Socioeconomic status and colon cancer incidence: a prospective cohort study

Loon, A.J.M. van; Brandt, Piet A. van den; Golbohm, R. A.

doi:10.1038/bjc.1995.170

Cited by 31 publications

(22 citation statements)

References 26 publications

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“…6 This was thought to be due to known risk factors for CRC, including lower occupational physical activity and dietary factors such as a higher intake of meat and eggs in the higher social class. 6 Similar results were found in a Dutch cohort-nested case-control study performed in 1995, 7 in which a positive association was found for cancer in the colon in the highest education levels. A large cohort study conducted in Finland reported higher standardized incidence ratios for cancer in both the colon and rectum in higher social classes.…”

supporting

confidence: 77%

Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location

Leufkens

Duijnhoven

Boshuizen

et al. 2011

Intl Journal of Cancer

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Existing evidence is inconclusive on whether socioeconomic status (SES) and educational inequalities influence colorectal cancer (CRC) risk, and whether low or high SES/educational level is associated with developing CRC. The aim of our study was to investigate the relationship between educational level and CRC. We studied data from 400,510 participants in the EPIC (European Prospective Investigation into Cancer and Nutrition) study, of whom 2,447 developed CRC (colon: 1,551, rectum: 896, mean follow‐up 8.3 years). Cox proportional hazard regression analysis stratified by age, gender and center, and adjusted for potential confounders were used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI). Relative indices of inequality (RII) for education were estimated using Cox regression models. We conducted separate analyses for tumor location, gender and geographical region. Compared with participants with college/university education, participants with vocational secondary education or less had a nonsignificantly lower risk of developing CRC. When further stratified for tumor location, adjusted risk estimates for the proximal colon were statistically significant for primary education or less (HR 0.73, 95%CI 0.57–0.94) and for vocational secondary education (HR 0.76, 95%CI 0.58–0.98). The inverse association between low education and CRC risk was particularly found in women and Southern Europe. These associations were statistically significant for CRC, for colon cancer and for proximal colon cancer. In conclusion, CRC risk, especially in the proximal colon, is lower in subjects with a lower educational level compared to those with a higher educational level. This association is most pronounced in women and Southern Europe.

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supporting

confidence: 77%

Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location

Leufkens

Duijnhoven

Boshuizen

et al. 2011

Intl Journal of Cancer

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“…While education is a surrogate for socioeconomic status, which has been suggested to be associated with breast and colorectal cancer incidence rates [34,35], the positive association observed here might be partly due to greater cancer risk awareness in participants with a higher education level.…”

Section: Discussionmentioning

confidence: 66%

Prevalence of Family History of Breast, Colorectal, Prostate, and Lung Cancer in a Population-Based Study

Mai¹,

Wideroff²,

Greene³

et al. 2010

Public Health Genomics

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Background: A positive family history is a known risk factor for several cancers; thus, obtaining a thorough family cancer history is essential in cancer risk evaluation and prevention management. Methods: The Family Health Study, a telephone survey in Connecticut, was conducted in 2001. A total of 1,019 participants with demographic information and family cancer history were included in this study. Prevalence of a positive family history of breast, colorectal, prostate, and lung cancer for first- and second-degree relatives was estimated. Logistic regression was used to compare prevalence by demographic factors. Results: A positive family history among first-degree relatives was reported by 10.9% (95% Confidence Interval, CI = 8.8–13.3) of respondents for breast cancer, 5.1% (95% CI = 3.9–6.7) for colorectal cancer, 7.0% (95% CI = 5.2–9.4) for prostate cancer, and 6.4% (95% CI = 4.9–8.3) for lung cancer. The reported prevalence of family history of specific cancers varied by sex, age and race/ethnicity of the respondents. Conclusion: Family history prevalence for 4 of the most common adult solid tumors is substantial and the reported prevalence varied by respondent characteristics. Additional studies are needed to evaluate tools to promote accurate reporting of family history of cancer.

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“…Only the significant association between social position and the risk of colon cancer persisted after further adjustment for other risk factors for colon cancer (P = 0.005), but the highest risk was found only in the highest social status (RR = 2.60, 95% CI 1.31 to 5.14). In women, there were no clear associations between indicators of socioeconomic status and colorectal cancer (25) . Italian study did combination of two hospital-based case-control studies conducted in six Italian centers between 1985 and 1996 found that, compared with individuals with less than 7 years of education, the odds ratio for colon (22) .…”

Section: Discussionmentioning

confidence: 79%

Increase Income and Mortality of Colorrectal Cancer in Brazil, 2001-2009

Guimarães

Rocha

Muzi

et al. 2013

Arq. Gastroenterol.

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ContextSeveral international studies have observed a correlation between the improvement of socio-demographic indicators and rates of incidence and mortality from cancer of the colon and rectum.ObjectiveThe objective of this study is to estimate the correlation between average per capita income and the rate of colorectal cancer mortality in Brazil between 2001 and 2009.MethodsWe obtained data on income inequality (Gini index), population with low incomes (½ infer the minimum wage/month), average family income, per capita ICP and mortality from colon cancer and straight between 2001-2009 by DATASUS. A trend analysis was performed using linear regression, and correlation between variables by Pearson's correlation coefficient.ResultsThere was a declining trend in poverty and income inequality, and growth in ICP per capita and median family income and standardized mortality rate for colorectal cancer in Brazil. There was also strong positive correlation between mortality from this site of cancer and inequality (men r = -0.30, P = 0.06, women r = -0.33, P = 0.05) income low income (men r = -0.80, P<0.001, women r = -0.76, P<0.001), median family income (men r = 0.79, P = 0.06, women r = 0.76, P<0.001) and ICP per capita (men r = 0.73, P<0.001, women r = 0.68, P<0.001) throughout the study period.ConclusionThe increase of income and reducing inequality may partially explain the increased occurrence of colorectal cancer and this is possibly due to differential access to food recognized as a risk factor, such as red meat and high in fat. It is important therefore to assess the priority of public health programs addressing nutrition in countries of intermediate economy, as is the case of Brazil.

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Socioeconomic status and colon cancer incidence: a prospective cohort study

Cited by 31 publications

References 26 publications

Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location

Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location

Prevalence of Family History of Breast, Colorectal, Prostate, and Lung Cancer in a Population-Based Study

Increase Income and Mortality of Colorrectal Cancer in Brazil, 2001-2009

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