{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T05:20:27Z","timestamp":1791609627277,"version":"4.3.4"},"reference-count":49,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","award":["R269\u2010A15811"],"award-info":[{"award-number":["R269\u2010A15811"]}],"id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005860","name":"Helsefonden","doi-asserted-by":"publisher","award":["20\u2010B\u20100434"],"award-info":[{"award-number":["20\u2010B\u20100434"]}],"id":[{"id":"10.13039\/501100005860","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF18OC0052543"],"award-info":[{"award-number":["NNF18OC0052543"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>With a growing population of cancer survivors in Denmark, the evaluation of health\u2010related quality of life (HRQoL) has become increasingly important. We describe variations in HRQoL between educational groups in a national population of cancer survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross\u2010sectional questionnaire study among breast, prostate, lung, and colon cancer survivors diagnosed in 2010\u20132019 in Denmark. We used the EORTC QLQ\u2010C30 to assess HRQoL including physical, role, emotional, cognitive, social functioning, and symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Information on educational level and clinical data were extracted from national registers and clinical databases. Levels of impaired functioning and severe symptoms were identified using newly established thresholds for clinical importance. Multivariate logistic regression was used to examine associations between education and HRQoL. All statistical tests were 2\u2010sided.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 27,857 (42%) participated in the study. Up to 72% and 75% of cancer survivors with short education (\u22649\u2009years) reported impaired functioning and severe symptoms, respectively. Cancer survivors with short compared to long education (&gt;12\u2009years) were more likely to report impaired functioning and severe symptoms, with for example significantly higher odds ratios (ORs) for impaired physical function (breast OR\u2009=\u20092.41, 99% CI\u2009=\u20092.01\u20132.89; prostate OR\u2009=\u20091.81, 99% CI\u2009=\u20091.48\u20132.21; lung OR\u2009=\u20092.97, 99% CI\u2009=\u20091.95\u20134.57; and colon cancer OR\u2009=\u20091.69, 99% CI\u2009=\u20091.28\u20132.24).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cancer survivors with short education are at greater risk of impaired HRQoL than survivors with long education 2\u201312\u2009years after diagnosis. This underscores the need for systematic screening and symptom management in cancer aftercare, in order to reach all cancer survivors, also cancer survivors with short education.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6596","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T09:35:27Z","timestamp":1695980127000},"page":"20150-20162","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Social inequality in cancer survivorship: Educational differences in health\u2010related quality of life among 27,857 cancer survivors in Denmark"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0906-1873","authenticated-orcid":false,"given":"Anne Katrine Graudal","family":"Levinsen","sequence":"first","affiliation":[{"name":"Survivorship and Inequality in Cancer Danish Cancer Institute  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trille Kristina","family":"Kjaer","sequence":"additional","affiliation":[{"name":"Survivorship and Inequality in Cancer Danish Cancer Institute  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lau Caspar","family":"Thygesen","sequence":"additional","affiliation":[{"name":"National Institute of Public Health University of Southern Denmark  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Maltesen","sequence":"additional","affiliation":[{"name":"Statistics and Data Analysis Danish Cancer Institute  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Department of Thoracic surgery Odense University hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"G\u00f6genur","sequence":"additional","affiliation":[{"name":"Dept. 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