Education and Cancer Mortality: A Significant Correlation
Research has consistently demonstrated that education levels play a crucial role in reducing all-cause mortality, including cancer mortality, across all age groups and demographic profiles. A comprehensive study published in Lancet Public Health in 2024 confirmed this relationship: for every additional year of education, the risk of cancer mortality decreases by an average of 1.9%.
Mechanisms Behind Education's Protective Effect
The protective effect of education on health can be attributed to several factors:
Increased Health Knowledge: Education empowers individuals with knowledge about health risks, prevention strategies, and treatment options, enabling them to make informed decisions regarding their health.
Enhanced Health-Related Behaviours: Higher education levels are associated with an increased likelihood of engaging in health-promoting behaviours, such as regular exercise, healthy eating, and smoking avoidance, which reduce the risk of cancer and other chronic diseases.
Access to Healthcare and Resources: Education provides access to better job opportunities, healthcare providers, and health insurance coverage, which facilitate timely diagnosis and treatment and increase the likelihood of successful outcomes.
Social Determinants of Health: Education is a strong socioeconomic determinant of health, influencing access to housing, sanitation, and a supportive social network, all of which contribute to overall well-being and reduced risk of disease.
The effect of education on mortality risk is greater in younger age groups than in older age groups.
For adults aged 18–49 years, each additional year of education is associated with a 2.9% reduction in mortality risk, compared with a 0.8% reduction for adults older than 70 years.
The effect of education on mortality from breast cancer decreases as people age.
In the study of 3.5 million Norwegian women, the mortality rate for breast cancer was 38% higher for those with the lowest education level than for those with the highest education level. However, these differences lessened with each decade and were no longer significant for those over 50. In fact, for women under 50, those with the lowest education level now have a 28% higher mortality rate than those with the highest education level.
Breast cancer mortality rates increased more among those with lower education levels than among those with higher education levels. Therefore, the relative mortality gap between women with the highest and lowest education levels widened over time. This widening gap was mainly due to the increase in breast cancer mortality among women with no formal education or a primary education and women with a secondary education. This was followed by a decrease in breast cancer mortality among women with a tertiary education.
Educational Differences in Breast Cancer Incidence and Mortality Across Age Groups
Educational disparities in breast cancer incidence and mortality have varied across different age groups over time.
Before the year 2000, breast cancer incidence and mortality rates were significantly higher in higher-educated women compared to lower-educated women in all age groups. This disparity was attributed to factors such as higher age at first birth, lower parity, older age at menopause, greater height, greater alcohol consumption, lower total physical activity levels, and greater use of postmenopausal hormone therapy among higher educated women.
After 2000, educational differences in breast cancer incidence attenuated, though incidence remained higher for higher-educated women. In contrast, educational differences in breast cancer mortality no longer varied significantly by education level in all age groups except in women below 50. Notably, breast cancer mortality was 28% lower for the highest versus lowest educated women during 2000-2009 among women below 50. This suggests an educational gradient reversal for mortality in younger women.
The reasons for these changing patterns are not fully understood but may be related to changes in breast cancer risk factors and screening practices. For example, the reproductive behaviour of higher and lower-educated women has converged over time. Even though higher educated women still have higher age at first birth and lower parity than lower educated women, lower educated women have had greater increases in age at first birth and greater declines in parity. Additionally, advances in breast cancer screening and treatment may have also contributed to the reduction in educational disparities in breast cancer mortality.
It is important to note that these educational differences in breast cancer incidence and mortality highlight the complex interplay between socioeconomic factors and health outcomes. Understanding the reasons for these disparities can help to develop targeted interventions aimed at reducing the burden of breast cancer in all populations.
Implications for Public Health Policies
The strong correlation between education and cancer mortality underscores the importance of investing in education as a vital public health strategy. Governments and policymakers should prioritise initiatives to improve access to quality education, particularly in disadvantaged communities. This includes:
Expanding early childhood education programs
Reducing barriers to secondary and tertiary education
Providing financial assistance and scholarships for students from low-income backgrounds
Increasing funding for teacher training and professional development
Investing in education can empower individuals with the knowledge and resources they need to make healthy choices, reduce their risk of cancer, and improve their overall well-being. Education is a powerful tool for promoting health equity and reducing the burden of cancer mortality in society.