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

Camilla Præstegaard; Susanne Krüger Kjær; Thor Schütt Svane Nielsen; Signe Marie Jensen; Penelope M. Webb; Christina M Nagle; Estrid Vilma Solyom 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

doi:10.1016/j.canep.2016.01.012

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

Camilla Præstegaard, Susanne Krüger Kjær, Thor Schütt Svane Nielsen, Signe Marie Jensen, Penelope M. Webb, Christina M Nagle, Estrid Vilma Solyom 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 CramerKathryn 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

Department of Clinical Medicine

13 Citations (Scopus)

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.

Original language	English
Journal	Cancer Epidemiology
Volume	41
Pages (from-to)	71-79
Number of pages	9
ISSN	1877-7821
DOIs	https://doi.org/10.1016/j.canep.2016.01.012
Publication status	Published - 1 Apr 2016

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Præstegaard, C., Kjær, S. K., Nielsen, T. S. S., Jensen, S. M., Webb, P. M., Nagle, C. M., Høgdall, E. V. S., 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., ... Jensen, A. (2016). The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer: a pooled analysis of 18 case-control studies. Cancer Epidemiology, 41, 71-79. https://doi.org/10.1016/j.canep.2016.01.012

Præstegaard, C, Kjær, SK, Nielsen, TSS, Jensen, SM, Webb, PM, Nagle, CM, Høgdall, EVS, Risch, HA, Rossing, MA, Doherty, JA, Wicklund, KG, Goodman, MT, Modugno, F, Moysich, K, Ness, RB, Edwards, RP, Goode, EL, Winham, SJ, Fridley, BL, Cramer, DW, Terry, KL, Schildkraut, JM, Berchuck, A, Bandera, EV, Paddock, L, Kiemeney, LA, Massuger, LF, Wentzensen, N, Pharoah, P, Song, H, Whittemore, AS, McGuire, V, Sieh, W, Rothstein, J, Anton-Culver, H, Ziogas, A, Menon, U, Gayther, SA, Ramus, SJ, Gentry-Maharaj, A, Wu, AH, Pearce, CL, Pike, MC, Lee, AW, Chang-Claude, J & Jensen, A 2016, 'The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer: a pooled analysis of 18 case-control studies', Cancer Epidemiology, vol. 41, pp. 71-79. https://doi.org/10.1016/j.canep.2016.01.012

@article{d53af184cae343af89f7a737515f9898,

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.",

author = "Camilla Pr{\ae}stegaard and Kj{\ae}r, {Susanne Kr{\"u}ger} and Nielsen, {Thor Sch{\"u}tt Svane} and Jensen, {Signe Marie} and Webb, {Penelope M.} and Nagle, {Christina M} and H{\o}gdall, {Estrid Vilma Solyom} and Risch, {Harvey A} and Rossing, {Mary Anne} and Doherty, {Jennifer A} and Wicklund, {Kristine G} and Goodman, {Marc T} and Francesmary Modugno and Kirsten Moysich and Ness, {Roberta B} and Edwards, {Robert P} and Goode, {Ellen L} and Winham, {Stacey J} and Fridley, {Brooke L} and Cramer, {Daniel W} and Terry, {Kathryn L} and Schildkraut, {Joellen M} and Andrew Berchuck and Bandera, {Elisa V} and Lisa Paddock and Kiemeney, {Lambertus A} and Massuger, {Leon F} and Nicolas Wentzensen and Paul Pharoah and Honglin Song and Whittemore, {Alice S} and Valerie McGuire and Weiva Sieh and Joseph Rothstein and Hoda Anton-Culver and Argyrios Ziogas and Usha Menon and Gayther, {Simon A} and Ramus, {Susan J} and Aleksandra Gentry-Maharaj and Wu, {Anna H} and Pearce, {Celeste L} and Pike, {Malcolm C} and Lee, {Alice W} and Jenny Chang-Claude and Allan Jensen",

year = "2016",

month = apr,

day = "1",

doi = "10.1016/j.canep.2016.01.012",

language = "English",

volume = "41",

pages = "71--79",

journal = "Cancer Epidemiology",

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TY - JOUR

T1 - The association between socioeconomic status and tumour stage at diagnosis of ovarian cancer

T2 - a pooled analysis of 18 case-control studies

AU - Præstegaard, Camilla

AU - Kjær, Susanne Krüger

AU - Nielsen, Thor Schütt Svane

AU - Jensen, Signe Marie

AU - Webb, Penelope M.

AU - Nagle, Christina M

AU - Høgdall, Estrid Vilma Solyom

AU - Risch, Harvey A

AU - Rossing, Mary Anne

AU - Doherty, Jennifer A

AU - Wicklund, Kristine G

AU - Goodman, Marc T

AU - Modugno, Francesmary

AU - Moysich, Kirsten

AU - Ness, Roberta B

AU - Edwards, Robert P

AU - Goode, Ellen L

AU - Winham, Stacey J

AU - Fridley, Brooke L

AU - Cramer, Daniel W

AU - Terry, Kathryn L

AU - Schildkraut, Joellen M

AU - Berchuck, Andrew

AU - Bandera, Elisa V

AU - Paddock, Lisa

AU - Kiemeney, Lambertus A

AU - Massuger, Leon F

AU - Wentzensen, Nicolas

AU - Pharoah, Paul

AU - Song, Honglin

AU - Whittemore, Alice S

AU - McGuire, Valerie

AU - Sieh, Weiva

AU - Rothstein, Joseph

AU - Anton-Culver, Hoda

AU - Ziogas, Argyrios

AU - Menon, Usha

AU - Gayther, Simon A

AU - Ramus, Susan J

AU - Gentry-Maharaj, Aleksandra

AU - Wu, Anna H

AU - Pearce, Celeste L

AU - Pike, Malcolm C

AU - Lee, Alice W

AU - Chang-Claude, Jenny

AU - Jensen, Allan

PY - 2016/4/1

Y1 - 2016/4/1

N2 - 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.

AB - 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.

U2 - 10.1016/j.canep.2016.01.012

DO - 10.1016/j.canep.2016.01.012

M3 - Journal article

C2 - 26851750

SN - 1877-7821

VL - 41

SP - 71

EP - 79

JO - Cancer Epidemiology

JF - Cancer Epidemiology

ER -

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

Abstract

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