Socioeconomic distribution of cancer of the gastrointestinal tract in new haven

Cohart, Edward M.; Müller, Charlotte

doi:10.1002/1097-0142(1955)8:2<379::aid-cncr2820080217>3.0.co;2-9

Cited by 31 publications

(2 citation statements)

References 3 publications

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“…Rates of pancreatic cancer have been reported to be high among some low socioeconomic populations [33], while other studies have not demonstrated any consistent relationship of pancreatic cancer with socioeconomic status [18,25,34]. In England and Wales the Registrar General [35] observed no relationship with social class even when the cancers were separated by location into head of the pancreas, other specified parts of the pancreas, and unspecified location.…”

Section: Religionmentioning

confidence: 99%

Epidemiology of pancreatic cancer

1984

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In the United States the incidence of and mortality from pancreatic cancer have increased over the past several decades but have tended to level off in recent years. The rates are higher in blacks than in whites and higher in males than in females. Mortality rates increase with age but there appears to be a decline in elderly blacks, possibly on an artifactual basis. There is a suggestion that rates are higher in Jews. No consistent differences by socioeconomic status or by geographic location within the United States have been identified. Both genetic and environmental factors may be playing significant roles in this disease. Cigarette smoking may be etiologically related, or at the very least, may help to identify a group of patients at increased risk of pancreatic cancer. However, the relative risk estimated for cigarette smoking is much lower than that found for cancer of the lung. The leveling off in incidence and mortality rates for pancreatic cancer in recent years also differs from the time trends observed for lung cancer. However, this could result from differences in site‐specific carcinogens and from the fact that the lung is the first organ to be exposed to cigarette smoke in the highest concentrations and prior to the metabolism of any of its components. Dietary factors may have an important role in pancreatic cancer, but further research is needed to clarify this relationship. In particular, the possibility that dietary fats may be implicated and that vitamins or fiber may be protective in this disease remains to be explored. Finally, there is suggestive evidence that specific chemical exposures may be carcinogenic for the pancreas. Many of the data are from animal studies, and the findings from human studies are not entirely consistent.

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Section: Religionmentioning

confidence: 99%

Epidemiology of pancreatic cancer

1984

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“…Social class diVerences have been studied most extensively among cancer patients, the first reports dating back to the 1950s [33][34][35] and later research conducted in the USA, 8 21 26 27 Europe, 1 2 6 7 12 Japan, 9 and Australia. 23 Although results have been somewhat conflicting, the largest population-based studies have reported social class diVerences in survival for several, but not all, types of cancer.…”

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confidence: 99%

Measuring social class differences in cancer patient survival: is it necessary to control for social class differences in general population mortality? A Finnish population-based study

Dickman

Auvinen

Voutilainen

et al. 1998

Journal of Epidemiology & Community Health

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Study objectives-Estimation of cancer patient survival by social class has been performed using observed, corrected (cause specific), and relative (with expected survival based on the national population) survival rates. Each of these measures are potentially biased and the optimal method is to calculate relative survival rates using social class specific death rates to estimate expected survival. This study determined the degree to which the choice of survival measure aVects the estimation of social class diVerences in cancer patient survival. Setting and participants-All Finnish residents diagnosed with at least one of 10 common malignant neoplasms during the period 1977-1985 were identified from the Finnish Cancer Registry and followed up for deaths to the end of 1992. Design-Survival rates were calculated by site, sex, and age at 5, 10, and 15 years subsequent to diagnosis for each of three measures of survival; relative survival, corrected (cause specific) survival, and relative survival adjusted for social class diVerences in general mortality. Regression models were fitted to each set of rates for the first five years of follow up. Main results-The degree of variation in relative survival resulting from social class decreased, although did not disappear, after controlling for social class diVerences in general mortality. The results obtained using corrected survival were close to those obtained using relative survival with a social class correction. The diVerences between the three measures were largest when the proportion of deaths from other causes was large, for example, in cancers with high survival, among older patients, and for longer follow up times. Conclusions-Although each of the three measures gave comparable results, it is recommended that relative survival rates are used with expected survival adjusted for social class when studying social class variation in cancer patient survival. If this is not an available option, it is recommended that corrected survival rates are used. Relative survival rates without the social class correction overestimate social class diVerences and should be used with caution.

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