Abstract 148P
Background
Inequality in lung cancer is a major problem. An inverse relationship between risk of lung cancer and education level has previously been shown in cohort and small registry-based studies. This nationwide epidemiological study covering 1994–2018 evaluates education level in lung cancer patients and matched controls.
Methods
Using the nationwide Danish Cancer Registry and Danish Statistics Education Registry, all lung cancer patients in Denmark in the period 1994–2018 were identified. The patients were divided into a period I cohort (1994–2007) and a period II cohort (2008–2018). Lung cancer patients were matched with controls at a 1:4 ratio by age, gender, marital status, and municipality at time of diagnosis. A multinomial logistic regression was performed to assess odds ratio of lung cancer.
Results
Education levels were divided into primary school, secondary school, vocational school, and college. Lung cancer patients were more likely to be primary school graduates compared to matched controls, and this tendency increased from period I to period II (47.3% vs. 41.1% in 1994–2007; 46.2% vs. 38.0% in 2008–2018; p < 0.01). Contrary, control subjects were more likely to have a college degree compared to lung cancer patients (8.7% vs. 13.7% in 1994–2007; 13.2% vs. 21.0% in 2008–2018; p < 0.01). When comparing lung cancer patients and matched controls, there was no difference regarding secondary school and vocational school. The education levels: Secondary school, vocational school, and college were all significantly less associated with lung cancer compared to primary school; odds ratio 0.59 (95% CI: 0.54–0.63); 0.82 (0.80–0.84) and 0.52 (0.50–0.53), respectively.
Conclusions
In a nationwide study covering 1994–2018, lung cancer patients were more likely to have primary school as education level and less likely to have a college degree. Study subjects with education levels: Secondary school, vocational school, and college were all less likely to have lung cancer compared with primary school. Special attention regarding prevention and early detection of lung cancer should be aimed at people with primary school as education level. Information from this study could be of great importance in a lung cancer screening setting.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.