Highest education, best cancer survival


A large Finnish study shows that the cancer-specific survival proportions are highest for patients with highest education level. If patients with a shorter education had the same survival proportions as those with the longest education, about 4300 deaths would have been avoided during the first five years after diagnosis in patients diagnosed in 1996-2005.
The risk of encountering cancer has a clear relationship with social class and occupation but the risk is not always highest in the lowest socio-economic strata. The new study shows now that the most educated had systematically higher cancer-specific survival proportions in the 27 cancer types in the study. The patients were divided into three groups (basic, medium and high education). A particular health-conscious group (physicians, nurses, teachers etc.) was studied separately and had even higher survival proportions than those with high education.
The cancer-specific survival proportions are in Finland among the highest in Europe. The differences by level of education show that there is still room for higher survival proportions in Finland. The results cannot be explained by differences in treatment and patterns of care. Those with highest education are likely to visit the diagnostic services because of early symptoms more often than the others. They are also likely to participate more in the mass-screenings organized for early detection cancers.
A high education may also help the patient in navigating within the health care and in its systems that may appear complicated. Among those with highest education level, the highest survival proportions were observed in the health-conscious group, which, e.g., exercises more than the others. Other life-style factors such as smoking and consumption of alcohol may also lay behind the relatively low survival proportions in those with the shortest education.


Cancer-specific five-year survival proportions (%), by tumour location and patient’s education

Stomach, males2924
Colon, females6056
Lung, males119
Breast, females8985
Cervix uteri7963
Corpus uteri8882


Arun Pokhrel, Pekka Martikainen, Eero Pukkala, Matti Rautalahti, Karri Seppä, Timo Hakulinen. Education, survival and avoidable deaths in cancer patients in Finland. British Journal of Cancer 2010;103:1109-1114.