期刊
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
卷 28, 期 6, 页码 1089-1092出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-18-1153
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资金
- European Commission (DG-SANCO)
- International Agency for Research on Cancer (IARC)
- Danish Cancer Society (Denmark)
- Ligue Contre le Cancer
- Institut Gustave Roussy
- Mutuelle Generale de l'Education Nationale
- Institut National de la Sante et de la Recherche Medicale (INSERM
- France)
- German Cancer Aid (Germany)
- German Cancer Research Center (DKFZ) (Germany)
- Federal Ministry of Education and Research (BMBF) (Germany)
- Deutsche Krebshilfe (Germany)
- Deutsches Krebsforschungszentrum (Germany)
- Federal Ministry of Education and Research (Germany)
- Hellenic Health Foundation (Greece)
- Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy (Italy)
- National Research Council (Italy)
- Dutch Ministry of Public Health, Welfare and Sports (VWS) (the Netherlands)
- Netherlands Cancer Registry (NKR) (the Netherlands)
- LK Research Funds (the Netherlands)
- Dutch Prevention Funds (the Netherlands)
- Dutch ZON (Zorg Onderzoek Nederland) (the Netherlands)
- World Cancer Research Fund (WCRF) (the Netherlands)
- Statistics Netherlands (the Netherlands)
- Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway)
- Health Research Fund (FIS) [PI13/00061, PI13/01162]
- Regional Government of Andalucia
- Regional Government of Asturias
- Regional Government of Basque Country
- Regional Government of Murcia
- Regional Government of Navarra
- ISCIII RETIC (Spain) [RD06/0020]
- Swedish Cancer Society (Sweden)
- Swedish Research Council (Sweden)
- County Council of Skane (Sweden)
- County Council of Vasterbotten (Sweden)
- Cancer Research UK [14136, C570/A16491, C8221/A19170]
- Medical Research Council (United Kingdom) [1000143, MR/M012190/1]
- [ERC-2009-AdG 232997]
- MRC [MR/N003284/1] Funding Source: UKRI
Background: To analyze the potential effect of social inequality on pancreatic cancer risk in Western Europe, by reassessing the association within the European Prospective Investigation into Cancer and Nutrition (EPIC) Study, including a larger number of cases and an extended follow-up. Methods: Data on highest education attained were gathered for 459,170 participants (70% women) from 10 European countries. A relative index of inequality (RII) based on adult education was calculated for comparability across countries and generations. Cox regression models were applied to estimate relative inequality in pancreatic cancer risk, stratifying by age, gender, and center, and adjusting for known pancreatic cancer risk factors. Results: A total of 1,223 incident pancreatic cancer cases were included after a mean follow-up of 13.9 (+/- 4.0) years. An inverse social trend was found in models adjusted for age, sex, and center for both sexes [HR of RII, 1.27; 95% confidence interval (CI), 1.02-1.59], which was also significant among women (HR, 1.42; 95% CI, 1.05-1.92). Further adjusting by smoking intensity, alcohol consumption, body mass index, prevalent diabetes, and physical activity led to an attenuation of the RII risk and loss of statistical significance. Conclusions: The present reanalysis does not sustain the existence of an independent social inequality influence on pancreatic cancer risk in Western European women and men, using an index based on adult education, the most relevant social indicator linked to individual lifestyles, in a context of very low pancreatic cancer survival from (quasi) universal public health systems. Impact: The results do not support an association between education and risk of pancreatic cancer.
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