Examining the Association Between Socioeconomic Status and Invasive Colorectal Cancer Incidence and Mortality in California

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Steinbrecher, Astrid ; Fish, Kari ; Clarke, Christina A. ; West, Dee W. ; Gomez, Scarlett L. ; Cheng, Iona
• Description:
  Background
  
  Colorectal cancer (CRC) incidence and mortality rates vary across race/ethnicity. Socioeconomic status (SES) also influences CRC rates; however, these associations might be inconsistent across racial/ethnic groups and tumor subsite. We examined associations between area-level SES and CRC incidence and mortality in a population-based registry study of non-Hispanic Whites, African Americans, Hispanics, and Asians/Pacific Islanders from California.
  
  Methods
  
  Data on 52,608 incident CRC cases (1998–2002) and 14,515 CRC deaths (1999–2001) aged ≥50 years were obtained from the California Cancer Registry. Based on 2000 U.S. Census data, each cancer case and death was assigned a multidimensional census tract-level SES index. SES-specific quintiles of CRC incidence and mortality rates, incidence rate ratios (IRR) and mortality rate ratios, and 95% confidence intervals (CI) were estimated. Analyses were stratified by anatomical site, including left- versus right-sided tumors, race/ethnicity, and stage of disease.
  
  Results
  
  Overall CRC incidence and SES did not show a clear association, yet patterns of associations varied across tumor subsite and race/ethnicity. Positive associations between SES and CRC incidence were found in Hispanics [SES Q5 v. Q1: IRR = 1.54, CI = 1.39–1.69], irrespective of the subsite. For Whites [SES Q5 v. Q1: IRR = 0.80, CI = 0.77–0.83], and African Americans [SES Q5 v. Q1: IRR = 0.83, CI = 0.70–0.97] inverse associations were observed, predominantly for left-sided tumors. Mortality rates declined with increasing SES in Whites, whereas in Hispanics mortality rates significantly increased with SES.
  
  Conclusions
  
  Our findings show that SES differences in CRC incidence and mortality vary considerably across anatomical subsite and race/ethnicity.
  
  Impact
  
  Studies combining area- and individual-level SES information are warranted.
  
  
• Subjects:
  Aged Aged, 80 And Over Colorectal Neoplasms Female Humans Incidence Male Middle Aged Social Class
• Source:
  Cancer Epidemiol Biomarkers Prev. 21(10):1814-1822.
• Pubmed ID:
  22911333
• Pubmed Central ID:
  PMC5738465
• Document Type:
  Journal Article
• Funding:
  HHSN261201000034C/PHS HHS/United States ; HHSN261201000035C/PC,CA/None/None ; HHSN261201000140C/CA/NCI NIH HHS/United States ; HHSN261201000035C/PHS HHS/United States ; U58 DP000807/DP/NCCDPHP CDC HHS/United States ; 1U58 DP000807-01/DP/NCCDPHP CDC HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; HHSN261201000140C/PHS HHS/United States ; N01 PC035137/PC/NCI NIH HHS/United States
• Place as Subject:
  California
• Volume:
  21
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3c716eba1b74fcfaa657be86d0a4c09fba3a5956730cabba972cd8538dba8047
• Download URL:
  https://stacks.cdc.gov/view/cdc/50603/cdc_50603_DS1.pdf
• File Type:
  [PDF - 131.39 KB ]