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@article{Cirera:2019:10.1158/1055-9965.EPI-18-1153,
author = {Cirera, L and Maria, Huerta J and Dolores, Chirlaque M and Overvad, K and Lindstrom, M and Regner, S and Tjonneland, A and Boutron-Ruault, M-C and Rebours, V and Fagherazzi, G and Katzke, VA and Boeing, H and Peppa, E and Trichopoulou, A and Valanou, E and Palli, D and Grioni, S and Panico, S and Tumino, R and Ricceri, F and van, Gils C and Vermeulen, RCH and Skeie, G and Braaten, T and Weiderpass, E and Merino, S and Jose, Sanchez M and Larranaga, N and Ardanaz, E and Sund, M and Khaw, K-T and Key, TJ and Jenab, M and Naudin, S and Murphy, N and Aune, D and Ward, H and Riboli, E and Bueno-de-Mesquita, B and Navarro, C and Duell, EJ},
doi = {10.1158/1055-9965.EPI-18-1153},
journal = {Cancer Epidemiology, Biomarkers and Prevention},
pages = {1089--1092},
title = {Socioeconomic effect of education on pancreatic cancer risk in Western Europe: an update on the EPIC cohorts study},
url = {http://dx.doi.org/10.1158/1055-9965.EPI-18-1153},
volume = {28},
year = {2019}
}

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TY  - JOUR
AB  - 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.
AU  - Cirera,L
AU  - Maria,Huerta J
AU  - Dolores,Chirlaque M
AU  - Overvad,K
AU  - Lindstrom,M
AU  - Regner,S
AU  - Tjonneland,A
AU  - Boutron-Ruault,M-C
AU  - Rebours,V
AU  - Fagherazzi,G
AU  - Katzke,VA
AU  - Boeing,H
AU  - Peppa,E
AU  - Trichopoulou,A
AU  - Valanou,E
AU  - Palli,D
AU  - Grioni,S
AU  - Panico,S
AU  - Tumino,R
AU  - Ricceri,F
AU  - van,Gils C
AU  - Vermeulen,RCH
AU  - Skeie,G
AU  - Braaten,T
AU  - Weiderpass,E
AU  - Merino,S
AU  - Jose,Sanchez M
AU  - Larranaga,N
AU  - Ardanaz,E
AU  - Sund,M
AU  - Khaw,K-T
AU  - Key,TJ
AU  - Jenab,M
AU  - Naudin,S
AU  - Murphy,N
AU  - Aune,D
AU  - Ward,H
AU  - Riboli,E
AU  - Bueno-de-Mesquita,B
AU  - Navarro,C
AU  - Duell,EJ
DO  - 10.1158/1055-9965.EPI-18-1153
EP  - 1092
PY  - 2019///
SN  - 1055-9965
SP  - 1089
TI  - Socioeconomic effect of education on pancreatic cancer risk in Western Europe: an update on the EPIC cohorts study
T2  - Cancer Epidemiology, Biomarkers and Prevention
UR  - http://dx.doi.org/10.1158/1055-9965.EPI-18-1153
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000481682000013&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://cebp.aacrjournals.org/content/28/6/1089
VL  - 28
ER  -

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