Educational differences in incidence of cancer in Lithuania, 2001–2009

evidence from census-linked cancer registry data

Abstract

This study used population-based census-linked cancer incidence data to identify patterns of educational differentials in the risk of cancer by detailed sites of cancer in Lithuania. The study is based on the linkage between all records of the 2001 population census, all records from the Lithuanian Cancer Registry (cancer incidence), and all death and emigration records from Statistics Lithuania for the period between 6 April 2001 and 31 December 2009. The study population (cohort) includes all permanent residents of Lithuania aged 30–74 years on the day of the census (6 April 2001). The study found that cancers of the lip, mouth, and pharynx, esophagus, stomach, larynx, urinary bladder, pancreas, and lung for men and cancers of the cervix uteri, lung, and colon for women show a statistically significant inverse educational gradient with excess incidence in the lowest educational group. At the same time, a reversed cancer risk gradient with the highest incidence for the higher education group was observed for thyroid cancer, melanoma, nonmelanoma skin cancers, and non-Hodgkin lymphomas. This group also includes prostate cancer, kidney cancer, and multiple myeloma for men and cancer of the pancreas, breast cancer, cancer of the colon, and cancer of the uterus for women. The associations between education and cancer incidence observed in this study reflect the concordance between social status and lifestyle-related risk factors for cancer. Cancer awareness in society has also contributed toward the observed higher risk of cancer, which is usually promoted more by patients with higher education.