Level of Education and the Risk of Cancer in Sweden

Kari Hemminki; Xinjun Li

DOI: Published August 2003

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Fig. 1.
SIR for cancer in male and female university graduates at sites for which the SIR in Tables 2<$REFLINK> or 3<$REFLINK> is significant for at least one gender. ∗ shows that the 95% CIs for the SIR did not include 1.00.

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Table 1

Population and cases in male and female educational groups

Education	Men					Women
Education		Population	Person-years	Cases	Population	Person-years	Cases
Less than 9 years	843,530	21,205,139	122,771	909,615	23,714,365	135,945
9 years	275,464	7,616,729	12,907	349,815	9,631,969	27,685
10–11 years	382,542	10,166,507	38,484	422,048	11,520,232	42,735
12 years	292,865	7,896,530	25,159	122,130	3,342,114	8,786
College < 3 years	49,956	1,319,173	6258	61,314	1,666,168	6,716
University graduate	93,015	2,450,640	11,234	63,848	1,740,773	6,971
Doctorate	7219	185,245	1054	832	21,794	119
All	1,944,591	50,839,963	217,867	1,929,602	51,637,415	228,957

Table 2

SIR and trend for cancer in male educational groups^a

Cancer site	Less than 9 years							University educated				PAF (%)
Cancer site		Observed	SIR	95%	CI	Observed	SIR	95%	CI	χ²	P	PAF (%)
Upper aerodigestive tract	4,546	1.00	0.97	1.03	334	0.60	0.54	0.67	752.41	0.00	28.1
Salivary gland	285	1.00	0.89	1.12	35	1.07	0.74	1.49	13.89	0.00	14.5
Esophagus	1,465	1.00	0.95	1.05	96	0.53	0.43	0.65	239.27	0.00	31.1
Stomach	6,227	1.00	0.98	1.03	310	0.50	0.45	0.56	1,012.93	0.00	51.2
Small intestine	625	1.00	0.92	1.08	77	1.11	0.88	1.39	4.01	0.05	0.2
Colon	8,337	1.00	0.98	1.02	966	1.11	1.04	1.18	20.59	0.00	3.9
Rectum	6,122	1.00	0.98	1.03	536	0.83	0.76	0.91	70.56	0.00	6.3
Anus	141	1.00	0.84	1.18	14	0.79	0.43	1.33	13.96	0.00	22.5
Liver	3,198	1.00	0.97	1.04	234	0.68	0.59	0.77	158.34	0.00	2.7
Pancreas	3,716	1.00	0.97	1.03	325	0.83	0.74	0.92	98.58	0.00	23.9
Lung	14,207	1.00	0.98	1.02	794	0.47	0.44	0.50	2,670.32	0.00	37.7
Breast	168	1.00	0.85	1.16	30	1.49	1.01	2.14	18.93	0.00	2.6
Prostate	29,152	1.00	0.99	1.01	3,256	1.14	1.10	1.18	266.96	0.00	3.3
Testis	649	1.00	0.92	1.08	124	1.44	1.20	1.72	349.72	0.00	38.6
Other male genitals	444	1.00	0.91	1.10	37	0.74	0.52	1.02	12.72	0.00	31.4
Kidney	4,871	1.00	0.97	1.03	416	0.79	0.71	0.87	36.69	0.00	17.9
Urinary bladder	8,999	1.00	0.98	1.02	845	0.85	0.79	0.91	12.65	0.00	0.1
Melanoma	3,713	1.00	0.97	1.03	886	1.89	1.76	2.02	2,047.73	0.00	15.4
Skin (squamous cell)	4,010	1.00	0.97	1.03	623	1.47	1.35	1.59	396.67	0.00	3.1
Eye	409	1.00	0.91	1.10	41	0.92	0.66	1.25	20.44	0.00	18.3
Nervous system	3,738	1.00	0.97	1.03	493	1.12	1.03	1.23	28.48	0.00	15.5
Thyroid gland	624	1.00	0.92	1.08	75	1.15	0.91	1.44	26.04	0.00	9.5
Endocrine gland	1,574	1.00	0.95	1.05	212	1.12	0.97	1.28	1.78	0.18	0.9
Bone	231	1.00	0.88	1.14	18	0.65	0.38	1.02	2.96	0.09	55.7
Connective tissue	853	1.00	0.93	1.07	102	1.08	0.88	1.31	6.24	0.01	2.0
Non-Hodgkin’s lymphoma	4,370	1.00	0.97	1.03	499	1.00	0.92	1.09	7.89	0.00	3.1
Hodgkin’s disease	691	1.00	0.93	1.08	75	0.96	0.76	1.20	35.85	0.00	28.4
Myeloma	2,019	1.00	0.96	1.04	182	0.89	0.76	1.03	2.10	0.15	15.3
Leukemia	3,757	1.00	0.97	1.03	393	0.96	0.87	1.06	18.92	0.00	9.6
All	119,141	1.00	0.99	1.01	12,028	0.93	0.92	0.95	329.41	0.00	13.8^b

^a Bold type: 95% CI does not include 1.00, P < 0.05.
^b Weighted PAF of all sites.

