Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium.

Autor:	Yang K; Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA., Zhang Y; Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA., Saito E; Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan., Rahman MS; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Gupta PC; Healis - Sekhsaria Institute for Public Health, Navi Mumbai, India., Sawada N; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan., Tamakoshi A; Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan., Gao YT; State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China., Koh WP; Health Services and Systems Research, Duke-NUS Medical School, Singapore., Shu XO; Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Tsuji I; Tohoku University Graduate School of Medicine, Sendai, Japan., Sadakane A; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan., Nagata C; Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan., You SL; School of Medicine, Big Data Research Centre, Fu-Jen Catholic University, Taipei, Taiwan., Yuan JM; Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Shin MH; Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, The Republic of Korea., Chen Y; Department of Population Health, Department of Environmental Medicine, New York University School of Medicine, New York City, New York, USA., Pan WH; Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan., Pednekar MS; Healis - Sekhsaria Institute for Public Health, Navi Mumbai, India., Tsugane S; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan., Cai H; Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Xiang YB; State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China., Ozasa K; Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan., Tomata Y; Tohoku University Graduate School of Medicine, Sendai, Japan., Kanemura S; Tohoku University Graduate School of Medicine, Sendai, Japan., Sugawara Y; Tohoku University Graduate School of Medicine, Sendai, Japan., Wada K; Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan., Wang R; Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Ahn YO; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, The Republic of Korea., Yoo KY; Armed Forces Capital Hospital, Seoul National University College of Medicine, Seoul, The Republic of Korea., Ahsan H; Department of Public Health Sciences, The University of Chicago, Chicago, Illinois, USA., Chia KS; Epidemiology Program, Saw Swee Hock School of Public Health, National University of Singapore, Singapore., Boffetta P; Icahn School of Medicine at Mount Sinai, New York, New York, USA., Kang D; Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, The Republic of Korea., Potter JD; Centre for Public Health Research, Massey University, Wellington, New Zealand., Inoue M; Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan., Zheng W; Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Nan H; Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA hnan@iu.edu.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2019 Aug 22; Vol. 9 (8), pp. e026225. Date of Electronic Publication: 2019 Aug 22.
DOI:	10.1136/bmjopen-2018-026225
Abstrakt:	Objective: To study the association of educational level and risk of death from all causes, cardiovascular disease (CVD) and cancer among Asian populations. Design: A pooled analysis of 15 population-based cohort studies. Setting and Participants: 694 434 Asian individuals from 15 prospective cohorts within the Asia Cohort Consortium. Interventions: None. Main Outcome Measures: HRs and 95% CIs for all-cause mortality, as well as for CVD-specific mortality and cancer-specific mortality. Results: A total of 694 434 participants (mean age at baseline=53.2 years) were included in the analysis. During a mean follow-up period of 12.5 years, 103 023 deaths were observed, among which 33 939 were due to cancer and 34 645 were due to CVD. Higher educational levels were significantly associated with lower risk of death from all causes compared with a low educational level (≤primary education); HRs and 95% CIs for secondary education, trade/technical education and ≥university education were 0.88 (0.85 to 0.92), 0.81 (0.73 to 0.90) and 0.71 (0.63 to 0.80), respectively (p trend =0.002). Similarly, HRs (95% CIs) were 0.93 (0.89 to 0.97), 0.86 (0.78 to 0.94) and 0.81 (0.73 to 0.89) for cancer death, and 0.88 (0.83 to 0.93), 0.77 (0.66 to 0.91) and 0.67 (0.58 to 0.77) for CVD death with increasing levels of education (both p trend <0.01). The pattern of the association among East Asians and South Asians was similar compared with ≤primary education; HR (95% CI) for all-cause mortality associated with ≥university education was 0.72 (0.63 to 0.81) among 539 724 East Asians (Chinese, Japanese and Korean) and 0.61 (0.54 to 0.69) among 154 710 South Asians (Indians and Bangladeshis). Conclusion: Higher educational level was associated with substantially lower risk of death among Asian populations. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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