Cancer Mortality in the United States by Education Level and Race

Albano, Jessica D.; Ward, Elizabeth; Jemal, Ahmedin; Anderson, Robert N.; Cokkinides, Vilma; Murray, Taylor; Henley, S. Jane; Liff, Jonathan M.; Thun, Michael J.

doi:10.1093/jnci/djm127

Cited by 409 publications

(332 citation statements)

References 39 publications

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“…Continued monitoring of cervical cancer mortality by SES levels is warranted and may utilize the databases used in the current study and other administrative health record systems. 3 The major impact of HPV vaccination will take decades to manifest as vaccination coverage increases and as girls age into periods when cervical cancer risk is highest. The disparities noted in the current study may be partly addressed by clinicians through enhanced screening and continuity of care for low-resource women to facilitate treatment.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, progress in reducing the cervical cancer burden has been stymied among those with low versus high socioeconomic status (SES) and among blacks versus whites. [2][3][4] SES influences cancer risk factors, such as persistent human papillomavirus (HPV) infection, 5 a necessary cause of cervical cancer, as well as access to the health care system (eg, cancer prevention, screening, and treatment). 2 In addition, advanced disease stage, insurance status, and older age at diagnosis are associated with poorer outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Widening socioeconomic disparities in cervical cancer mortality among women in 26 states, 1993‐2007

Simard

Fedewa

et al. 2012

Cancer

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BACKGROUND: Despite substantial declines in cervical cancer mortality because of widespread screening, socioeconomic status (SES) disparities persist. The authors examined trends in cervical cancer mortality rates and the risk of late-stage diagnoses by SES. METHODS: Using data from the National Vital Statistics System, trends in age-standardized mortality rates among women ages 25 to 64 years (1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) by education level ( 12 years, 13-15 years, and !16 years) and race/ethnicity for non-Hispanic white (NHW) women and non-Hispanic black (NHB) women in 26 states were assessed using log-linear regression. Rate ratios (RRs) and 95% confidence intervals (CIs) were used to assess disparities between those with 12 years versus !16 years of education during 1993 to 1995 and 2005 to 2007. Avertable deaths were calculated by applying mortality rates from the most educated women to others in 48 states. Trends in the risk of late-stage diagnosis by race/ethnicity and insurance status were evaluated in the National Cancer Data Base. RESULTS: Declines in mortality were steepest for those with the highest education levels (3.2% per year among NHW women and 6.8% per year among NHB women). Consequently, the education disparity widened between the periods 1993 to 1995 and 2005 to 2007 from 3.1 (95% CI, 2.4-3.9) to 4.4 (95% CI, 3.5-5.6) for NHW women and from 3.8 (95% CI, 2.0-7.0) to 5.6 (95% CI, 3.1-10.0) for NHB women.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Widening socioeconomic disparities in cervical cancer mortality among women in 26 states, 1993‐2007

Simard

Fedewa

et al. 2012

Cancer

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“…On the basis of the whole male population of Sweden aged 25-74 years, this study confirms that low SES increases the risk of prostate cancer mortality. [1][2][3][4][5][6]23 Therefore, both neighborhood-and individual-level perspectives are Neighborhood deprivation and mortality X Li et al needed when studying socioeconomic factors and their relationships with prostate cancer mortality. Various mechanisms have been proposed as possible explanations for neighborhood effects on individual health.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to age, androgen levels and family history, studies have consistently shown associations between individual-level socioeconomic status (SES) and prostate cancer risk and survival. [1][2][3][4][5][6][7][8] For example, a study from Switzerland showed that patients with low occupational status had a twofold increased risk of dying from prostate cancer because of delayed diagnosis, poor examinations and less invasive treatments. 9 During the first decade of this millennium an increasing number of studies have described the separate influences of individual-and neighborhood-level SES on health.…”

Section: Introductionmentioning

confidence: 99%

Neighborhood deprivation and prostate cancer mortality: a multilevel analysis from Sweden

Sundquist

2011

Prostate Cancer Prostatic Dis

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in patients aged 25-74 years (a total of 73 159 patients). Multilevel logistic regression analyses were performed with individual-level characteristics at the first level and level of neighborhood deprivation at the second level. RESULTS:The age-standardized prostate cancer mortality rate was 1.5 times higher in men living in high-deprivation neighborhoods than in those living in the most affluent neighborhoods. Mortality rates were also associated with certain individual-level characteristics, that is, age, marital status, family income, educational attainment, immigration status, urban/rural status, mobility and comorbidity. For example, there was a strong relationship between prostate cancer mortality and being unmarried, having a low income or educational attainment, and hospitalization for chronic obstructive pulmonary disease. In the full model, the risk of prostate cancer mortality was 25% higher in men living in the most deprived neighborhoods than in those living in the most affluent neighborhoods.CONCLUSIONS: High level of neighborhood deprivation independently predicts prostate cancer mortality. This raises important clinical and public health concerns. Both individual-and neighborhood-level approaches are important in healthcare policies.

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“…However, in the current study, we observed that the effect of race on receipt of multimodality therapy was confounded by uninsured status. 31,32 To allow for future interventions, mechanisms to better understand the relation between hospital volume and insurance status with the receipt of multimodality therapy are needed.…”

Section: Discussionmentioning

confidence: 99%

Variations in gastric cancer care

Al‐Refaie

Virnig

Tseng

et al. 2009

Cancer

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BACKGROUND:Race is associated with patterns of presentation and survival outcomes of gastric cancer in the United States. However, the impact of race on the receipt of guideline‐recommended care is not well characterized. By using current recommendations, the authors examined the association between race and guideline‐recommended treatments and identified factors that are predictive of variations in gastric cancer care.METHODS:By using the National Cancer Database for 1998 through 2005, 106,002 patients with gastric adenocarcinoma were identified. Multivariate analysis techniques were used to examine the association between race, the receipt of guideline‐recommended care, and survival after adjusting for covariates.RESULTS:Although African‐American and Hispanic patients were more likely to undergo adequate lymphadenectomy (≥15 lymph nodes) and to receive care at comprehensive cancer centers and high‐volume facilities (for all, P ≤ .001), they were less likely to receive adjuvant multimodality therapy for American Joint Committee on Cancer stage IB through IV, lymph node‐negative (M0) disease. Up to 60% of all patients who underwent gastrectomy failed to receive adequate lymphadenectomy and adjuvant multimodality therapy. The delivery of multimodality therapy varied significantly by stage and lymph node evaluation (P ≤ .001). These findings persisted on our multivariate analyses, indicating that African‐American and Hispanic patients received adequate lymph node evaluation (P ≤ .001), whereas they were associated with receiving no adjuvant multimodality therapy (P ≤ .025).CONCLUSIONS:There were significant variations in treatment for gastric cancer among ethnic groups in the United States. It was noteworthy that, although nonwhite race was associated with improved surgical care, gastric cancer care remained suboptimal overall. Cancer programs need to identify procedures to maximize the delivery of adequate gastric cancer care to all patients. Cancer 2010. © 2010 American Cancer Society.

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Cancer Mortality in the United States by Education Level and Race

Abstract: Cancer death rates vary considerably by level of education. Identifying groups at high risk of death from cancer by level of education as well as by race may be useful in targeting interventions and tracking cancer disparities.

Cited by 409 publications

References 39 publications

Widening socioeconomic disparities in cervical cancer mortality among women in 26 states, 1993‐2007

Widening socioeconomic disparities in cervical cancer mortality among women in 26 states, 1993‐2007

Neighborhood deprivation and prostate cancer mortality: a multilevel analysis from Sweden

Variations in gastric cancer care

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