Dataset Information

Association between Socioeconomic Status and Digestive Tract Cancers: A Case-Control Study.

ABSTRACT: Although socioeconomic status (SES) has been associated with cancer risk, little research on this association has been done in Japan. To evaluate the association between SES and digestive tract cancer risk, we conducted a case-control study for head and neck, esophageal, stomach, and colorectal cancers in 3188 cases and the same number of age- and sex-matched controls within the framework of the Hospital-based Epidemiological Research Program at Aichi Cancer Center III (HERPACC III). We employed the education level and areal deprivation index (ADI) as SES indicators. The association was evaluated with odds ratios (ORs) and 95% confidence intervals (CIs) by conditional logistic models adjusted for potential confounders. Even after allowance for known cancer risk factors, the education level showed linear inverse associations with head and neck, stomach, and colorectal cancers. Compared to those educated to junior high school, those with higher education showed statistically significantly lower risks of cancer (0.43 (95% CI: 0.27-0.68) for head and neck, 0.52 (0.38-0.69) for stomach, and 0.52 (0.38-0.71) for colorectum). Consistent with these results for the educational level, the ADI in quintiles showed positive associations with head and neck, esophageal, and stomach cancers (p-trend: p = 0.035 for head and neck, p = 0.02 for esophagus, and p = 0.013 for stomach). Interestingly, the positive association between ADI and stomach cancer risk disappeared in the additional adjustment for Helicobacter pylori infection and/or atrophic gastritis status. In conclusion, a lower SES was associated with an increased risk of digestive cancers in Japan and should be considered in cancer prevention policies for the target population.

SUBMITTER: Kawakatsu Y

PROVIDER: S-EPMC7694284 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Association between Socioeconomic Status and Digestive Tract Cancers: A Case-Control Study.

Kawakatsu Yukino Y Koyanagi Yuriko N YN Oze Isao I Kasugai Yumiko Y Morioka Hisayoshi H Yamaguchi Rui R Ito Hidemi H Matsuo Keitaro K

Cancers 20201104 11

Although socioeconomic status (SES) has been associated with cancer risk, little research on this association has been done in Japan. To evaluate the association between SES and digestive tract cancer risk, we conducted a case-control study for head and neck, esophageal, stomach, and colorectal cancers in 3188 cases and the same number of age- and sex-matched controls within the framework of the Hospital-based Epidemiological Research Program at Aichi Cancer Center III (HERPACC III). We employed ...[more]

PMID: 33158224

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Project description:ImportanceSome studies based on proportions of patients with perforated appendicitis (PA) among all patients with acute appendicitis (AA) have found an association between socioeconomic status (SES) and risk of perforation. A potential limitation is their use of proportions, which assumes that incidence of AA is evenly distributed across populations at risk. This assumption may be invalid, and SES may have a more complex association with both AA and PA.ObjectiveTo generate population-based incidences of AA and PA and to examine geographic patterns of incidence alongside geographic patterns of SES.Design, setting, and participantsRetrospective study of data from Washington's Comprehensive Hospital Abstract Reporting System and the 2010 US census. Geographic methods were used to identify patterns of age- and sex-standardized incidence in Washington State between 2008 and 2012. The study included all patients discharged with International Classification of Diseases, Ninth Revision codes for AA or PA. Data were analyzed between November 2016 and December 2018.ExposuresLocation of primary residence.Main outcomes and measuresAge- and sex-standardized incidence for AA and PA was generated for each census tract (CT). Global spatial autocorrelation was examined using Moran index (0.0?=?completely random incidence; 1.0?=?fully dependent on location). Clusters of low-incidence CTs (cold spots) and high-incidence CTs (hot spots) were identified for AA. Census-based SES data were aggregated for hot spots and cold spots and then compared.ResultsStatewide, over the 5-year study period, there were 35?730 patients with AA (including 9780 cases of PA), of whom 16?574 were women (46.4%). Median age of the cohort was 29 years (IQR, 16-48 years). Statewide incidence of AA and PA was 106 and 29 per 100?000 person-years (PY), respectively. Crude incidence was higher within the male population and peaked at age 10 to 19 years. Age- and sex-standardized incidence of AA demonstrated significant positive spatial autocorrelation (Moran index, 0.30; P?<?.001), but autocorrelation for PA was only half as strong (0.16; P?<?.001). Median incidence of AA was 118.1 per 100?000 PY among hot spots vs 86.2 per 100?000 PY among cold spots (P?<?.001). Socioeconomic status was higher in cold spots vs hot spots: mean proportion of college-educated adults was 56% vs 26% (P?<?.001), and mean per capita income was $44?691 vs $30?027 (P?<?.001).Conclusions and relevanceAge- and sex-standardized incidence of appendicitis is not randomly distributed across geographic subunits, and geographic clustering of AA is twice as strong as PA. Socioeconomic advantages, such as higher income and secondary education, are strongly associated with lower incidence of AA. These findings challenge conventional views that AA occurs randomly and has no predisposing characteristics beyond age/sex. Socioeconomic status, and likely other geographically circumscribed factors, are associated with incidence of AA.

Dataset Information

Association between Socioeconomic Status and Digestive Tract Cancers: A Case-Control Study.

Publications

Association between Socioeconomic Status and Digestive Tract Cancers: A Case-Control Study.

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