Educational Differences in Breast Cancer Incidence and Breast Cancer Survival. How Do They Add up?

Sylvie Gadeyne , Vrije Universiteit Brussel
Victoria Sass, VUB

Background/Aim: There is consistent evidence of a negative association between socioeconomic position and nearly all indicators of morbidity and mortality. Yet, for cancer, the picture is less homogeneous. In breast cancer for instance research initially observed a positive relation between education and breast cancer mortality. However, for more recent periods the relationship seems to have disappeared or even reversed into a negative relationship. This study will investigate educational differences in breast cancer mortality in Belgium and ‘decompose’ these differences in breast cancer incidence and survival differences. Furthermore, our study will consider the impact of fertility variables on these inequalities. Methods: Data will be derived from record linkage between the 2001 census, emigration and mortality data during 2001-2014 and cancer data from the Belgian Cancer Registry. These data are quite unique; only Nordic countries dispose of equally nationwide comprehensive data. Survival regression will be used to calculate educational inequalities in breast cancer mortality, incidence and survival. Control for fertility variables will be included to investigate their impact on breast cancer inequalities. Results: At younger age, lower educated women show lower breast cancer incidence and mortality rates compared to the higher educated. At older age, this pattern reverses, lower educated women having higher breast cancer incidence and mortality rates. In survival however, lower educated women have lower chances to survive from breast cancer independently of duration since diagnosis. Conclusions: This study illustrates that the relation between education and breast cancer depends upon age and the indicator considered (mortality, incidence or survival).

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 Presented in Session P2. Poster Session Ageing, Health and Mortality