Relationship of Socio Economic Status, Income, and Education with the Survival Rate of Breast Cancer: A Meta-Analysis

  • Majid TAHERI Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Mohammad TAVAKOL Department of Sociology, School of Social Sciences, University of Tehran, Tehran, Iran
  • Mohammad Esmaeil AKBARI Cancer Research Center (CRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Amir ALMASI-HASHIANI Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran AND Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
  • Mahmoud ABBASI Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Breast cancer, Social determinant of health, Meta-analysis, Review


Background: Despite our awareness of the significant effect of Social Determinant of Health (SDoH) such as Socio Economic Status (SES), income and education on breast cancer survival, there was a serious lack of information about the effect of different level of these factors on breast cancer survival. So far, no meta-analysis has been conducted with this aim, but this gap was addressed by this meta-analysis.

Methods: Main electronic databases such as PubMed, Web of Science, and Scopus were investigated up to January 2019. Epidemiological studies focusing on the association between SDoH and breast cancer were singled out. Q-test and I2 statistic were used to study the heterogeneity across studies. Begg's and Egger's tests were applied to explore the likelihood of the publication bias. The results were reported as hazard ratio (HR) with 95% confidence intervals (CI) through a random-effects model.

Results: We identified 7,653 references and included 25 studies involving 1,497,881 participants. The HR estimate of breast cancer survival was 0.82 (0.67, 0.98) among high level of SES, 0.82 (0.70, 0.94) among high level of income and 0.72 (0.66, 0.78) among academic level of education.

Conclusions: The SES, income, and education were associated with breast cancer survival, although the association was not very strong. However, there was a significant association between the levels of these factors and breast cancer survival.




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How to Cite
TAHERI M, TAVAKOL M, AKBARI ME, ALMASI-HASHIANI A, ABBASI M. Relationship of Socio Economic Status, Income, and Education with the Survival Rate of Breast Cancer: A Meta-Analysis. Iran J Public Health. 48(8):1428-1438.
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