title: Socioeconomic differences in cancer survival among Swedish children.
abstract: BACKGROUND
  Earlier evidence, also from high-income countries, suggests that parental socioeconomic status might influence survival from childhood cancer. This nationwide cohort study aimed to determine whether survival from childhood cancer in Sweden varies according to parental educational level and household income at the time of the child's diagnosis.
  
  
  METHODS
  All children aged 1-14 years with a first primary diagnosis of cancer during 1991 to 2010 identified from the Swedish Cancer Register were included. Using Cox regression, the effects of parental educational level and household income on childhood cancer survival were estimated.
  
  
  RESULTS
  For all diagnoses combined (n=4700), children of parents with compulsory or less education and upper-secondary education had poorer survival compared with children with parents who had the highest educational level, adjusted hazard ratios 1.28 (95% confidence interval 1.03-1.59) and 1.17 (1.00-1.38). Results for leukaemia and nervous system tumours showed a similar pattern but were not statistically significant in adjusted analyses. The observed differences began within the first year after diagnosis. Household income was not associated with survival.
  
  
  CONCLUSIONS
  Also in Sweden, with universal health care, there are indications of inequalities in survival after childhood cancer diagnosis. Further studies are needed to determine which mechanisms explain the association.
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, Stockholm SE-171 77, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Mogensen
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, Stockholm SE-171 77, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Modig
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, Stockholm SE-171 77, Sweden.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Tettamanti
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, Stockholm SE-171 77, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Talbäck
authors.affiliation: Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, Stockholm SE-171 77, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Feychting
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007182:Income; D007223:Infant; D009369:Neoplasms / Q000401:mortality*; D016016:Proportional Hazards Models; D012923:Social Class; D013548:Sweden