Harvei S, Kravdal O
Institute for Epidemiological Cancer Research, Cancer Registry of Norway, Montebello, Oslo, Norway.
Prev Med. 1997 Sep-Oct;26(5 Pt 1):623-32. doi: 10.1006/pmed.1997.0153.
Previous studies of the association between social and family status and prostate cancer (PCa) have given somewhat divergent results. Little attention has been paid to the possible importance of these factors for survival.
In this study, hazard regression models for PCa incidence and mortality were estimated on the basis of register- and census-based histories for complete Norwegian birth cohorts, giving a follow-up time of 16 million person years and 30,000 cases of PCa.
A significant excess incidence of about 20% was found for ever-married men and for those with higher education. Marriage and socioeconomic resources appeared, however, to have a favorable effect on survival. Five-year relative survival from metastasized cancer among men with a high educational level was found to be 15 percentage points higher than among men with lower education.
The observed differences in incidence are not easily explained. They apparently run counter to the hypothesis that multiple partners give a higher PCa risk, but may be consistent with the view that fat and meat consumption is risky. Better survival from PCa in higher socioeconomic groups and among married men may reflect differences in the search for, access to, or quality of treatment or a better constitution to fight the disease.
先前关于社会和家庭地位与前列腺癌（PCa）之间关联的研究结果存在一定差异。这些因素对生存率的潜在重要性却很少受到关注。
在本研究中，基于挪威完整出生队列的登记和人口普查历史记录，估计了前列腺癌发病率和死亡率的风险回归模型，随访时间达1600万人年，有30000例前列腺癌病例。
已婚男性和受过高等教育的男性的发病率显著高出约20%。然而，婚姻和社会经济资源似乎对生存率有积极影响。发现高学历男性转移性癌症的五年相对生存率比低学历男性高15个百分点。
观察到的发病率差异难以解释。它们显然与多个性伴侣会增加前列腺癌风险这一假设相悖，但可能与脂肪和肉类消费有风险的观点一致。社会经济地位较高群体和已婚男性中前列腺癌更好的生存率可能反映出在寻求、获得治疗或治疗质量方面的差异，或者是对抗疾病的更好体质。
