The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here: https://www.microsoft.com/en-us/microsoft-365/windows/end-of-ie-support).

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Ulf Gerdtham. Photo.

Ulf Gerdtham

Professor

Ulf Gerdtham. Photo.

Socioeconomic inequalities in breast cancer incidence and mortality in Europe - A systematic review and meta-analysis

Author

  • Adam Lundqvist
  • Emelie Andersson
  • Ida Ahlberg
  • Mef Nilbert
  • Ulf Gerdtham

Summary, in English

Background: Breast cancer is the leading cause of female cancer in Europe and is estimated to affect more than one in 10 women. Higher socioeconomic status has been linked to higher incidence but lower case fatality, while the impact on mortality is ambiguous. Methods: We performed a systematic literature review and meta-analysis on studies on association between socioeconomic status and breast cancer outcomes in Europe, with a focus on effects of confounding factors. Summary relative risks (SRRs) were calculated. Results: The systematic review included 25 articles of which 8 studied incidence, 10 case fatality and 8 mortality. The meta-analysis showed a significantly increased incidence (SRR 1.25, 1.17-1.32), a significantly decreased case fatality (SRR 0.72, 0.63-0.81) and a significantly increased mortality (SRR 1.16, 1.10-1.23) for women with higher socioeconomic status. The association for incidence became insignificant when reproductive factors were included. Case fatality remained significant after controlling for tumour characteristics, treatment factors, comorbidity and lifestyle factors. Mortality remained significant after controlling for reproductive factors. Conclusion: Women with higher socioeconomic status show significantly higher breast cancer incidence, which may be explained by reproductive factors, mammography screening, hormone replacement therapy and lifestyle factors. Lower case fatality for women with higher socioeconomic status may be partly explained by differences in tumour characteristics, treatment factors, comorbidity and lifestyle factors. Several factors linked to breast cancer risk and outcome, such as lower screening attendance for women with lower socioeconomic status, are suitable targets for policy intervention aimed at reducing socioeconomic-related inequalities in health outcomes.

Department/s

  • EpiHealth: Epidemiology for Health
  • Breastcancer-genetics
  • BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation
  • Health Economics

Publishing year

2016-10-01

Language

English

Pages

804-813

Publication/Series

European Journal of Public Health

Volume

26

Issue

5

Document type

Journal article

Publisher

Oxford University Press

Topic

  • Public Health, Global Health, Social Medicine and Epidemiology
  • Cancer and Oncology

Status

Published

Research group

  • Health Economics

ISBN/ISSN/Other

  • ISSN: 1101-1262