Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Brusselaers N

PROVIDER: S-EPMC3855588 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Brusselaers Nele N Ljung Rickard R Mattsson Fredrik F Johar Asif A Wikman Anna A Lagergren Pernilla P Lagergren Jesper J

BMJ open 20131203 12

<h4>Objectives</h4>This study aimed to investigate whether a higher education level is associated with an improved long-term survival after oesophagectomy for cancer.<h4>Design</h4>A prospective, population-based cohort study.<h4>Setting</h4>Sweden-nationwide.<h4>Participants</h4>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). ...[more]

PMID: 24302504

Similar Datasets

Project description:PurposeThe Finnish National Esophago-Gastric Cancer Cohort (FINEGO) was established to combine the available registry data with detailed patient information to form a comprehensive, retrospective, population-based research platform of surgically treated oesophageal and gastric cancer in Finland. This cohort profile describes the 2045 surgically treated patients with oesophageal cancer included in the FINEGO cohort.ParticipantsRegistry data were collected from the National Cancer, Patient, Education and Death Registries from 1 January 1987 to 31 December 2016. All patients over 18 years of age, who had either curative surgery, palliative surgery or salvage surgery for primary cancer in the oesophagus are included in this study.Findings to date2045 patients had surgery for oesophageal cancer in the selected time period. 67.2% were man, and the majority had only minor comorbidities. The proportions of adenocarcinomas and squamous cell carcinomas were 43.1% and 44.4%, respectively, and 12.5% had other or missing histology. Only about 23% of patients received neoadjuvant therapy. Oesophagectomy was the treatment of choice and most patients were treated at low-volume centres, but median annual hospital volume increased over time. Median overall survival was 23 months, 5-year survival for all patients in the cohort was 32.9% and cancer-specific survival was 36.5%.Future plansEven though Finland only has a population of 5.5 million, surgery for oesophageal carcinoma has not been centralised and therefore previously reported results have mostly been small, single-centre cohorts. Because of FINEGO, we now have a population-based, unselected cohort of surgically treated patients, enabling research on national trends over time regarding oesophageal cancer, including patient characteristics, tumour histology, stage and neoadjuvant treatment, surgical techniques, hospital volumes and patient mortality. Data collection is ongoing, and the cohort will be expanded to include more detailed data from patient records and national biobanks.

Dataset Information

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

Objectives

Design

Setting

Participants

Outcome measures

Results

Conclusions

Publications

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

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure