Mogensen Hanna, Modig Karin, Tettamanti Giorgio, Talbäck Mats, Feychting Maria
Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, Stockholm SE-171 77, Sweden.
Br J Cancer. 2016 Jan 12;114(1):118-24. doi: 10.1038/bjc.2015.449. Epub 2016 Jan 5.
Earlier evidence, also from high-income countries, suggests that parental socioeconomic status might influence survival from childhood cancer. This nationwide cohort study aimed to determine whether survival from childhood cancer in Sweden varies according to parental educational level and household income at the time of the child's diagnosis.
All children aged 1-14 years with a first primary diagnosis of cancer during 1991 to 2010 identified from the Swedish Cancer Register were included. Using Cox regression, the effects of parental educational level and household income on childhood cancer survival were estimated.
For all diagnoses combined (n=4700), children of parents with compulsory or less education and upper-secondary education had poorer survival compared with children with parents who had the highest educational level, adjusted hazard ratios 1.28 (95% confidence interval 1.03-1.59) and 1.17 (1.00-1.38). Results for leukaemia and nervous system tumours showed a similar pattern but were not statistically significant in adjusted analyses. The observed differences began within the first year after diagnosis. Household income was not associated with survival.
Also in Sweden, with universal health care, there are indications of inequalities in survival after childhood cancer diagnosis. Further studies are needed to determine which mechanisms explain the association.
早期证据（同样来自高收入国家）表明，父母的社会经济地位可能会影响儿童癌症患者的生存率。这项全国性队列研究旨在确定瑞典儿童癌症患者的生存率是否会因孩子确诊时父母的教育水平和家庭收入而有所不同。
纳入所有在1991年至2010年期间首次被瑞典癌症登记处确诊为原发性癌症的1至14岁儿童。使用Cox回归分析，评估父母教育水平和家庭收入对儿童癌症生存率的影响。
对于所有合并诊断（n = 4700），父母接受义务教育或以下教育以及高中教育的孩子，与父母接受最高教育水平的孩子相比，生存率较低，调整后的风险比分别为1.28（95%置信区间1.03 - 1.59）和1.17（1.00 - 1.38）。白血病和神经系统肿瘤的结果呈现类似模式，但在调整分析中无统计学意义。观察到的差异在确诊后的第一年内就已出现。家庭收入与生存率无关。
同样在瑞典这个拥有全民医疗保健的国家，儿童癌症诊断后的生存情况也存在不平等迹象。需要进一步研究以确定哪些机制可以解释这种关联。
