No association between educational level and pancreatic cancer incidence in the European Prospective Investigation into Cancer and Nutrition

Petra G A van Boeckel, Hendriek C. Boshuizen, Peter D. Siersema, Alina Vrieling, Anton E. Kunst, Weimin Ye, Malin Sund, Dominique S. Michaud, Valentina Gallo, Elizabeth A. Spencer, Antonia Trichopoulou, Vasiliki Benetou, Philippos Orfanos, Lluis Cirera, Eric J. Duell, Sabine Rohrmann, Silke Hemann, Giovanni Masala, Jonas Manjer, Amalia MattielloBjorn Lindkvist, María José Sánchez, Valeria Pala, Petra H M Peeters, Tonje Braaten, Anne Tjonneland, Susanne Oksbjerg Dalton, Nerea Larranaga, Miren Dorronsoro, Kim Overvad, Anne Kathrin Illner, Eva Ardanaz, M. Marron, K. Straif, E. Riboli, B. Bueno-de-Mesquita

Research output: Contribution to journalArticlepeer-review


Introduction: Until now, studies examining the relationship between socioeconomic status and pancreatic cancer incidence have been inconclusive. Aim: To prospectively investigate to what extent pancreatic cancer incidence varies according to educational level within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods: In the EPIC study, socioeconomic status at baseline was measured using the highest level of education attained. Hazard ratios by educational level and a summary index, the relative indices of inequality (RII), were estimated using Cox regression models stratified by age, gender, and center and adjusted for known risk factors. In addition, we conducted separate analyses by age, gender and geographical region. Results: Within the source population of 407, 944 individuals at baseline, 490 first incident primary pancreatic adenocarcinoma cases were identified in 9 European countries. The crude difference in risk of pancreatic cancer according to level of education was small and not statistically significant (RII=1.14, 95% CI 0.80-1.62). Adjustment for known risk factors reduced the inequality estimates to only a small extent. In addition, no statistically significant associations were observed for age groups (adjusted RII≤ 60 years=0.85, 95% CI 0.44-1.64, adjusted RII>60 years=1.18, 95% CI 0.73-1.90), gender (adjusted RIImale=1.20, 95% CI 0.68-2.10, adjusted RIIfemale=0.96, 95% CI 0.56-1.62) or geographical region (adjusted RIINorthern Europe=1.14, 95% CI 0.81-1.61, adjusted RIIMiddle Europe=1.72, 95% CI 0.93-3.19, adjusted RIISouthern Europe=0.75, 95% CI 0.32-1.80). Conclusion: Despite large educational inequalities in many risk factors within the EPIC study, we found no evidence for an association between educational level and the risk of developing pancreatic cancer in this European cohort.

Original languageEnglish
Pages (from-to)696-701
Number of pages6
JournalCancer Epidemiology
Issue number6
Publication statusPublished - Dec 2010


  • Educational level
  • Epidemiology
  • Pancreatic cancer incidence
  • Socioeconomic status

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Epidemiology


Dive into the research topics of 'No association between educational level and pancreatic cancer incidence in the European Prospective Investigation into Cancer and Nutrition'. Together they form a unique fingerprint.

Cite this