Trends in educational inequalities in mortality, seven types of cancers, Norway 1971-2002
Trends in educational inequalities in mortality, seven types of cancers, Norway 1971-2002
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DOI：
10.1093/eurpub/ckr181
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发表时间：
2012-12-01
影响因子：
4.4
通讯作者：
Kravdal, Oystein
中科院分区：
文献类型：
--
作者：
Elstad, Jon Ivar;Torstensrud, Rita;Kravdal, Oystein
背景：关于特定癌症部位死亡的教育差异的知识是不完整的。关于特定癌症死亡率的教育模式的时间趋势的信息甚至更少。这项研究审查了1971-2002年挪威在肺癌和喉癌、结肠直肠癌、胃癌、黑色素瘤、前列腺癌、乳腺癌和宫颈癌死亡率方面的教育不平等。研究方法：建立了一个数据档案，其中包括1971-2002年期间某个时候登记的所有45-74岁的挪威居民，并将行政登记册的信息联系起来。在超过4000万人-年的暴露期间，在分析的癌症类型中登记了约87000例死亡。通过年龄标准化死亡率、风险回归比值比和相对不平等指数分析了三个时期的绝对和相对不平等。结果：从20世纪70年代到90年代，男女在肺癌和相关癌症死亡率方面的教育不平等大大扩大。胃癌和宫颈癌的中等教育梯度持续存在，结肠直肠癌的弱梯度也是如此。在任何时间段都没有观察到前列腺癌的教育差异。乳腺癌和黑色素瘤死亡的适度反向教育梯度保持在同一水平。结论：在这项研究中检查的七种癌症类型中，只有肺癌死亡率显示出教育差距的明显扩大。由于肺癌死亡率在所有癌症死亡中占很大比例，这一增加可能导致整体癌症死亡率的更大差异。对观察到的癌症死亡率模式提出了一些解释。
Background: Knowledge about educational disparities in deaths from specific cancer sites is incomplete. Even more scant is information about time trends in educational patterns in specific cancer mortality. This study examines educational inequalities in Norway 1971-2002 for mortality in lung and larynx, colorectal, stomach, melanoma, prostate, breast and cervix uteri cancer. Methods: A data file encompassing all Norwegian inhabitants registered some time during 1971-2002 while aged 45-74 was constructed with linked information from administrative registers. During an exposure of more than 40 millions person-years, about 87 000 deaths in the analysed cancer types were registered. Absolute and relative inequalities during three periods were analysed by age-standardized deaths rates, hazard regression odds ratios and Relative Index of Inequality. Results: Educational inequalities in lung and related cancer mortality widened considerably from the 1970s to the 1990s for both sexes. The moderate educational gradient for stomach and cervix uteri cancer persisted, as did the weak gradient for colorectal cancer. No educational differences in prostate cancer were observed in any of the time periods. The modest inverse educational gradients in deaths from breast cancer and melanoma remained at the same level. Conclusion: Among the seven cancer types examined in this study, only lung cancer mortality showed a clear widening in educational disparities. As lung cancer mortality constitutes a large proportion of all cancer deaths, this increase may result in larger disparities for overall cancer mortality. Some explanations for the observed patterns in cancer mortality are suggested.