Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium
ObjectiveTo study the association of educational level and risk of death from all causes, cardiovascular disease (CVD) and cancer among Asian populations.DesignA pooled analysis of 15 population-based cohort studies.Setting and participants694 434 Asian individuals from 15 prospective cohorts within...
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BMJ Publishing Group
2019-08-01
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Series: | BMJ Open |
Online Access: | https://bmjopen.bmj.com/content/9/8/e026225.full |
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English |
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DOAJ |
author |
Renwei Wang Jian-Min Yuan Yasutake Tomata Daehee Kang Chisato Nagata Mangesh S Pednekar Keming Yang Eiko Saito Md Shafiur Rahman Prakash Chandra Gupta Akiko Tamakoshi Yu-Tang Gao Woon-Puay Koh Xiao-Ou Shu Atsuko Sadakane San-Lin You Myung-Hee Shin Wen-Harn Pan Hui Cai Yong-Bing Xiang Kotaro Ozasa Seiki Kanemura Keiko Wada Yoon-Ok Ahn Keun-Young Yoo Habibul Ahsan Kee Seng Chia Manami Inoue Hongmei Nan |
spellingShingle |
Renwei Wang Jian-Min Yuan Yasutake Tomata Daehee Kang Chisato Nagata Mangesh S Pednekar Keming Yang Eiko Saito Md Shafiur Rahman Prakash Chandra Gupta Akiko Tamakoshi Yu-Tang Gao Woon-Puay Koh Xiao-Ou Shu Atsuko Sadakane San-Lin You Myung-Hee Shin Wen-Harn Pan Hui Cai Yong-Bing Xiang Kotaro Ozasa Seiki Kanemura Keiko Wada Yoon-Ok Ahn Keun-Young Yoo Habibul Ahsan Kee Seng Chia Manami Inoue Hongmei Nan Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium BMJ Open |
author_facet |
Renwei Wang Jian-Min Yuan Yasutake Tomata Daehee Kang Chisato Nagata Mangesh S Pednekar Keming Yang Eiko Saito Md Shafiur Rahman Prakash Chandra Gupta Akiko Tamakoshi Yu-Tang Gao Woon-Puay Koh Xiao-Ou Shu Atsuko Sadakane San-Lin You Myung-Hee Shin Wen-Harn Pan Hui Cai Yong-Bing Xiang Kotaro Ozasa Seiki Kanemura Keiko Wada Yoon-Ok Ahn Keun-Young Yoo Habibul Ahsan Kee Seng Chia Manami Inoue Hongmei Nan |
author_sort |
Renwei Wang |
title |
Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium |
title_short |
Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium |
title_full |
Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium |
title_fullStr |
Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium |
title_full_unstemmed |
Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium |
title_sort |
association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the asia cohort consortium |
publisher |
BMJ Publishing Group |
series |
BMJ Open |
issn |
2044-6055 |
publishDate |
2019-08-01 |
description |
ObjectiveTo study the association of educational level and risk of death from all causes, cardiovascular disease (CVD) and cancer among Asian populations.DesignA pooled analysis of 15 population-based cohort studies.Setting and participants694 434 Asian individuals from 15 prospective cohorts within the Asia Cohort Consortium.InterventionsNone.Main outcome measuresHRs and 95% CIs for all-cause mortality, as well as for CVD-specific mortality and cancer-specific mortality.ResultsA total of 694 434 participants (mean age at baseline=53.2 years) were included in the analysis. During a mean follow-up period of 12.5 years, 103 023 deaths were observed, among which 33 939 were due to cancer and 34 645 were due to CVD. Higher educational levels were significantly associated with lower risk of death from all causes compared with a low educational level (≤primary education); HRs and 95% CIs for secondary education, trade/technical education and ≥university education were 0.88 (0.85 to 0.92), 0.81 (0.73 to 0.90) and 0.71 (0.63 to 0.80), respectively (ptrend=0.002). Similarly, HRs (95% CIs) were 0.93 (0.89 to 0.97), 0.86 (0.78 to 0.94) and 0.81 (0.73 to 0.89) for cancer death, and 0.88 (0.83 to 0.93), 0.77 (0.66 to 0.91) and 0.67 (0.58 to 0.77) for CVD death with increasing levels of education (both ptrend <0.01). The pattern of the association among East Asians and South Asians was similar compared with ≤primary education; HR (95% CI) for all-cause mortality associated with ≥university education was 0.72 (0.63 to 0.81) among 539 724 East Asians (Chinese, Japanese and Korean) and 0.61 (0.54 to 0.69) among 154 710 South Asians (Indians and Bangladeshis).ConclusionHigher educational level was associated with substantially lower risk of death among Asian populations. |
