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Demographic, social and lifestyle risk factors for cancer registry-notified cancer of unknown primary site (CUP)

Journal Article


Abstract


  • Background: Little is known about the risk factors for cancer of unknown primary site (CUP). We examined the demographic, social and lifestyle risk factors for CUP in a prospective cohort of 266,724 people aged 45 years and over in New South Wales, Australia.

    Methods: Baseline questionnaire data were linked to cancer registration, hospitalisation, emergency department admission, and mortality data. We compared individuals with incident cancer registry-notified CUP (n = 327) to two sets of controls randomly selected (3:1) using incidence density sampling with replacement: (i) incident cancer registry-notified metastatic cancer of known primary site (n = 977) and (ii) general cohort population (n = 981). We used conditional logistic regression to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).

    Results: In a fully adjusted model incorporating self-rated overall health and comorbidity, people diagnosed with CUP were more likely to be older (OR 1.05, 95% CI 1.04–1.07 per year) and more likely to have low educational attainment (OR 1.77, 95% CI 1.24–2.53) than those diagnosed with metastatic cancer of known primary. Similarly, compared to general cohort population controls, people diagnosed with CUP were older (OR 1.10, 95% CI 1.08–1.12 per year), of low educational attainment (OR 1.69, 95% CI 1.08–2.64), and current (OR 3.42, 95% CI 1.81–6.47) or former (OR 1.95, 95% CI 1.33–2.86) smokers.

    Conclusion: The consistent association with educational attainment suggests low health literacy may play a role in CUP diagnosis. These findings highlight the need to develop strategies to achieve earlier identification of diagnostically challenging malignancies in people with low health literacy.

UOW Authors


  •   Vajdic, C (external author)
  •   Perez-Concha, O (external author)
  •   Dobbins, Timothy (external author)
  •   Ward, Robyn L. (external author)
  •   Schaffer, Andrea L. (external author)
  •   van Leeuwen, M (external author)
  •   Rhee, Joel
  •   Laaksonen, M (external author)
  •   Craigen, G (external author)
  •   Pearson, Sallie-Anne (external author)

Publication Date


  • 2019

Citation


  • Vajdic, C., Perez-Concha, O., Dobbins, T., Ward, R. L., Schaffer, A. L., van Leeuwen, M. T., Rhee, J. J., Laaksonen, M. A., Craigen, G. & Pearson, S. A. (2019). Demographic, social and lifestyle risk factors for cancer registry-notified cancer of unknown primary site (CUP). Cancer Epidemiology, 60 156-161.

Scopus Eid


  • 2-s2.0-85064428428

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers1/661

Number Of Pages


  • 5

Start Page


  • 156

End Page


  • 161

Volume


  • 60

Place Of Publication


  • United States

Abstract


  • Background: Little is known about the risk factors for cancer of unknown primary site (CUP). We examined the demographic, social and lifestyle risk factors for CUP in a prospective cohort of 266,724 people aged 45 years and over in New South Wales, Australia.

    Methods: Baseline questionnaire data were linked to cancer registration, hospitalisation, emergency department admission, and mortality data. We compared individuals with incident cancer registry-notified CUP (n = 327) to two sets of controls randomly selected (3:1) using incidence density sampling with replacement: (i) incident cancer registry-notified metastatic cancer of known primary site (n = 977) and (ii) general cohort population (n = 981). We used conditional logistic regression to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).

    Results: In a fully adjusted model incorporating self-rated overall health and comorbidity, people diagnosed with CUP were more likely to be older (OR 1.05, 95% CI 1.04–1.07 per year) and more likely to have low educational attainment (OR 1.77, 95% CI 1.24–2.53) than those diagnosed with metastatic cancer of known primary. Similarly, compared to general cohort population controls, people diagnosed with CUP were older (OR 1.10, 95% CI 1.08–1.12 per year), of low educational attainment (OR 1.69, 95% CI 1.08–2.64), and current (OR 3.42, 95% CI 1.81–6.47) or former (OR 1.95, 95% CI 1.33–2.86) smokers.

    Conclusion: The consistent association with educational attainment suggests low health literacy may play a role in CUP diagnosis. These findings highlight the need to develop strategies to achieve earlier identification of diagnostically challenging malignancies in people with low health literacy.

UOW Authors


  •   Vajdic, C (external author)
  •   Perez-Concha, O (external author)
  •   Dobbins, Timothy (external author)
  •   Ward, Robyn L. (external author)
  •   Schaffer, Andrea L. (external author)
  •   van Leeuwen, M (external author)
  •   Rhee, Joel
  •   Laaksonen, M (external author)
  •   Craigen, G (external author)
  •   Pearson, Sallie-Anne (external author)

Publication Date


  • 2019

Citation


  • Vajdic, C., Perez-Concha, O., Dobbins, T., Ward, R. L., Schaffer, A. L., van Leeuwen, M. T., Rhee, J. J., Laaksonen, M. A., Craigen, G. & Pearson, S. A. (2019). Demographic, social and lifestyle risk factors for cancer registry-notified cancer of unknown primary site (CUP). Cancer Epidemiology, 60 156-161.

Scopus Eid


  • 2-s2.0-85064428428

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers1/661

Number Of Pages


  • 5

Start Page


  • 156

End Page


  • 161

Volume


  • 60

Place Of Publication


  • United States