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  • 1.
    Gadeyne, S
    et al.
    Vrij Universiteit Brussel, Brussels, Belgium / Erasmus Medical Centre, Rotterdam, The Netherlands.
    Menvielle, G
    Sorbonne Universités, Paris, France.
    Kulhanova, I
    rasmus Medical Centre, Rotterdam, The Netherlands.
    Bopp, M
    University of Zürich, Switzerland.
    Deboosere, P
    Vrij Universiteit Brussel, Brussels, Belgium.
    Eikemo, T A
    Erasmus Medical Centre, Rotterdam, The Netherlands / Norwegian University of Science and Technology, Trondheim, Norway.
    Hoffmann, R
    Erasmus Medical Centre, Rotterdam, The Netherlands.
    Kovács, K
    Demographic Research Institute, Budapest, Hungary.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Martikainen, P
    University of Helsinki, Helsinki, Finland.
    Regidor, E
    Universidad Complutense de Madrid, Madrid, Spain.
    Rychtarikova, J
    Charles University, Prague, Czech Republic.
    Spadea, T
    Local Health Authority TO3 of Piedmont Region, Italy.
    Strand, B H
    Norwegian Institute of Public Health, Oslo, Norway.
    Trewin, C
    Norwegian Institute of Public Health, Oslo, Norway.
    Wojtyniak, B
    National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.
    Mackenbach, J P
    Erasmus Medical Centre, Rotterdam, The Netherlands.
    The turn of the gradient? Educational differences in breast cancer mortality in 18 European populations during the 2000s2017In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 141, no 1, p. 33-44Article in journal (Refereed)
    Abstract [en]

    This study aims to investigate the association between educational level and breast cancer mortality in Europe in the 2000s. Unlike most other causes of death, breast cancer mortality tends to be positively related to education, with higher educated women showing higher mortality rates. Research has however shown that the association is changing from being positive over non-existent to negative in some countries. To investigate these patterns, data from national mortality registers and censuses were collected and harmonized for 18 European populations. The study population included all women aged 30-74. Age-standardized mortality rates, mortality rate ratios, and slope and relative indexes of inequality were computed by education. The population was stratified according to age (women aged 30-49 and women aged 50-74). The relation between educational level and breast cancer mortality was predominantly negative in women aged 30-49, mortality rates being lower among highly educated women and higher among low educated women, although few outcomes were statistically significant. Among women aged 50-74, the association was mostly positive and statistically significant in some populations. A comparison with earlier research in the 1990s revealed a changing pattern of breast cancer mortality. Positive educational differences that used to be significant in the 1990s were no longer significant in the 2000s, indicating that inequalities have decreased or disappeared. This evolution is in line with the "fundamental causes" theory which stipulates that whenever medical insights and treatment become available to combat a disease, a negative association with socio-economic position will arise, independently of the underlying risk factors.

  • 2. Koupil, Ilona
    et al.
    Plavinskaja, Svetlana
    Parfenova, Nina
    Shestov, Dmitri B.
    Danziger, Phoebe Day
    Vågerö, Denny
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Cancer mortality in women and men who survived the siege of Leningrad (1941-1944)2009In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 124, no 6, p. 1416-1421Article in journal (Refereed)
    Abstract [en]

    The population of Leningrad suffered from severe starvation, coldand psychological stress during the siege in World War II in1941–1944. We investigated the long-term effects of the siege oncancer mortality in 3,901 men and 1,429 women, born between1910 and 1940. All study subjects were residents of St. Petersburg,formerly Leningrad, between 1975 and 1982. One third of themhad experienced the siege as children, adolescents or young adults(age range, 1–31 years at the peak of starvation in 1941–1942).Associations of siege exposure with risk of death from cancer werestudied using a multivariable Cox regression, stratified by genderand period of birth, adjusted for age, smoking, alcohol and socialcharacteristics, from 1975 to 1977 (men) and 1980 to 1982, respectively(women), until the end of 2005. Women who were 10–18 years old at the peak of starvation were taller as adults (ageadjusteddifference, 1.7 cm; 95% CI, 0.5–3.0) and had a higherrisk of dying from breast cancer compared with unexposedwomen born during the same period (age-adjusted HR, 9.9; 95%CI, 1.1–86.5). Mortality from prostate cancer was nonsignificantlyhigher in exposed men. The experience of severe starvation andstress during childhood and adolescence may have long-termeffects on cancer in surviving men and women.

  • 3. Leinsalu, Mall
    et al.
    Rahu, Mati
    Time trends in cancer mortality in Estonia, 1965–19891993In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 53, no 6, p. 914-918Article in journal (Refereed)
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