National Institute of Statistics, Directorate for Social Statistics and Welfare, Integrated System for Health, Social Assistance, and Welfare, Rome, Italy.
L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
Cancer. 2020 Nov 1;126(21):4753-4760. doi: 10.1002/cncr.33146. Epub 2020 Aug 18.
Progress in the treatment of juvenile cancers has led to remarkable improvements in survival. However, not all families have the resources to cope with the burden that such diseases require. This study was aimed at evaluating the association between parental education and cancer mortality in children, adolescents, and young adults.
This was a case-cohort study based on 1889 cancer cases and 108,387 noncases sampled from the 2011 Italian census cohort of 10,964,837 individuals younger than 20 years and followed for 6 years. Mortality rate ratios (MRRs) were estimated for individuals with parents with high and intermediate levels of education (International Standard Classification of Education [ISCED] levels 5-8 and 3-4, respectively) in comparison with individuals with less educated parents (ISCED levels < 3) through multiple Poisson regression models.
Over the follow-up, 684, 858, and 347 cancer cases with parents with the lowest, intermediate, and highest levels of education, respectively, were registered. In comparison with the individuals with parents with the lowest level of education, the MRR from all neoplasms was 0.92 (95% confidence interval [CI], 0.83-1.03) for those with parents with an intermediate level of education and 0.83 (95% CI, 0.72-0.95) for those with parents with the highest level of education. The MRRs from all neoplasms for individuals with parents with the highest level of education were 0.88 (95% CI, 0.69-1.11) among children, 0.87 (95% CI, 0.70-1.06) among adolescents, and 0.64 (95% CI, 0.50-0.83) among young adults.
Children, adolescents, and young adults with highly educated parents have reduced mortality from cancer. This calls for further efforts to optimize treatment for children of less educated parents.
青少年癌症治疗的进展带来了生存状况的显著改善。然而，并非所有家庭都有资源来应对此类疾病带来的负担。本研究旨在评估父母受教育程度与儿童、青少年和青年癌症患者死亡率之间的关系。
这是一项基于 1889 例癌症病例和从意大利 2011 年人口普查队列中抽取的 108387 例非病例的病例对照研究，该队列由 10964837 名年龄小于 20 岁的个体组成，随访时间为 6 年。通过多泊松回归模型，比较父母受教育程度高（国际标准教育分类[ISCED]等级 5-8）和中等（ISCED 等级 3-4）的个体与受教育程度较低（ISCED 等级<3）的个体的死亡率比值（MRR）。
在随访期间，分别登记了父母受教育程度最低、中等和最高的癌症病例 684、858 和 347 例。与父母受教育程度最低的个体相比，父母受教育程度中等的个体的所有肿瘤的 MRR 为 0.92（95%置信区间[CI]，0.83-1.03），父母受教育程度最高的个体的 MRR 为 0.83（95% CI，0.72-0.95）。父母受教育程度最高的个体的所有肿瘤的 MRR 为儿童 0.88（95% CI，0.69-1.11）、青少年 0.87（95% CI，0.70-1.06）和青年成人 0.64（95% CI，0.50-0.83）。
受教育程度高的父母的儿童、青少年和青年癌症患者的死亡率降低。这需要进一步努力，优化对受教育程度较低的父母的儿童的治疗。
