Associations between education and physical functioning and pain in adult Danish cancer survivors

Dorte Winther, Tina K Nygaard, Trine A Horsbøl, Trille Kjær, Peter Vedsted, Christoffer Johansen, Hanna B Hovaldt, Mette Sandager, Susanne O Dalton

Research output: Contribution to journalJournal articleResearchpeer-review


BACKGROUND: Late effects after cancer diagnosis and treatment are common, but only few studies have examined the role of social factors in developing these late effects. The aim of this study was to examine the association between educational level and physical function and pain among cancer survivors two years after diagnosis.

MATERIAL AND METHODS: The study population consisted of adult Danish patients with a first-time cancer diagnosis who were sent a questionnaire in 2010 and followed up in 2012. In total, 4346 returned the first questionnaire shortly after diagnosis and 2568 returned the follow-up questionnaire. After exclusion of 177 due to missing information, we included 2391 cancer survivors in the analyses. Physical function and pain were measured using the EORTC QLQ-C30. Linear regression analyses were conducted separately for men and women, and adjusted for demographic and clinical characteristics. Additionally, analyses were stratified on comorbidity.

RESULTS: Differences in mean scores according to educational level were small. Physical function was better in women with medium (2.8; 95% CI 0.1;5.4) and higher education (3.4; 95% CI 0.9;5.9) compared to women with short education. In contrast, men with medium education reported lower physical function (-2.9; 95% CI -5.7;-0.1) than men with short education. Compared to women with short education, we found lower pain scores among women with medium (-5.0; 95% CI -8.7;-1.4) and higher education (-3.4; 95% CI -6.7;0.0). Similarly, men with higher education experienced lower pain score (-3.4; 95% CI -6.9;0.1) than men with short education. The role of educational level differed between those with and without comorbidity.

CONCLUSION: Educational level is slightly associated with physical function and pain among cancer survivors. However, mean differences in this study were small and below what is considered clinically relevant.

Original languageEnglish
JournalActa oncologica (Stockholm, Sweden)
Issue number2
Pages (from-to)348-353
Publication statusPublished - Feb 2017
Externally publishedYes


  • Aged
  • Cancer Pain/physiopathology
  • Denmark/epidemiology
  • Educational Status
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms/mortality
  • Surveys and Questionnaires
  • Survivors


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