Table 5.
Effects of area‐based socioeconomic status (SES) on cervical cancer cumulative 5‐year survival estimated by Cox proportional hazards regression models
| Independent variable | Unemployment Univariate Hazard ratio (95%CI) | Model 1 Hazard ratio (95%CI) | Model 2 Hazard ratio (95%CI) | Model 3 Hazard ratio (95%CI) | Education Univariate Hazard ratio (95%CI) | Model 1 Hazard ratio (95%CI) | Model 2 Hazard ratio (95%CI) | Model 3 Hazard ratio (95%CI) |
|---|---|---|---|---|---|---|---|---|
| Area‐based SES † | ||||||||
| High | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| Middle | 1.19 (1.10–1.29) | 1.15 (1.07–1.24) | 1.11 (1.23–1.20) | 1.08 (0.99–1.17) | 1.10 (1.03–1.18) | 1.09 (1.02–1.17) | 1.06 (0.99–1.13) | 1.05 (0.95–1.12) |
| Low | 1.80 (1.67–1.95) | 1.59 (1.47–1.72) | 1.39 (1.28–1.50) | 1.31 (1.21–1.42) | 1.36 (1.26–1.47) | 1.29 (1.20–1.40) | 1.21 (1.12–1.31) | 1.17 (1.09–1.27) |
| Age (years) | ||||||||
| Under 40 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
| 40–49 | 1.56 (1.35–1.79) | 1.56 (1.36–1.79) | 1.31 (1.14–1.50) | 1.24 (1.08–1.43) | 1.56 (1.35–1.79) | 1.55 (1.35–1.78) | 1.31 (1.14–1.50) | 1.24 (1.08–1.43) |
| 50–59 | 2.32 (2.03–2.65) | 2.25 (1.97–2.56) | 1.56 (1.36–1.78) | 1.31 (1.15–1.50) | 2.32 (2.03–2.65) | 2.30 (2.02–2.63) | 1.58 (1.38–1.80) | 1.32 (1.16–1.51) |
| 60–69 | 2.80 (2.46–3.20) | 2.66 (2.33–3.03) | 1.82 (1.59–2.08) | 1.39 (1.22–1.60) | 2.80 (2.46–3.20) | 2.77 (2.43–3.16) | 1.85 (1.62–2.11) | 1.40 (1.23–1.61) |
| 70–79 | 4.29 (3.75–4.90) | 4.61 (3.56–4.65) | 2.57 (2.21–2.90) | 1.75 (2.28–3.17) | 4.29 (3.75–4.90) | 4.24 (3.71–4.85) | 2.58 (2.25–2.95) | 1.77 (1.53–2.03) |
| 80+ | 7.85 (6.71–9.19) | 7.42 (6.34–8.69) | 4.06 (3.46–4.76) | 2.69 (2.77–3.22) | 7.85 (6.71–9.19) | 7.76 (6.63–9.08) | 4.16 (3.54–4.88) | 2.72 (2.31–3.21) |
| Cancer stage | ||||||||
| Localized | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||
| Regional | 4.82 (4.49–5.18) | 4.02 (3.74–4.32) | 2.99 (2.77–3.22) | 4.82 (4.49–5.18) | 4.09 (3.80–4.40) | 3.01 (2.79–3.24) | ||
| Distant | 14.94 (13.42–16.63) | 11.25 (10.09–12.55) | 8.06 (7.21–9.01) | 14.94 (13.42–16.63) | 11.44 (10.25–12.76) | 8.10 (7.25–9.06) | ||
| Unknown | 3.25 (2.93–3.60) | 2.43 (2.19–2.70) | 1.89 (1.70–2.10) | 3.25 (2.93–3.60) | 2.48 (2.23–2.75) | 1.91 (1.71–2.12) | ||
| Histology | ||||||||
| Squamous carcinomas | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||
| Adenocarcinomas | 1.43 (1.28–1.60) | 1.61 (1.44–1.80) | 1.62 (1.45–1.81) | 1.43 (1.28–1.60) | 1.61 (1.44–1.79) | 1.62 (1.45–1.81) | ||
| Other specific | 1.05 (0.86–1.30) | 1.27 (1.03–1.56) | 1.28 (1.04–1.58) | 1.05 (0.86–1.30) | 1.25 (1.01–1.54) | 1.26 (1.02–1.56) | ||
| Carcinomas | ||||||||
| Other | 3.10 (2.85–3.38) | 2.56 (2.35–2.79) | 2.43 (2.22–2.65) | 3.10 (2.85–3.38) | 2.58 (2.36–2.81) | 2.44 (2.24–2.67) | ||
| Treatment | ||||||||
| Surgery alone | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Surgery combined with either radiation, chemotherapy, or both | 4.95 (4.36–5.63) | 2.84 (2.49–3.25) | 4.95 (4.36–5.63) | 2.87 (2.51–3.28) | ||||
| No surgery (radiation alone, chemo alone, or combined radiation + chemotherapy) | 10.27 (9.07–11.63) | 4.04 (3.52–4.63) | 10.27 (9.07–11.63) | 4.121 (3.59–4.73) | ||||
| Other treatments and unknown | 9.31 (7.96–10.88) | 4.48 (3.79–5.28) | 9.31 (7.96–10.88) | 4.501 (3.82–5.31) | ||||
†
In the case of ‘unemployment’, high area‐based SES means a low percentage of male unemployment in each municipality. In the case of ‘education’, high area‐based SES means a high percentage of college or graduate school graduates in each municipality. In model 1 we controlled for age; in model 2 we controlled for age plus biological factors (cancer stage and histology); in model 3 we controlled for all of the variables in model 2, plus treatment type. CI, confidence interval.