url |
https://bmjopen.bmj.com/content/9/8/e026225.full |
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doaj-fe367244f77a4e7e8321aa6c4d78cba42021-03-22T09:02:05ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2018-026225Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort ConsortiumRenwei Wang0Jian-Min Yuan1Yasutake Tomata2Daehee Kang3Chisato NagataMangesh S PednekarKeming YangEiko Saito4Md Shafiur RahmanPrakash Chandra GuptaAkiko Tamakoshi5Yu-Tang Gao6Woon-Puay Koh7Xiao-Ou Shu8Atsuko SadakaneSan-Lin YouMyung-Hee Shin9Wen-Harn Pan10Hui Cai11Yong-Bing Xiang12Kotaro OzasaSeiki Kanemura13Keiko WadaYoon-Ok Ahn14Keun-Young Yoo15Habibul Ahsan16Kee Seng Chia17Manami Inoue18Hongmei NanThe University of Pittsburgh Cancer Institute, Pittsburgh, PA, USAThe University of Pittsburgh Cancer Institute, Pittsburgh, PA, USADivision of Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, JapanDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, South KoreaDivision of Cancer Statistics and Integration, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, JapanDepartment of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, JapanState Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaHealth Services and Systems Research, Duke-NUS Graduate Medical School, SingaporeDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USADepartment of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, South KoreaInstitute of Biomedical Sciences, Academia Sinica BRC, Taipei, TaiwanDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USAState Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDivision of Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, JapanDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Health Studies, Center for Cancer Epidemiology and Prevention, University of Chicago, Chicago, IL, USASaw Swee Hock School of Public Health, National University of Singapore, SingaporeEpidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, JapanObjectiveTo study the association of educational level and risk of death from all causes, cardiovascular disease (CVD) and cancer among Asian populations.DesignA pooled analysis of 15 population-based cohort studies.Setting and participants694 434 Asian individuals from 15 prospective cohorts within the Asia Cohort Consortium.InterventionsNone.Main outcome measuresHRs and 95% CIs for all-cause mortality, as well as for CVD-specific mortality and cancer-specific mortality.ResultsA total of 694 434 participants (mean age at baseline=53.2 years) were included in the analysis. During a mean follow-up period of 12.5 years, 103 023 deaths were observed, among which 33 939 were due to cancer and 34 645 were due to CVD. Higher educational levels were significantly associated with lower risk of death from all causes compared with a low educational level (≤primary education); HRs and 95% CIs for secondary education, trade/technical education and ≥university education were 0.88 (0.85 to 0.92), 0.81 (0.73 to 0.90) and 0.71 (0.63 to 0.80), respectively (ptrend=0.002). Similarly, HRs (95% CIs) were 0.93 (0.89 to 0.97), 0.86 (0.78 to 0.94) and 0.81 (0.73 to 0.89) for cancer death, and 0.88 (0.83 to 0.93), 0.77 (0.66 to 0.91) and 0.67 (0.58 to 0.77) for CVD death with increasing levels of education (both ptrend <0.01). The pattern of the association among East Asians and South Asians was similar compared with ≤primary education; HR (95% CI) for all-cause mortality associated with ≥university education was 0.72 (0.63 to 0.81) among 539 724 East Asians (Chinese, Japanese and Korean) and 0.61 (0.54 to 0.69) among 154 710 South Asians (Indians and Bangladeshis).ConclusionHigher educational level was associated with substantially lower risk of death among Asian populations.https://bmjopen.bmj.com/content/9/8/e026225.full |