Disparities in Cancer Incidence and Mortality by Area-Level Socioeconomic Status: A Multilevel Analysis

Details

• Personal Author:
  Beresford SAA ; Hastert TA ; Sheppard L ; White E
• Description:
  Background: Disparities in cancer incidence and mortality have been observed by measures of area-level socioeconomic status (SES); however, the extent to which these disparities are explained by individual SES is unclear. Methods: Participants included 60 756 men and women in the VITamins And Lifestyle (VITAL) study cohort, aged 50-76 years at baseline (2000-2002) and followed through 2010. We constructed a block group SES index using the 2000 US Census and fit Cox proportional hazards models to estimate the association between area-level SES (by quintile) and total and site-specific cancer incidence and total cancer mortality, with and without household income and individual education in the models. Results: Lower area-level SES was weakly associated with higher total cancer incidence and lower prostate cancer risk, but was not associated with risk of breast cancer. Compared with the highest-SES areas, living in the lowest-SES areas was associated with higher lung (HR: 2.21, 95% CI 1.69 to 2.90) and colorectal cancer incidence (HR: 1.52, 95% CI 1.11 to 2.09) and total cancer mortality (HR: 1.68, 95% CI 1.47 to 1.93). Controlling for individual education and household income weakened the observed associations, but did not eliminate them (lung cancer HR: 1.43, 95% CI 1.07 to 1.91; colorectal cancer HR: 1.35, 95% CI 0.97 to 1.88; cancer mortality HR: 1.28, 95% CI 1.11 to 1.48). Conclusions: Area-level socioeconomic disparities exist for several cancer outcomes. These differences are not fully explained by individual SES, suggesting area-level factors may play a role. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Epidemiology Healthcare Disparities Mortality Neoplasms Occupational Health Safety
• Keywords:
  Cancer Rates Cohort Studies Health Disparities Mortality Rates Socioeconomics
• ISSN:
  0143-005X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Michigan ; OSHA Region 10 ; OSHA Region 5 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  168-176
• Volume:
  69
• Issue:
  2
• NIOSHTIC Number:
  nn:20054803
• Citation:
  J Epidemiol Community Health 2015 Feb; 69(2):168-176
• Contact Point Address:
  Dr Theresa Hastert, Wayne State University Department of Oncology, Karmanos Cancer Institute, 4100 John R Street, MM04EP, Detroit, MI 48201, USA
• Email:
  hastertt@karmanos.org
• Federal Fiscal Year:
  2015
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of Epidemiology and Community Health
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d35ef5b9d506dc49d7b553602b3f69df7666ac91bad3da78e373afaca2a1d63382fd9f31e6413bf6a75a31ff0193eae9ad19e9f4cc9385a224dcd14725eb9d82
• Download URL:
  https://stacks.cdc.gov/view/cdc/217233/cdc_217233_DS1.pdf
• File Type:
  [PDF - 298.03 KB ]