Differences in Cancer Incidence and Mortality Among Socio-Economic Groups

Objectives: In this article studies on the association between socioeconomic status (SES) and risk for cancer at different sites are reviewed. Methods: The review is restricted to studies conducted in affluent societies, after 1970. Only studies using income, education and/or occupation as SES indicators are included. Results: A more or less consistent positive association between SES and cancer risk was found for colon and breast cancer. More or less consistent inverse associations were found for lung, stomach, oropharyngeal and esophageal cancer. Inconsistent associations were reported for cancer of the rectum and pancreas. Possible explanations for SES differences in cancer risk are discussed with special emphasis on lifestyle variables related to cancer risk. Conclusions: It is concluded that it is still unclear whether the reported associations can be (partially) attributed to lifestyle related risk factors for cancer such as smoking, nutritional habits, drinking habits and reproductive factors.

[1]  R. Gofin,et al.  Indicators of social class. A comparative appraisal of measures for use in epidemiological studies. , 1982, Social science & medicine.

[2]  R Doll,et al.  An Overview of the epidemiological evidence linking diet and cancer , 1990, Proceedings of the Nutrition Society.

[3]  R. Knibbe.  Van gangbaar tot problematies drankgebruik , 1984 .

[4]  S. Y. Choi,et al.  Effect of cigarette smoking and alcohol consumption in the etiology of cancers of the digestive tract , 1991, International journal of cancer.

[5]  K. Rosenman,et al.  Cancer by industry: analysis of a population-based cancer registry with an emphasis on blue-collar workers. , 1991, American journal of industrial medicine.

[6]  D. Crawford,et al.  Sociodemographic determinants in Australia of the intake of food and nutrients implicated in cancer aetiology , 1990, The Medical journal of Australia.

[7]  T. Sterling,et al.  Changes in smoking characteristics by type of employment from 1970 to 1979/80. , 1987, American journal of industrial medicine.

[8]  M. Bader.  Smoking patterns by occupation, industry, sex and race. , 1979, Archives of environmental health.

[9]  J. Fraumeni,et al.  A cohort study of stomach cancer in a high‐risk American population , 2006 .

[10]  A. Rimpelä,et al.  Cancers of affluence: positive social class gradient and rising incidence trend in some cancer forms. , 1987, Social science & medicine.

[11]  S. Wacholder,et al.  A cohort study of stomach cancer in a high‐risk american population , 1991, Cancer.

[12]  E. Lanza,et al.  NCI dietary guidelines: rationale. , 1988, The American journal of clinical nutrition.

[13]  L. Brinton,et al.  A prospective study of reproductive, familial and socioeconomic risk factors for breast cancer using NHANES I data. , 1989, Public health reports.

[14]  C. la Vecchia,et al.  Dietary indicators of oral and pharyngeal cancer. , 1991, International journal of epidemiology.

[15]  J. Kelsey,et al.  The epidemiology of breast cancer. , 1991, CA: a cancer journal for clinicians.

[16]  E. Wynder,et al.  Type of alcoholic beverage and oral cancer , 1989, International journal of cancer.

[17]  E. Riboli,et al.  Dietary factors and stomach cancer in Spain: A multi‐centre case‐control study , 1991, International journal of cancer.

[18]  D. Winn,et al.  The Relation of Socioeconomic Status to Oral and Pharyngeal Cancer , 1991, Epidemiology.

[19]  T C Chalmers,et al.  A meta-analysis of alcohol consumption in relation to risk of breast cancer. , 1988, JAMA.

[20]  E. Wynder,et al.  Breast cancer and alcohol consumption. A study in weak associations , 1989, Journal of the American Medical Association (JAMA).

[21]  J. Boice,et al.  Preexisting lung disease and lung cancer among nonsmoking women. , 1992, American journal of epidemiology.

[22]  J. Flannery,et al.  On the role of aging in cancer incidence: An interpretation of the prostate cancer anomaly with implications for routine screening , 1986, The Prostate.

[23]  N. Pearce,et al.  Stomach cancer in New Zealand: time trends, ethnic group differences and a cancer registry-based case-control study. , 1991, International journal of epidemiology.

[24]  Physical activity and colon cancer risk. , 1988, International journal of epidemiology.

[25]  P A Van den Brandt,et al.  Development of a record linkage protocol for use in the Dutch Cancer Registry for Epidemiological Research. , 1990, International journal of epidemiology.

[26]  J. Freudenheim,et al.  Nutritional epidemiology of postmenopausal breast cancer in western New York. , 1991, American journal of epidemiology.

[27]  R A Goldbohm,et al.  A large-scale prospective cohort study on diet and cancer in The Netherlands. , 1990, Journal of clinical epidemiology.

[28]  M. A. Faia.  Selection by Certification: A Neglected Variable in Stratification Research , 1981, American Journal of Sociology.

[29]  A. Osborn,et al.  The Rationale for a Composite Index of Social Class and Its Evaluation , 1979 .

[30]  H. Zurayk,et al.  Measures of social class based on education for use in health studies in developing countries. , 1987, Journal of epidemiology and community health.

[31]  M. Shipley,et al.  Socioeconomic differentials in cancer among men. , 1991, International journal of epidemiology.

[32]  S. Wall,et al.  Changing smoking habits in Sweden: towards better health, but not for all. , 1990, International journal of epidemiology.

[33]  P. van’t Veer,et al.  Consumption of fermented milk products and breast cancer: a case-control study in The Netherlands. , 1989, Cancer research.

[34]  B. Jacobsen,et al.  Level of education, use of oral contraceptives and reproductive factors: the Tromsø Study. , 1990, International journal of epidemiology.

