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Occupational class differences in pancreatic cancer survival: A population‐based cancer registry‐based study in Japan
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 patien...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558482/ https://www.ncbi.nlm.nih.gov/pubmed/30953422 http://dx.doi.org/10.1002/cam4.2138 |
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author | Zaitsu, Masayoshi Kim, Yongjoo Lee, Hye‐Eun Takeuchi, Takumi Kobayashi, Yasuki Kawachi, Ichiro |
author_facet | Zaitsu, Masayoshi Kim, Yongjoo Lee, Hye‐Eun Takeuchi, Takumi Kobayashi, Yasuki Kawachi, Ichiro |
author_sort | Zaitsu, Masayoshi |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6558482 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-65584822019-06-13 Occupational class differences in pancreatic cancer survival: A population‐based cancer registry‐based study in Japan Zaitsu, Masayoshi Kim, Yongjoo Lee, Hye‐Eun Takeuchi, Takumi Kobayashi, Yasuki Kawachi, Ichiro Cancer Med Cancer Prevention 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. John Wiley and Sons Inc. 2019-04-05 /pmc/articles/PMC6558482/ /pubmed/30953422 http://dx.doi.org/10.1002/cam4.2138 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Cancer Prevention Zaitsu, Masayoshi Kim, Yongjoo Lee, Hye‐Eun Takeuchi, Takumi Kobayashi, Yasuki Kawachi, Ichiro Occupational class differences in pancreatic cancer survival: A population‐based cancer registry‐based study in Japan |
title | Occupational class differences in pancreatic cancer survival: A population‐based cancer registry‐based study in Japan |
title_full | Occupational class differences in pancreatic cancer survival: A population‐based cancer registry‐based study in Japan |
title_fullStr | Occupational class differences in pancreatic cancer survival: A population‐based cancer registry‐based study in Japan |
title_full_unstemmed | Occupational class differences in pancreatic cancer survival: A population‐based cancer registry‐based study in Japan |
title_short | Occupational class differences in pancreatic cancer survival: A population‐based cancer registry‐based study in Japan |
title_sort | occupational class differences in pancreatic cancer survival: a population‐based cancer registry‐based study in japan |
topic | Cancer Prevention |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558482/ https://www.ncbi.nlm.nih.gov/pubmed/30953422 http://dx.doi.org/10.1002/cam4.2138 |
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