Table 3

SIR and trend for cancer in women in educational groups^a

Cancer site	Less than 9 years							University educated				PAF (%)
Cancer site		Observed	SIR	95%	CI	Observed	SIR	95%	CI	χ²	P	PAF (%)
Upper aerodigestive tract	1,424	1.00	0.95	1.05	54	0.69	0.51	0.89	23.51	0.00	27.7
Salivary gland	339	1.00	0.90	1.11	15	0.84	0.47	1.39	4.07	0.04	11.1
Esophagus	518	1.00	0.92	1.09	18	0.80	0.47	1.26	20.50	0.00	13.5
Stomach	3,736	1.00	0.97	1.03	85	0.57	0.45	0.70	495.94	0.00	52.8
Small intestine	547	1.00	0.92	1.09	24	0.90	0.57	1.34	0.26	0.61	11.7
Colon	9,984	1.00	0.98	1.02	370	0.90	0.81	0.99	102.07	0.00	11.9
Rectum	4,926	1.00	0.97	1.03	194	0.92	0.80	1.06	64.99	0.00	9.8
Anus	405	1.00	0.90	1.10	9	0.41	0.18	0.77	100.80	0.00	56.1
Liver	4,566	1.00	0.97	1.03	93	0.52	0.42	0.64	468.80	0.00	47.2
Pancreas	3,730	1.00	0.97	1.03	99	0.64	0.52	0.78	113.47	0.00	10.2
Lung	6,733	1.00	0.98	1.02	173	0.43	0.37	0.50	1,379.10	0.00	32.8
Breast	35,397	1.00	0.99	1.01	2,972	1.37	1.32	1.42	1,805.33	0.00	9.6
Cervix	5,442	1.00	0.97	1.03	162	0.43	0.37	0.51	1,793.56	0.00	52.8
Endometrium	9,188	1.00	0.98	1.02	484	1.04	0.95	1.13	0.16	0.69	6.3
Uterus	986	1.00	0.94	1.06	45	0.80	0.59	1.08	20.19	0.00	10.1
Ovary	8,313	1.00	0.98	1.02	380	0.82	0.74	0.90	315.95	0.00	11.1
Other female genitals	1,171	1.00	0.94	1.06	32	0.58	0.40	0.82	216.32	0.00	10.1
Kidney	3,919	1.00	0.97	1.03	126	0.75	0.62	0.89	192.32	0.00	25.6
Urinary bladder	2,965	1.00	0.96	1.04	105	0.80	0.65	0.97	73.75	0.00	10.0
Melanoma	4,038	1.00	0.97	1.03	443	1.57	1.42	1.72	787.94	0.00	17.8
Skin (squamous cell)	2,727	1.00	0.96	1.04	132	1.23	1.03	1.46	106.13	0.00	3.8
Eye	398	1.00	0.90	1.10	22	1.04	0.65	1.57	5.43	0.02	15.3
Nervous system	4,623	1.00	0.97	1.03	294	1.06	0.95	1.19	12.05	0.00	12.0
Thyroid gland	1,783	1.00	0.95	1.05	87	0.76	0.61	0.93	123.16	0.00	29.8
Endocrine gland	4,249	1.00	0.97	1.03	181	0.82	0.70	0.95	106.31	0.00	14.0
Bone	178	1.00	0.86	1.16	16	1.54	0.88	2.51	3.61	0.06	40.6
Connective tissue	833	1.00	0.93	1.07	38	0.86	0.61	1.18	6.37	0.01	25.7
Non-Hodgkin’s lymphoma	3,779	1.00	0.97	1.03	166	0.91	0.78	1.06	68.43	0.00	17.4
Hodgkin’s disease	460	1.00	0.91	1.10	21	0.79	0.49	1.22	5.48	0.02	57.1
Myeloma	1,829	1.00	0.95	1.05	53	0.76	0.57	0.99	45.95	0.00	3.9
Leukemia	3,074	1.00	0.96	1.04	115	0.81	0.67	0.97	35.06	0.00	12.3
All	132,260	1.00	0.99	1.01	7,008	0.99	0.97	1.02	372.10	0.00	16.7^b

^a Bold type: 95% CI does not include 1.00, P < 0.05.
^b Weighted PAF of all sites.

