penelope M Webb - Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, Queensland 4006, Brisbane, Australia
Christina M Nagle - Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, Queensland 4006, Brisbane, Australia
Estrid Høgdall - Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
Harvey A Risch - Department of Chronic Disease Epidemiology, Yale School of Public Health, LEPH 413, 60 College Street, New Haven, CT 06510, USA
Mary Anne Rossing - Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, PO Box 19024, Seattle, WA 98109-1024, USA
Jennifer A Doherty - Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, Geisel School of Medicine, Dartmouth College, 1 Medical Center Drive, 7927 Rubin Building, Room 884, Lebanon, Hanover, NH 03756, USA
Kristine G Wicklund - Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, PO Box 19024, Seattle, WA 98109-1024, USA
Marc T Goodman - Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Room 1S37, Los Angeles 90048, CA, USA
Francesmary Modugno - Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, University of Pittsburgh School of Medicine, Magee-Womens Hospital, 300 Halket Street (Room #2130), Pittsburgh, PA 15222, USA
Kirsten Moysich - Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA
Roberta B Ness - The University of Texas, School of Public Health, P.O. Box 20186, Houston, TX 77225, USA
Robert P Edwards - Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, 300 Halket Street (Room #2130), Pittsburgh, PA 15222, USA
Ellen L Goode - Department of Health Science Research, Division of Epidemiology, Mayo Clinic, 200 First Street SW, Charlton 6, Rochester, MN, USA
Stacey J Winham - Department of Biostatistics, University of Kansas, 5028B Robinson Building, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
Brooke L Fridley - Department of Biostatistics, University of Kansas, 5028B Robinson Building, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
Daniel W Cramer - Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, 221 Longwood Avenue, RFB 368, Boston, MA 02115, USA
Kathryn L Terry - Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, 221 Longwood Avenue, RFB 368, Boston, MA 02115, USA
Joellen M Schildkraut - Department of Public Health Sciences, School of Medicine, University of Virginia, Box: 800717, Charlottesville, VA 22908, USA
Andrew Berchuck - Department of Obstetrics and Gynecology, Duke University Medical Center, 3079, Durham, NC 27710, USA
Elisa V Bandera - Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, Room 5568, New Brunswick, NJ 08903, USA
Lisa Paddock - New Jersey State Cancer registry, PO Box 369, Trenton, NJ 08625-0369, USA
Lambertus A Kiemeney - Department for Health Evidence, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
Leon F Massuger - Department of Obstetrics and Gynaecology, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
Nicolas Wentzensen - Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Rockville, MD 20852, USA
Paul Pharoah - Department of Oncology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Wortscauseway, Cambridge, CB1 8RN, United Kingdom
Honglin Song - Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Wortscauseway, Cambridge, CB1 8RN, United Kingdom
Alice S Whittemore - Department of Health Research and Policy—Epidemiology, Stanford University School of Medicine, 259 Campus Drive, Stanford, CA 94305-5405, USA
Valerie McGuire - Department of Health Research and Policy—Epidemiology, Stanford University School of Medicine, 259 Campus Drive, Stanford, CA 94305-5405, USA
Weiva Sieh - Department of Health Research and Policy—Epidemiology, Stanford University School of Medicine, 259 Campus Drive, Stanford, CA 94305-5405, USA
Joseph Rothstein - Department of Health Research and Policy—Epidemiology, Stanford University School of Medicine, 259 Campus Drive, Stanford, CA 94305-5405, USA
Hoda Anton-Culver - Department of Epidemiology, University of California Irvine, Center for Cancer Genetics Research & Prevention, School of Medicine, 224 Irvine Hall, Irvine, CA 92697-7550, USA
Argyrios Ziogas - Department of Epidemiology, University of California Irvine, 224 Irvine Hall, Irvine, CA 92697-7550, USA
Usha Menon - Women’s Cancer, UCL EGA Institute for Women’s Health, Maple House 1st Floor, 149 Tottenham Court Road, London W1T 7DN, United Kingdom
Simon A Gayther - Women’s Cancer, UCL EGA Institute for Women’s Health, Maple House 1st Floor, 149 Tottenham Court Road, London W1T 7DN, United Kingdom
Susan J Ramus - Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Harlyne Norris Research Tower 1450 Biggy Street, Office 2517G, Los Angeles, CA 90033, USA
Aleksandra Gentry-Maharaj - Women’s Cancer, UCL EGA Institute for Women’s Health, Maple House 1st Floor, 149 Tottenham Court Road, London W1T 7DN, United Kingdom
Anna H Wu - Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Harlyne Norris Research Tower 1450 Biggy Street, Office 2517G, Los Angeles, CA 90033, USA
Celeste L Pearce - Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Harlyne Norris Research Tower 1450 Biggy Street, Office 2517G, Los Angeles, CA 90033, USA
Malcolm C Pike - Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Harlyne Norris Research Tower 1450 Biggy Street, Office 2517G, Los Angeles, CA 90033, USA
Alice W Lee - Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Harlyne Norris Research Tower 1450 Biggy Street, Office 2517G, Los Angeles, CA 90033, USA
Jenny Chang-Claude - German Cancer Research Center, Division of Cancer Epidemiology, Postfach 101949, 69009 Heidelberg, Germany
Allan Jensen - Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
Ovarian Cancer Association Consortium
Publication Details: Cancer epidemiology, Vol.41, pp.71-79
Date published: 04/2016
Publisher: Elsevier Ltd
Academic Unit: Cancer Epidemiology and Health Outcomes
Language: English
Resource Type: Journal article
Identifiers: 991031665685204646