[35]  J. Faivre,et al.  Epidemiological evidence for distinguishing subsites of colorectal cancer. , 1989, Journal of epidemiology and community health.

[36]  E. Riboli,et al.  Proportion of lung cancers due to occupational exposure , 1984, International journal of cancer.

[37]  B. Carlton,et al.  Behavior, lifestyle, and socioeconomic variables as determinants of health status: implications for health policy development. , 1985, American journal of preventive medicine.

[38]  L. Vitetta,et al.  Alcohol consumption and the etiology of colorectal cancer: a review of the scientific evidence from 1957 to 1991. , 1992, Nutrition and cancer.

[39]  C. la Vecchia,et al.  Social factors, diet and breast cancer in a northern Italian population. , 1984, British Journal of Cancer.

[40]  D. Kritchevsky.  Diet, nutrition, and cancer: The role of fiber , 2022 .

[41]  D. Vågerö,et al.  Occurrence of Cancer in Socioeconomic Groups in Sweden: An Analysis Based on the Swedish Cancer Environment Registry , 1986, Scandinavian journal of social medicine.

[42]  M. Ewertz,et al.  Risk of breast cancer in relation to social factors in Denmark. , 1988, Acta oncologica.

[43]  K. Kirchgässler.  Health and social inequities in the Federal Republic of Germany. , 1990, Social science & medicine.

[44]  I. G. Jones,et al.  Social class analysis--an embarrassment to epidemiology. , 1984, Community medicine.

[45]  B. H. Patterson,et al.  Food choices and the cancer guidelines. , 1988, American journal of public health.

[46]  R. Brownson,et al.  Occupational risk of colon cancer. An analysis by anatomic subsite. , 1989, American journal of epidemiology.

[47]  C. la Vecchia,et al.  Risk factors for hepatocellular carcinoma in Northern Italy , 1988, International journal of cancer.

[48]  L. Berkman,et al.  Social class, susceptibility and sickness. , 1976, American journal of epidemiology.

[49]  F. di Orio,et al.  Social differences in health and utilization of health services in Italy. , 1990, Social science & medicine.

[50]  J. Horm,et al.  Socioeconomic factors and cancer incidence among blacks and whites. , 1991, Journal of the National Cancer Institute.

[51]  L. Pickle,et al.  Life-style risk factors for pancreatic cancer in Louisiana: a case-control study. , 1988, American journal of epidemiology.

[52]  R. Williams,et al.  Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. , 1977, Journal of the National Cancer Institute.

[53]  G. Block,et al.  Fruit, vegetables, and cancer prevention: a review of the epidemiological evidence. , 1992, Nutrition and cancer.

[54]  E. Pukkala,et al.  Socioeconomic status and education as risk determinants of gastrointestinal cancer. , 1986, Preventive medicine.

[55]  J L Kelsey,et al.  The measurement of social class in epidemiology. , 1988, Epidemiologic reviews.

[56]  S. Epstein,et al.  Fallacies of lifestyle cancer theories , 1981, Nature.

[57]  D. Blane.  An assessment of the Black Report's explanations of health inequalities , 1985 .

[58]  L Mutch,et al.  Perusing the literature: comparison of MEDLINE searching with a perinatal trials database. , 1985, Controlled clinical trials.

[59]  N. Pearce,et al.  Occupation, social class and male cancer mortality in New Zealand, 1974-78. , 1986, International journal of epidemiology.

[60]  H. Bingham.  Comparative epidemiology of tobacco-related cancers , 1978 .

[61]  M G Marmot,et al.  Social/economic status and disease. , 1987, Annual review of public health.

[62]  C. la Vecchia,et al.  Socioeconomic indicators, tobacco and alcohol in the aetiology of digestive tract neoplasms. , 1989, International journal of epidemiology.

[63]  E. Benito.  Overview of Dietary Recommendations on Diet and Cancer , 1992 .

[64]  J. Freudenheim,et al.  Lifetime alcohol intake and risk of rectal cancer in western New York. , 1990, Nutrition and cancer.

[65]  C. la Vecchia,et al.  Food consumption and cancer of the colon and rectum in north‐eastern Italy , 1992, International journal of cancer.

[66]  J. Elwood,et al.  Alcohol, smoking, social and occupational factors in the aetiology of cancer of the oral cavity, pharynx and larynx , 1984, International journal of cancer.

[67]  L. Teppo.  Cancer incidence by living area, social class and occupation. , 1984, Scandinavian journal of work, environment & health.

[68]  S. Curtis,et al.  Social inequalities in self-reported morbidity: interpretation and comparison of data from Britain and France. , 1990, Social science & medicine.

[69]  J. Kelsey,et al.  Epidemiology of breast cancer. , 1990, Epidemiologic reviews.

[70]  B. Drasar,et al.  Faecal steroids and bacteria and large bowel cancer in Hong Kong by socio-economic groups. , 1976, British Journal of Cancer.

[71]  C. la Vecchia,et al.  Socioeconomic groups and cancer risk at death in the Swiss Canton of Vaud. , 1988, International journal of epidemiology.

[72]  N. Day,et al.  Biosocial correlates of colorectal cancer in Greece. , 1984, International journal of epidemiology.

[73]  E. Wynder,et al.  Oral contraceptives and breast cancer risk: a case-control study. , 1990, International journal of epidemiology.

[74]  J. Mackenbach,et al.  Socio-economic health differences in The Netherlands: a review of recent empirical findings. , 1992, Social science & medicine.

[75]  U. Pastorino,et al.  The relationship of dietary intake and serum levels of retinol and beta‐carotene with breast cancer. Results of a case‐control study , 1988, Cancer.