Winther Dorte, Nygaard Tina K, Horsbøl Trine A, Kjær Trille, Vedsted Peter, Johansen Christoffer, Hovaldt Hanna B, Sandager Mette, Dalton Susanne O
a Unit of Survivorship , Danish Cancer Society Research Center , Copenhagen , Denmark.
b Research Centre for Cancer Diagnosis in Primary Care, Aarhus University , Aarhus , Denmark.
Acta Oncol. 2017 Feb;56(2):348-353. doi: 10.1080/0284186X.2016.1268712. Epub 2017 Jan 12.
Late effects after cancer diagnosis and treatment are common, but only few studies have examined the role of social factors in developing these late effects. The aim of this study was to examine the association between educational level and physical function and pain among cancer survivors two years after diagnosis.
The study population consisted of adult Danish patients with a first-time cancer diagnosis who were sent a questionnaire in 2010 and followed up in 2012. In total, 4346 returned the first questionnaire shortly after diagnosis and 2568 returned the follow-up questionnaire. After exclusion of 177 due to missing information, we included 2391 cancer survivors in the analyses. Physical function and pain were measured using the EORTC QLQ-C30. Linear regression analyses were conducted separately for men and women, and adjusted for demographic and clinical characteristics. Additionally, analyses were stratified on comorbidity.
Differences in mean scores according to educational level were small. Physical function was better in women with medium (2.8; 95% CI 0.1;5.4) and higher education (3.4; 95% CI 0.9;5.9) compared to women with short education. In contrast, men with medium education reported lower physical function (-2.9; 95% CI -5.7;-0.1) than men with short education. Compared to women with short education, we found lower pain scores among women with medium (-5.0; 95% CI -8.7;-1.4) and higher education (-3.4; 95% CI -6.7;0.0). Similarly, men with higher education experienced lower pain score (-3.4; 95% CI -6.9;0.1) than men with short education. The role of educational level differed between those with and without comorbidity.
Educational level is slightly associated with physical function and pain among cancer survivors. However, mean differences in this study were small and below what is considered clinically relevant.
癌症诊断和治疗后的晚期效应很常见，但仅有少数研究探讨了社会因素在这些晚期效应发生过程中的作用。本研究的目的是调查癌症幸存者在确诊两年后教育水平与身体功能及疼痛之间的关联。
研究人群包括首次被诊断为癌症的成年丹麦患者，他们于2010年收到一份问卷，并于2012年接受随访。总共有4346名患者在确诊后不久返回了第一份问卷，2568名患者返回了随访问卷。在排除因信息缺失的177名患者后，我们将2391名癌症幸存者纳入分析。使用欧洲癌症研究与治疗组织的QLQ-C30问卷来测量身体功能和疼痛。分别对男性和女性进行线性回归分析，并对人口统计学和临床特征进行调整。此外，分析按合并症进行分层。
根据教育水平的平均得分差异较小。与受教育年限短的女性相比，中等教育水平（2.8；95%可信区间0.1；5.4）和高等教育水平（3.4；95%可信区间0.9；5.9）的女性身体功能更好。相比之下，中等教育水平的男性报告的身体功能（-2.9；95%可信区间-5.7；-0.1）低于受教育年限短的男性。与受教育年限短的女性相比，我们发现中等教育水平（-5.0；95%可信区间-8.7；-1.4）和高等教育水平（-3.4；95%可信区间-6.7；0.0）的女性疼痛得分更低。同样地，与受教育年限短的男性相比，高等教育水平的男性疼痛得分更低（-3.4；95%可信区间-6.9；0.1）。教育水平在有合并症和无合并症的人群中的作用有所不同。
教育水平与癌症幸存者的身体功能和疼痛略有关联。然而，本研究中的平均差异较小，低于临床相关水平。
