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Low level of educat...
Low level of education is associated with later stage at diagnosis and reduced survival in cutaneous malignant melanoma : A nationwide population-based study in Sweden
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- Eriksson, Hanna (author)
- Karolinska Institutet
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- Lyth, Johan (author)
- Östergötlands Läns Landsting,Linköpings universitet,Onkologi,Hälsouniversitetet,Regionalt cancercentrum
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- Månsson-Brahme, Eva (author)
- Karolinska Institutet
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- Frohm-Nilsson, Margareta (author)
- Karolinska Institutet
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- Ingvar, Christian (author)
- Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University, Sweden
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- Lindholm, Christer (author)
- Östergötlands Läns Landsting,Regionalt cancercentrum
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- Naredi, Peter, 1955- (author)
- Umeå universitet,Kirurgi,Umeå University, Sweden
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- Stierner, Ulrika (author)
- Sahlgrenska University Hospital, Gothenburg, Sweden
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- Wagenius, Gunnar (author)
- Uppsala universitet,Karolinska Institutet,Enheten för onkologi
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- Carstensen, John (author)
- Linköpings universitet,Avdelningen för hälsa och samhälle,Hälsouniversitetet
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- Hansson, Johan (author)
- Karolinska Institutet
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(creator_code:org_t)
- Oxford : Elsevier, 2013
- 2013
- English.
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In: European Journal of Cancer. - Oxford : Elsevier. - 0959-8049 .- 1879-0852. ; 49:12, s. 2705-2716
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND:A worse outcome has been reported for cutaneous malignant melanoma (CMM) patients with low socioeconomic status. We have investigated the association between level of education, clinical stage at diagnosis (stage at diagnosis) and CMM-specific survival in Sweden.METHODS:We identified 27,235 patients from the Swedish Melanoma Register diagnosed with a primary invasive CMM between 1990 and 2007 and linked data to nationwide, population-based, health and census registers with a follow-up to 2010.RESULTS:The odds ratio (OR) of higher disease stage at diagnosis was significantly increased in lower education groups (OR stage II versus I=1.6; 95% confidence interval (CI)=1.5-1.7. OR stage III-IV versus I=2.3; 95% CI=1.8-2.9). The risk of dying of CMM, was significantly increased in patients with low (hazard ratio (HR) low versus high=2.02; 95% CI=1.80-2.26; p<0.0001) and intermediate (HR intermediate versus high=1.35; 95% CI=1.20-1.51; p<0.0001) level of education. After adjustment for age, gender, stage at diagnosis and other known prognostic factors, the HRs remained significant for low versus high (HR=1.13; 95% CI=1.01-1.27; p=0.04) but not for intermediate versus high (HR=1.11; 95% CI=0.99-1.24; p=0.08) education. The HR associated with low level of education was significantly higher among female patients, patients <55years, patients with truncal tumours and during the first 5years after diagnosis.CONCLUSION:Lower level of education is associated with reduced CMM-specific survival, which may at least partially be attributed to a more advanced stage at diagnosis. These results emphasise the need for improved early detection strategies.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Keyword
- Melanoma
- Survival
- Socioeconomic status
- Level of education
- Stage at diagnosis
- Population-based
- Melanoma
- Survival
- Socioeconomic status
- Level of education
- Stage at
- diagnosis
- Population-based
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Eriksson, Hanna
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Lyth, Johan
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Månsson-Brahme, ...
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Frohm-Nilsson, M ...
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Ingvar, Christia ...
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Lindholm, Christ ...
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Naredi, Peter, 1 ...
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Stierner, Ulrika
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Wagenius, Gunnar
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Carstensen, John
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Hansson, Johan
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Public Health Gl ...
- Articles in the publication
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European Journal ...
- By the university
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Linköping University
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Umeå University
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Lund University
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Karolinska Institutet
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Uppsala University