Gianfranco Alicandro1,2, Luisa Frova3, Gabriella Sebastiani3, Iman El Sayed4, Paolo Boffetta5, Carlo La Vecchia6. 1. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Vanzetti 5, 20133, Milan, Italy. gianfranco.alicandro@unimi.it. 2. Italian National Institute of Statistics, Via Cesare Balbo 16, 00184, Rome, Italy. gianfranco.alicandro@unimi.it. 3. Italian National Institute of Statistics, Via Cesare Balbo 16, 00184, Rome, Italy. 4. Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, 165 Horreya Avenue, Hadara Alexandria, Egypt. 5. Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, 1190 5th Ave, New York, NY, 10029, USA. 6. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Vanzetti 5, 20133, Milan, Italy.
Abstract
PURPOSE: Large studies are needed to evaluate socioeconomic inequality for site-specific cancer mortality. We conducted a longitudinal census-based national study to quantify the relative inequality in cancer mortality among educational levels in Italy. METHODS: We linked the 2011 Italian census with the 2012 and 2013 death registries. Educational inequality in overall cancer and site-specific cancer mortality were evaluated by computing the mortality rate ratio (MRR). RESULTS: A total of 35,708,445 subjects aged 30-74 years and 147,981 cancer deaths were registered. Compared to the lowest level of education (none or primary school), the MRR for all cancers in the highest level (university) was 0.57 (95% CI 0.55; 0.58) in men and 0.84 (95% CI 0.81; 0.87) in women. Higher education was associated with reduced risk of mortality from lip, oral cavity, pharynx, oesophagus, stomach, colon and liver in both sexes. Higher education (university) was associated with decreased risk of lung cancer in men (MRR: 0.43, 95% CI 0.41; 0.46), but not in women (MRR: 1.00, 95% CI 0.92; 1.10). Highly educated women had a reduced risk of mortality from cervical cancer than lower educated women (MRR: 0.39, 95% CI 0.27; 0.56), but they had a similar risk for breast cancer (MRR: 1.01, 95% CI 0.94; 1.09). CONCLUSIONS: Education is inversely associated with total cancer mortality, and the association was stronger in men. Different patterns and trends in tobacco smoking in men and women account for at least most of the gender differences.
PURPOSE: Large studies are needed to evaluate socioeconomic inequality for site-specific cancer mortality. We conducted a longitudinal census-based national study to quantify the relative inequality in cancer mortality among educational levels in Italy. METHODS: We linked the 2011 Italian census with the 2012 and 2013 death registries. Educational inequality in overall cancer and site-specific cancer mortality were evaluated by computing the mortality rate ratio (MRR). RESULTS: A total of 35,708,445 subjects aged 30-74 years and 147,981 cancer deaths were registered. Compared to the lowest level of education (none or primary school), the MRR for all cancers in the highest level (university) was 0.57 (95% CI 0.55; 0.58) in men and 0.84 (95% CI 0.81; 0.87) in women. Higher education was associated with reduced risk of mortality from lip, oral cavity, pharynx, oesophagus, stomach, colon and liver in both sexes. Higher education (university) was associated with decreased risk of lung cancer in men (MRR: 0.43, 95% CI 0.41; 0.46), but not in women (MRR: 1.00, 95% CI 0.92; 1.10). Highly educated women had a reduced risk of mortality from cervical cancer than lower educated women (MRR: 0.39, 95% CI 0.27; 0.56), but they had a similar risk for breast cancer (MRR: 1.01, 95% CI 0.94; 1.09). CONCLUSIONS: Education is inversely associated with total cancer mortality, and the association was stronger in men. Different patterns and trends in tobacco smoking in men and women account for at least most of the gender differences.
Authors: Paola Bertuccio; Gianfranco Alicandro; Gabriella Sebastiani; Nicolas Zengarini; Giuseppe Costa; Carlo La Vecchia; Luisa Frova Journal: Int J Public Health Date: 2018-07-26 Impact factor: 3.380
Authors: Gianfranco Alicandro; Paola Bertuccio; Giulia Collatuzzo; Claudio Pelucchi; Rossella Bonzi; Linda M Liao; Charles S Rabkin; Rashmi Sinha; Eva Negri; Michela Dalmartello; David Zaridze; Dmitry Maximovich; Jesus Vioque; Manoli Garcia de la Hera; Shoichiro Tsugane; Akihisa Hidaka; Gerson Shigueaki Hamada; Lizbeth López-Carrillo; Raúl Ulises Hernández-Ramírez; Reza Malekzadeh; Farhad Pourfarzi; Zuo-Feng Zhang; Robert C Kurtz; M Constanza Camargo; Maria Paula Curado; Nuno Lunet; Paolo Boffetta; Carlo La Vecchia Journal: Br J Cancer Date: 2022-05-27 Impact factor: 9.075
Authors: Gianfranco Alicandro; Paola Bertuccio; Gabriella Sebastiani; Carlo La Vecchia; Luisa Frova Journal: Int J Public Health Date: 2020-04-17 Impact factor: 3.380
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