title: Socioeconomic position and stage of cervical cancer in Danish women diagnosed 2005 to 2009.
abstract: BACKGROUND
  To reduce social disparities in cervical cancer survival, it is important to understand the mechanisms by which social position influence cancer prognosis. We investigated the relations between socioeconomic factors, comorbidity, time since last Papanicolau smear, and stage at diagnosis in Danish women with cervical cancer.
  
  
  METHODS
  We identified 1,651 cervical cancer cases diagnosed 2005 to 2009 from the Danish Gynaecological Cancer Database. Date of diagnosis, clinical cancer stage, tumor histology, and treating hospital were retrieved; Pap smear registrations were obtained from the Danish Pathology Register; data on comorbid conditions from the Danish National Patients Register; and data on education, income, and cohabitation from Statistics Denmark. Logistic regression models were used to analyze the relations between socioeconomic factors and cancer stage in a four-step model, with stepwise inclusion of mediators.
  
  
  RESULTS
  The risk for advanced (stage II-IV) compared with early-stage cancer (stage I) was increased for women with short and medium education (OR = 2.40; 1.67-3.45 and 1.76; 1.44-2.16), women living without a partner (OR = 1.31; 1.10-1.55), and older women (OR = 1.07; 1.06-1.08 increase per year). The relations between socioeconomic factors and cancer stage were partly mediated by time since last Pap smear test and to a lesser extent by comorbidity.
  
  
  CONCLUSIONS
  Shorter education, living alone, and older age were related to advanced stage cervical cancer, due partly to Pap smear testing and less to comorbidity.
  
  
  CONCLUSIONS
  It is relevant to further investigate how to decrease delay in cervical cancer diagnosis among disadvantaged groups.
authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark. else@cancer.dk
authors.forename: Else
authors.initials: E
authors.lastname: Ibfelt
authors.forename: Susanne K
authors.initials: SK
authors.lastname: Kjær
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
authors.forename: Claus
authors.initials: C
authors.lastname: Høgdall
authors.forename: Marianne
authors.initials: M
authors.lastname: Steding-Jessen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Frederiksen
authors.forename: Birgitte Lidegaard
authors.initials: BL
authors.lastname: Frederiksen
authors.forename: Merete
authors.initials: M
authors.lastname: Osler
authors.forename: Susanne Oksbjerg
authors.initials: SO
authors.lastname: Dalton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D012307:Risk Factors; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology