title: Education predicts cervical cancer survival: a Lithuanian cohort study.
abstract: : We examined inequalities in cervical cancer survival in Lithuania by education and place of residence. : The study is based on the linked dataset that includes all records of the 2001 population Census, all records from Lithuanian Cancer Registry (cancer incidence) and all death and emigration records from Statistics Lithuania for the period between 6 April 2001 and 31 December 2009. The study group includes cervical cancers registered in the Cancer Registry from 1 January 2002 to 31 December 2006. Analysis was restricted to women who were 25-64 years old at the Census date (in total 1 866 cases). : During the study period there were 671 deaths corresponding to an overall 5-year survival proportion 64.13% (95% CI 61.86-66.31). Place of residence and education of cervical cancer patients had strong impact on survival; 5-year survival was higher in women living in urban areas than in rural (68.61 and 55.93%) and survival decreased with decreasing education: from 79.77% in highest education group to 64.85 and 50.48% in groups with secondary and lower than secondary education. The effect of place of residence declined when stage of disease was included in the model and became not significant in final model with education adjustment. The effect of education declined after inclusion of stage and other variables, however, remained significant. : We found that women with higher education experienced higher survival following a cervical cancer diagnosis, and stage of disease at the time of diagnosis explains only the part of observed differences.
authors.affiliation: Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius, Lithuania.
authors.forename: Ieva
authors.initials: I
authors.lastname: Vincerževskiene
authors.affiliation: Laboratory for Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany.|Centre for Demographic Research, Vytautas Magnus University, Kaunas, Lithuania.
authors.forename: Domantas
authors.initials: D
authors.lastname: Jasilionis
authors.affiliation: Institute of Public Health, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Donatas
authors.initials: D
authors.lastname: Austys
authors.affiliation: Institute of Public Health, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Rimantas
authors.initials: R
authors.lastname: Stukas
authors.affiliation: Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius, Lithuania.
authors.forename: Auguste
authors.initials: A
authors.lastname: Kaceniene
authors.affiliation: Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius, Lithuania.|Institute of Public Health, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Giedre
authors.initials: G
authors.lastname: Smailyte
mesh_terms: D000328:Adult; D004522:Educational Status; D005260:Female; D006801:Humans; D008097:Lithuania / Q000453:epidemiology; D008875:Middle Aged; D012042:Registries; D012424:Rural Population / Q000706:statistics & numerical data; D016019:Survival Analysis; D014505:Urban Population / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000401:mortality*