Table 4

SIR for cancer in male educational groups in different periods

Cancer site	Period 1970–1984															Period 1985–1998
		Less than 9 years							University educated							Less than 9 years		University educated
		Observed	SIR	95%	CI	Observed	SIR	95%	CI	Observed	SIR	95%	CI	Observed	SIR	95%	CI
Upper aerodigestive tract	1,910	1.00	0.96	1.05	117	0.59	0.49	0.70	2,636	1.00	0.96	1.04	217	0.61	0.53	0.70
Salivary gland	131	1.00	0.84	1.19	19	1.40	0.84	2.20	154	1.00	0.85	1.17	16	0.83	0.48	1.36
Esophagus	445	1.00	0.91	1.10	21	0.44	0.27	0.68	1,020	1.00	0.94	1.06	75	0.56	0.44	0.70
Stomach	2,517	1.00	0.96	1.04	96	0.44	0.36	0.54	3,710	1.00	0.97	1.03	214	0.54	0.47	0.62
Small intestine	214	1.00	0.87	1.14	25	1.16	0.75	1.72	411	1.00	0.91	1.10	52	1.09	0.81	1.43
Colon	2,511	1.00	0.96	1.04	273	1.22	1.08	1.37	5,826	1.00	0.97	1.03	693	1.07	0.99	1.15
Rectum	1,854	1.00	0.95	1.05	132	0.81	0.68	0.96	4,268	1.00	0.97	1.03	404	0.84	0.76	0.93
Anus	49	1.00	0.74	1.32	3	0.52	0.10	1.54	92	1.00	0.81	1.23	11	0.92	0.45	1.65
Liver	929	1.00	0.94	1.07	69	0.77	0.60	0.98	2,269	1.00	0.96	1.04	1.65	0.64	0.55	0.75
Pancreas	1,427	1.00	0.95	1.05	103	0.82	0.67	0.99	2,289	1.00	0.96	1.04	222	0.83	0.73	0.95
Lung	4,942	1.00	0.97	1.03	240	0.48	0.42	0.55	9,265	1.00	0.98	1.02	554	0.46	0.43	0.50
Breast	55	1.00	0.75	1.30	6	1.05	0.38	2.30	113	1.00	0.82	1.20	24	1.67	1.07	2.49
Prostate	5,292	1.00	0.97	1.03	408	1.00	0.91	1.10	23,860	1.00	0.99	1.01	2,848	1.16	1.12	1.21
Testis	383	1.00	0.90	1.11	82	1.54	1.22	1.91	266	1.00	0.88	1.13	42	1.28	0.92	1.73
Other male genitals	163	1.00	0.85	1.17	15	0.85	0.47	1.40	281	1.00	0.89	1.12	22	0.68	0.43	1.03
Kidney	1,956	1.00	0.96	1.05	145	0.77	0.65	0.90	2,915	1.00	0.96	1.04	271	0.80	0.71	0.90
Urinary bladder	2,659	1.00	0.96	1.04	239	0.94	0.82	1.07	6,340	1.00	0.98	1.02	606	0.82	0.75	0.88
Melanoma	1,392	1.00	0.95	1.05	313	1.88	1.68	2.10	2,321	1.00	0.96	1.04	573	1.89	1.74	2.05
Skin (squamous cell)	739	1.00	0.93	1.07	102	1.54	1.26	1.87	3,271	1.00	0.97	1.03	521	1.45	1.33	1.58
Eye	178	1.00	0.86	1.16	17	1.02	0.59	1.64	231	1.00	0.88	1.14	24	0.86	0.55	1.29
Nervous system	1,648	1.00	0.95	1.05	206	1.21	1.05	1.38	2,090	1.00	0.96	1.04	287	1.07	0.95	1.20
Thyroid gland	297	1.00	0.89	1.12	39	1.35	0.96	1.85	327	1.00	0.89	1.11	36	0.99	0.70	1.38
Endocrine gland	672	1.00	0.93	1.08	80	1.08	0.86	1.35	902	1.00	0.94	1.07	132	1.14	0.95	1.35
Bone	129	1.00	0.83	1.19	13	0.89	0.47	1.52	102	1.00	0.82	1.21	5	0.38	0.12	0.89
Connective tissue	316	1.00	0.89	1.12	39	1.14	0.81	1.57	537	1.00	0.92	1.09	63	1.05	0.80	1.34
Non-Hodgkin’s lymphoma	1,342	1.00	0.95	1.05	136	0.97	0.81	1.15	3,028	1.00	0.96	1.04	363	1.01	0.91	1.12
Hodgkin’s disease	411	1.00	0.91	1.10	54	1.20	0.90	1.57	280	1.00	0.89	1.12	21	0.63	0.39	0.97
Myeloma	636	1.00	0.92	1.08	44	0.79	0.57	1.06	1,383	1.00	0.95	1.05	138	0.93	0.78	1.10
Leukemia	1,388	1.00	0.95	1.05	133	1.00	0.84	1.18	2,369	1.00	0.96	1.04	260	0.94	0.83	1.07
All	36,585	1.00	0.99	1.01	3,169	0.91	0.88	0.94	82,556	1.00	0.99	1.01	8,859	0.94	0.92	0.96