A1 Refereed original research article in a scientific journal

The impact of socioeconomic status on stage specific prostate cancer survival and mortality before and after introduction of PSA test in Finland




AuthorsSeikkula HA, Kaipia AJ, Ryynänen H, Seppä K, Pitkäniemi JM, Malila NK, Boström PJ

PublisherWiley

Publication year2018

JournalInternational Journal of Cancer

Volume142

Issue5

First page 891

Last page898

Number of pages8

ISSN0020-7136

eISSN1097-0215

DOIhttps://doi.org/10.1002/ijc.31109


Abstract

Socioeconomic status (SES) has an impact on prostate cancer (PCa) outcomes. Men with high SES have higher incidence and lower mortality of PCa versus lower SES males. PCa cases diagnosed in Finland in 1985–2014 (N = 95,076) were identified from the Finnish Cancer Registry. Information on education level (EL) was obtained from Statistics Finland. EL was assessed with three-tiered scale: basic, upper secondary and higher education. PCa stage at diagnosis was defined as localized, metastatic or unknown. Years of diagnosis 1985–1994 were defined as pre-PSA period and thereafter as post-PSA period. We report PCa-specific survival (PCSS) and relative risks (RR) for PCa specific mortality (PCSM) among cancer cases in Finland, where healthcare is 100% publicly reimbursed and inequality in healthcare services low. Men with higher EL had markedly better 10-year PCSS: 68 versus 63% in 1985–1994 and 90 versus 85% in 1995–2004 compared to basic EL in localized PCa. The RR for PCSM among men with localized PCa and higher EL compared to basic EL was 0.76(95%confidence interval (CI) 0.66–0.88) in 1985–1994 and 0.61(95%CI 0.53–0.70) in 1995–2004. Variation in PCSS and PCSM between EL categories was evident in metastatic PCa, too. The difference in PCSM between EL categories was larger in the first 10-year post-PSA period than before that but decreased thereafter in localized PCa, suggesting PSA testing became earlier popular among men with high EL. In summary, higher SES/EL benefit PCa survival both in local and disseminated disease and the effect of EL was more pronounced in early post-PSA period.



Last updated on 2024-26-11 at 22:05