Ten‐year change in neighborhood socioeconomic status and colorectal cancer

Abstract

Background A growing body of research has demonstrated that individuals who live in neighborhoods with more severe socioeconomic deprivation may have higher risks for colorectal cancer (CRC). However, previous studies have examined neighborhood socioeconomic status (SES) at only 1 point in time, and it is unclear whether changes in neighborhood SES also can influence the risks of CRC. Methods Cox regression analysis was used to examine different trajectories of change in neighborhood SES over 10 years in relation to the incidence of CRC among 266,804 participants (ages 51‐70 years) in the National Institutes of Health‐AARP Diet and Health Study. Eligible participants reported living in the same neighborhood at baseline (1995‐1996) and from 2004 to 2006 according to a follow‐up questionnaire. Changes in neighborhood SES were measured between 1990 and 2000 by SES indices derived from Census data. Neighborhoods were grouped into 4 categories based on median SES indices in 1990 and 2000 (low‐low, low‐high, high‐low, and high‐high). Results Compared with residents whose neighborhoods were in the higher SES group at both time points (reference category), those whose neighborhoods were consistently in the low SES group had a 7% higher risk of developing CRC (hazard ratio, 1.07; 95% confidence interval, 1.00‐1.14). Moreover, the risk of CRC was 15% higher (hazard ratio, 1.15; 95% confidence interval, 1.02‐1.28) for those living in neighborhoods with decreasing SES (high‐low) over time. Conclusions The current findings suggest that exposure to consistently low SES neighborhoods and/or a decrease in neighborhood SES over a period of time may be associated with higher risks of CRC.

Association of change in the neighborhood obesogenic environment with colorectal cancer risk: The Multiethnic Cohort Study

“…The above findings are consistent with our earlier analysis of baseline neighborhood attributes in the MEC, reported by Canchola et al (Canchola et al, 2017), where lower population density was associated with lower CRC risk, nonsignificantly among African American and Japanese American men and significantly among Latino women. Considering the negative correlation between population density and nSES, our findings also agree with the recent report by Zhang et al (Zhang, Matthews, Powell-Wiley, & Xiao, 2019), which examined trajectories of nSES in relation to CRC incidence among participants of the NIH-AARP Diet and Health Study and found consistently low or decreasing nSES associated with higher CRC risk.…”

Changes in Colorectal Cancer 5-Year Survival Disparities in California, 1997–2014

“…2,[4][5][6][11][12][13][14]. In addition, people of lower socioeconomic status (SES) are less likely to have access to treatment, have more postop-erative complications, and have higher mortality than their more affluent counterparts (7,10,(15)(16)(17).…”

Time Trends in Colorectal Cancer Incidence Rates by Income and Age at Diagnosis in Canada From 1992 to 2016

“…Income inequalities in CRC incidence rates appear to be emerging in the US. Zhang et al 24 investigated the association between changes in neighborhood SES and CRC incidence rates among individuals aged 50 to 71 years who lived in the same location for at least 10 years in several US states.…”