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@ARTICLE{Finke:166039,
      author       = {I. Finke$^*$ and K. Seppä and N. Malila and L. Jansen$^*$
                      and H. Brenner$^*$ and J. Pitkäniemi},
      title        = {{E}ducational inequalities and regional variation in
                      colorectal cancer survival in {F}inland.},
      journal      = {Cancer epidemiology},
      volume       = {70},
      issn         = {1877-7821},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2020-02578},
      pages        = {101858},
      year         = {2021},
      note         = {#EA:C070#},
      abstract     = {Previous studies have reported lower colorectal cancer
                      (CRC) survival in patients with low compared to high
                      educational levels. We investigated the impact of education
                      on CRC survival by using both individual and area-based
                      information on education.Patients diagnosed with CRC in
                      Finland in 2007-2016 were followed up for death until the
                      end of 2016. Age-standardized relative survival and relative
                      excess risk of death (RER) were estimated by sex using
                      period approach. RERs were adjusted for age, stage at
                      diagnosis, cancer site, urbanity, hospital district and
                      municipality by using Bayesian piecewise constant excess
                      hazard models. Analyses were conducted including individual
                      (basic, secondary, high) and area-based (quartiles Q1-Q4
                      based on the proportion of population with basic education)
                      education separately as well as both measures in one
                      model.We analysed in all 24 462 CRC patients. There was a
                      clear gradient in 5-year relative survival across education
                      groups (men: basic 62 $\%,$ secondary 64 $\%,$ high 69 $\%;$
                      women: basic 61 $\%,$ secondary 67 $\%,$ high 71 $\%).$
                      Compared to the basic education group, RER in the high
                      education group was significantly lower. This association
                      was still present after including area-based education in
                      the models (men: RER 0.72, 95 $\%$ Confidence interval (CI)
                      0.64-0.81; women: RER 0.76, 95 $\%$ CI 0.59-0.96).
                      Area-based education revealed smaller effect estimates than
                      individual education in CRC survival and no association for
                      men.Individual education information should be preferred
                      over area-based when survival differences are studied by
                      education. Educational differences in CRC survival are still
                      present in Finland.},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33246249},
      doi          = {10.1016/j.canep.2020.101858},
      url          = {https://inrepo02.dkfz.de/record/166039},
}