Socioeconomic disparities in breast cancer incidence and survival among parous women: findings from a population-based cohort, 1964–2008
Autor: | Susan Harlap, Ronit Calderon-Margalit, Orly Manor, Ora Paltiel, Yechiel Friedlander, Wiessam Abu Ahmad, Mandy Goldberg |
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Jazyk: | angličtina |
Předmět: |
Oncology
medicine.medical_specialty Cancer Research Survival Population Disparities Breast Neoplasms Ethnic origin Race/ethnicity White People Education Breast--Cancer--Patients Cohort Studies Breast cancer Internal medicine Ethnicity Genetics Medicine Humans Registries Israel education Socioeconomic status education.field_of_study Occupation Public health business.industry Incidence (epidemiology) Incidence Population-based cohort medicine.disease Survival Analysis Cancer registry Socioeconomic position Socioeconomic Factors Cohort Female Inequalities business Cancer--Patients--Economic conditions Cohort study Demography Research Article |
Zdroj: | BMC Cancer |
ISSN: | 1471-2407 |
DOI: | 10.1186/s12885-015-1931-4 |
Popis: | Background Socioeconomic position (SEP) has been associated with breast cancer incidence and survival. We examined the associations between two socioeconomic indicators and long-term breast cancer incidence and survival in a population-based cohort of parous women. Methods Residents of Jerusalem who gave birth between 1964–1976 (n = 40,586) were linked to the Israel Cancer Registry and Israel Population Registry to determine breast cancer incidence and vital status through mid-2008. SEP was assessed by husband’s occupation and the woman’s education. We used log ranks tests to compare incidence and survival curves by SEP, and Cox proportional hazard models to adjust for demographic, reproductive and diagnostic factors and assess effect modification by ethnic origin. Results In multivariable models, women of high SEP had a greater risk of breast cancer compared to women of low SEP (Occupation: HR 1.18, 95 % CI 1.03-1.35; Education: HR 1.39, 95 % CI 1.21-1.60) and women of low SEP had a greater risk of mortality after a breast cancer diagnosis (Occupation: HR 1.33, 95 % CI 1.04-1.70; Education: HR 1.37, 95 % CI 1.06-1.76). The association between education and survival was modified by ethnic origin, with a gradient effect observed only among women of European origin. Women of Asian, North African and Israeli origin showed no such trend. Conclusions SEP was associated with long-term breast cancer incidence and survival among Israeli Jews. Education had a stronger effect on breast cancer outcomes than occupation, suggesting that a behavioral mechanism may underlie disparities. More research is needed to explain the difference in the effect of education on survival among European women compared to women of other ethnicities. |
Databáze: | OpenAIRE |
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