Social inequality and incidence of and survival from tumours of the central nervous system in a population-based study in Denmark, 1994–2003
Introduction
Tumours of the central nervous system (CNS) are rare; however, the incidence rates have increased during the past few decades in both men and women.1 The increased incidence may be explained by improved diagnostic methods and by a lower threshold for performing diagnostic computed tomography or magnetic resonance image scanning; however, unknown risk factors may also play a role. In 2003, 922 new cases of CNS tumours were diagnosed in Denmark.2 The results of studies of an association between incidence and socioeconomic position (SEP) are conflicting: several reported increased incidences of CNS tumours amongst persons with higher SEP,3, 4, 5 whilst others found no association with SEP.6, 7
Age and tumour characteristics are known to be important prognostic factors for survival,8 but the effect of SEP has been investigated only rarely.9, 10, 11 The aim of this study was to investigate the effects of various socioeconomic indicators on the incidence of and survival from CNS tumours in Denmark on the basis of information from population-based, nationwide Danish administrative registers. It was carried out as part of a comprehensive, rigorous analysis of the role of socioeconomic position in cancer incidence and survival.
Section snippets
Material and methods
The material and methods are described elsewhere.12 Briefly, the study population comprised all Danish residents born between 1925 and 1973 without a previous cancer and who entered the cohort at age 30 (see Fig. 1 in [12]) Information on socioeconomic, demographic and health-related indicators was obtained from various Danish administrative registers.12 Crude, age-specific and age-standardised incidence rates are presented for CNS tumours (ICD-10 C70–C72, D32–D33, D42–43) diagnosed in the
Results
We included 5622 persons in whom a CNS tumour was diagnosed during the study period 1994–2003, of which 2391 were malignant tumours. Amongst Danish persons, the male:female ratio for all CNS tumours was 0.90, and that for malignant tumours was 1.4. The age- and period-standardised incidence rate was 20 per 100,000 person-years for men and 22 per 100,000 person-years for women.
Discussion
Overall, we observed no major effects of socioeconomic position or demographic factors on the incidence of CNS tumours, in line with the previous reports from large Scandinavian register-based cohort studies,6, 7, 15 as well as a large, recently published case–control study,16 in which occupational title or educational level was used as the indicator of SEP.6, 7, 15 A number of case–control studies have given conflicting results, with an increasing risk with increasing socioeconomic position
Conflict of interest statement
None declared.
Acknowledgement
The study was funded by a Grant from the Danish Cancer Society.
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