FIVE-YEAR OVERALL SURVIVAL AFTER DIAGNOSIS OF BREAST AND GYNAECOLOGICAL CANCERS BY EDUCATIONAL ATTAINMENT IN SWEDEN AND FINLAND: A NORDIC REAL-WORLD REGISTRY STUDY
Author(s)
Johan Rehnberg, PhD1, Bettina Mannerström, PhD2, Johanna Vikkula, MSc2, Ling Zhu, MSc1.
1Medaffcon AB, Stockholm, Sweden, 2Medaffcon Oy, Espoo, Finland.
1Medaffcon AB, Stockholm, Sweden, 2Medaffcon Oy, Espoo, Finland.
OBJECTIVES: Cancer survival varies across countries and socioeconomic groups despite universal healthcare, potentially reflecting differences in early detection, treatment pathways, and uptake of innovative therapies.
This study investigated 5-year overall survival (OS) among women with breast and gynaecological cancers in Sweden and Finland and assessed educational differences using harmonized Nordic registry data.
METHODS: This population-based register study included women aged 34-81 years in Sweden and Finland diagnosed with breast (ICD-10: C50), cervical (C53), or ovarian (C56) cancer in 2012-2018. Educational attainment was categorized as compulsory (Sweden only), intermediate, and tertiary education. Five-year OS was estimated using Kaplan-Meier methods, stratified by cancer, age (<65/≥65), and education.
RESULTS: Five-year OS was 86.2% in Sweden (n=52,468, median age 63) and 87.5% in Finland (n=24,627, median age 60). Educational gradients were observed across all cancers in Sweden but were less consistent in Finland.
Among women aged ≥65 years, OS for breast cancer was lower in women with intermediate versus tertiary education (Sweden 86.5% vs 90.4%; Finland 84.1% vs 88.0 %). For cervical cancer, educational differences were larger in Sweden than in Finland (48.0% vs 59.2% and 62.5% vs 63.6%, respectively). Ovarian cancer had the lowest OS, with educational differences observed in Sweden but not in Finland (Sweden 41.3% vs 44.3%; Finland 42.6 % vs 40.4 %). Results for women aged <65 years were similar but attenuated for all three cancers, except for ovarian cancer in Finland, where the OS difference by educational attainment (67.8% vs 59.2%) was greater than among women aged ≥65 years.
CONCLUSIONS: Differences in 5-year OS between Sweden and Finland, together with varying educational gradients, indicate persistent inequities in cancer outcomes despite universal healthcare.
These findings underscore the importance of integrating equity considerations into oncology care, access, and post-marketing evaluations to ensure therapeutic advances translate into improved outcomes across all patient groups.
This study investigated 5-year overall survival (OS) among women with breast and gynaecological cancers in Sweden and Finland and assessed educational differences using harmonized Nordic registry data.
METHODS: This population-based register study included women aged 34-81 years in Sweden and Finland diagnosed with breast (ICD-10: C50), cervical (C53), or ovarian (C56) cancer in 2012-2018. Educational attainment was categorized as compulsory (Sweden only), intermediate, and tertiary education. Five-year OS was estimated using Kaplan-Meier methods, stratified by cancer, age (<65/≥65), and education.
RESULTS: Five-year OS was 86.2% in Sweden (n=52,468, median age 63) and 87.5% in Finland (n=24,627, median age 60). Educational gradients were observed across all cancers in Sweden but were less consistent in Finland.
Among women aged ≥65 years, OS for breast cancer was lower in women with intermediate versus tertiary education (Sweden 86.5% vs 90.4%; Finland 84.1% vs 88.0 %). For cervical cancer, educational differences were larger in Sweden than in Finland (48.0% vs 59.2% and 62.5% vs 63.6%, respectively). Ovarian cancer had the lowest OS, with educational differences observed in Sweden but not in Finland (Sweden 41.3% vs 44.3%; Finland 42.6 % vs 40.4 %). Results for women aged <65 years were similar but attenuated for all three cancers, except for ovarian cancer in Finland, where the OS difference by educational attainment (67.8% vs 59.2%) was greater than among women aged ≥65 years.
CONCLUSIONS: Differences in 5-year OS between Sweden and Finland, together with varying educational gradients, indicate persistent inequities in cancer outcomes despite universal healthcare.
These findings underscore the importance of integrating equity considerations into oncology care, access, and post-marketing evaluations to ensure therapeutic advances translate into improved outcomes across all patient groups.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH25
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology