Dataset Information

Occupational class differences in pancreatic cancer survival: A population-based cancer registry-based study in Japan.

ABSTRACT:

Background

Little is known about occupational class differences in pancreatic cancer survival.

Methods

Using a population-based cancer registry in Japan, 3 578 patients with incident pancreatic cancer (1970-2011) were followed up for 5 years (median follow-up time 0.42 years). We classified patients into four occupational classes based on their longest-held jobs: white-collar (professional and managers), service, blue-collar, and those not actively employed. Using white-collar class as the reference group, hazard ratios (HRs) and 95% confidence intervals (CIs) for overall death were estimated by Cox proportional hazard model. Covariates included age, sex, and year of diagnosis. Prognostic variables (pathology, stage, and treatment) and smoking behaviors were additionally adjusted as possible mediating factors.

Results

Overall survival was poor in this population (median, 0.50 and 0.33 years in white-collar and service classes, respectively). Compared with white-collar patients, survival was significantly poorer across all occupational classes, most pronounced in the service worker group: mortality HRs ranged from 1.11 (95% CI 1.00-1.24) in blue-collar workers to 1.24 (95% CI 1.12-1.37) in service workers. Even after controlling for potential mediating factors, service workers showed worse survival.

Conclusion

We documented occupational class disparities in pancreatic cancer survival in Japan. Even in the setting of lethal prognostic cancer with universal health coverage, high-occupational class groups may enjoy a health advantage.

SUBMITTER: Zaitsu M

PROVIDER: S-EPMC6558482 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

Occupational class differences in pancreatic cancer survival: A population-based cancer registry-based study in Japan.

Zaitsu Masayoshi M Kim Yongjoo Y Lee Hye-Eun HE Takeuchi Takumi T Kobayashi Yasuki Y Kawachi Ichiro I

Cancer medicine 20190405 6

<h4>Background</h4>Little is known about occupational class differences in pancreatic cancer survival.<h4>Methods</h4>Using a population-based cancer registry in Japan, 3 578 patients with incident pancreatic cancer (1970-2011) were followed up for 5 years (median follow-up time 0.42 years). We classified patients into four occupational classes based on their longest-held jobs: white-collar (professional and managers), service, blue-collar, and those not actively employed. Using white-collar cla ...[more]

PMID: 30953422

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Project description:BackgroundThe relation between breast cancer molecular subtype and survival has been studied in several jurisdictions, but limited information is available for Ontario. The aim of this study was to determine breast cancer survival by molecular subtype and to assess the effect on survival of selected demographic and tumour-based characteristics.MethodsWe extracted 29 833 breast cancer cases (in 26 538 girls and women aged ≥ 15 yr) diagnosed between 2010 and 2012 from the Ontario Cancer Registry. Cancers were categorized into 4 molecular subtypes: 1) luminal A (estrogen-receptor-positive and/or progesterone-receptor-positive [ER+ and/or PR+] and negative for human epidermal growth factor receptor 2 [HER2-]), 2) luminal B (ER+ and/or PR+/HER2+), 3) HER2-enriched (ER- and PR-/HER2+) and 4) triple-negative (ER- and PR-/HER2-). We estimated associations with predictor variables (age, stage at diagnosis, histologic type, comorbidity and place of residence [urban or rural]) using a multivariate Cox proportional hazards model. Likelihood ratio testing was used to evaluate differences in risk of death.ResultsLuminal A was the most commonly diagnosed subtype (59.0%) and had the greatest survival, whereas triple-negative had the poorest survival. For all subtypes, a dose-response effect was observed between the hazard of death and age and stage at diagnosis, with the greatest effect found for the HER2-enriched subtype (age: hazard ratio [HR] 7.87 [95% confidence interval (CI) 3.68-11.81]; stage at diagnosis: HR 37.71 [95% CI 34.64-41.27]). Moderate comorbidity (Charlson Comorbidity Index score 1 or 2) was associated with increased risk of death for triple-negative cancers (HR 2.42 [95% CI 1.36-4.31]), and severe comorbidity (Charlson Comorbidity Index score ≥ 3) increased the risk for all molecular subtypes.InterpretationThe results indicate the importance of including molecular subtype, along with age, stage at diagnosis and comorbidity, in assessing breast cancer survival. They highlight the need to address outcomes related to hormone-receptor-negative cancers, for which survival lags behind that for hormone-receptor-positive cancers.

Dataset Information

Occupational class differences in pancreatic cancer survival: A population-based cancer registry-based study in Japan.

Background

Methods

Results

Conclusion

Publications

Occupational class differences in pancreatic cancer survival: A population-based cancer registry-based study in Japan.

Similar Datasets

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