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  • Brusselaers, NeleKarolinska Institutet (author)

Education level and survival after esophageal cancer surgery : a prospective population-based cohort study

  • Article/chapterEnglish2013

Publisher, publication year, extent ...

  • 2013-12-03
  • Stockholm :Karolinska Institutet, Dept of Molecular Medicine and Surgery,2013
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:openarchive.ki.se:10616/44565
  • ISSN:2044-6055
  • 10616/44565hdl
  • http://hdl.handle.net/10616/44565URI
  • https://doi.org/10.1136/bmjopen-2013-003754DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:128238971URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-428684URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Objectives: This study aimed to investigate whether a higher education level is associated with an improved long-term survival after oesophagectomy for cancer. Design: A prospective, population-based cohort study. Setting: Sweden—nationwide. Participants: 90% of all patients with oesophageal and cardia cancer who underwent a resection in Sweden in 2001–2005 were enrolled in this study (N=600; 80.3% male) and followed up until death or the end of the study period (2012). The study exposure was level of education, defined as compulsory (≤9 years), moderate (10–12 years) or high (≥13 years). Outcome measures The main outcome measure was overall 5-year survival after oesophagectomy. Cox regression was used to estimate the associations between education level and mortality, expressed as HRs with 95% CIs, with adjustment for sex, age, tumour stage, histological type, complications, comorbidities and annual surgeon volume. The patient group with highest education was used as the reference category. Results: Among the 600 included patients, 281 (46.8%) had compulsory education, 238 (39.7%) had moderate education and 81 (13.5%) had high education. The overall 5-year survival rate was 23.1%, 24.4% and 32.1% among patients with compulsory, moderate and high education, respectively. After adjustment for confounders, a slightly higher, yet not statistically significantly increased point HR was found among the compulsory educated patients (HR 1.08, 95% CI 0.80 to 1.47). In patients with tumour stage IV, increased adjusted HRs were found for compulsory (HR 2.88, 95% CI 1.07 to 7.73) and moderately (HR 2.83, 95% CI 1.15 to 6.95) educated patients. No statistically significant associations were found for the other tumour stages. Conclusions: This study provides limited evidence of an association between lower education and worse long-term survival after oesophagectomy for cancer.

Added entries (persons, corporate bodies, meetings, titles ...)

  • Ljung, RickardKarolinska Institutet (author)
  • Mattsson, FredrikKarolinska Institutet (author)
  • Johar, AsifKarolinska Institutet (author)
  • Wikman, AnnaKarolinska Institutet (author)
  • Lagergren, PernillaKarolinska Institutet (author)
  • Lagergren, JesperKarolinska Institutet (author)
  • Karolinska Institutet
  • Karolinska Institutet
  • Karolinska Institutet (creator_code:org_t)

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  • In:BMJ OpenStockholm : Karolinska Institutet, Dept of Molecular Medicine and Surgery2044-6055

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