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@ARTICLE{Cirera:143933,
author = {L. Cirera and J. M. Huerta and M. D. Chirlaque and K.
Overvad and M. Lindström and S. Regnér and A. Tjønneland
and M.-C. Boutron-Ruault and V. Rebours and G. Fagherazzi
and V. A. Katzke$^*$ and H. Boeing and E. Peppa and A.
Trichopoulou and E. Valanou and D. Palli and S. Grioni and
S. Panico and R. Tumino and F. Ricceri and C. van Gils and
R. C. H. Vermeulen and G. Skeie and T. Braaten and E.
Weiderpass and S. Merino and M. J. Sánchez and N.
Larrañaga and E. Ardanaz and M. Sund and K.-T. Khaw and T.
J. Key and M. Jenab and S. Naudin and N. Murphy and D. Aune
and H. Ward and E. Riboli and B. Bueno-de-Mesquita and C.
Navarro and E. J. Duell},
title = {{S}ocioeconomic {E}ffect of {E}ducation on {P}ancreatic
{C}ancer {R}isk in {W}estern {E}urope: {A}n {U}pdate on the
{EPIC} {C}ohorts {S}tudy.},
journal = {Cancer epidemiology, biomarkers $\&$ prevention},
volume = {28},
number = {6},
issn = {1538-7755},
address = {Philadelphia, Pa.},
publisher = {AACR},
reportid = {DKFZ-2019-01490},
pages = {1089 - 1092},
year = {2019},
abstract = {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.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.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.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.The results do not support an association between
education and risk of pancreatic cancer.},
cin = {C020},
ddc = {610},
cid = {I:(DE-He78)C020-20160331},
pnm = {313 - Cancer risk factors and prevention (POF3-313)},
pid = {G:(DE-HGF)POF3-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:31160392},
doi = {10.1158/1055-9965.EPI-18-1153},
url = {https://inrepo02.dkfz.de/record/143933},
}