Research article summary (published 6 Jul 2008):

Secular trends in mortality from common cancers in the United States by educational attainment, 1993-2001.

Full Abstract

BACKGROUND:
Death rates for the four major cancer sites (lung, breast, prostate, and colon and rectum) have declined steadily in the United States among persons aged 25-64 years since the early 1990s. We used national data to examine these trends in relation to educational attainment.

METHODS:
We calculated age-standardized death rates for each of the four cancers by level of education among 25- to 64-year-old non-Hispanic white and non-Hispanic black men and women for 1993 through 2001 using data on approximately 86% of US deaths from the National Center for Health Statistics, education level as recorded on the death certificate, and population data from the US Bureau of Census Current Population Survey. Annual percent changes in age-adjusted death rates were estimated using weighted log-linear regression models. All statistical tests were two-sided.

RESULTS:
Death rates for each cancer decreased statistically significantly from 1993 to 2001 in people with at least 16 years of education in every sex and race stratum except lung cancer in black women, for whom death rates were stable. For example, colorectal cancer death rates among white men, black men, white women, and black women with at least 16 years of education decreased by 2.4% (P < .001), 4.8% (P = .011), 3.0% (P < .001), and 2.6% (P = .030) annually, respectively. By contrast, among people with less than 12 years of education, a statistically significant decrease in death rates from 1993 through 2001 was seen only for breast cancer in white women (1.4% per year; P = .029). Death rates among persons with less than 12 years of education over the same time interval increased for lung cancer in white women (2.4% per year; P < .001) and for colon cancer in black men (2.7% per year; P < .001) and were stable for the remaining race/sex/site strata. Temporal trends generally followed an educational gradient in which the slopes of the decreases in death rate became steeper with higher educational attainment.

CONCLUSION:
The recent declines in death rates from major cancers in the United States mainly reflect declines in more highly educated individuals.

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Author information

Author/s: Kinsey, Tracy (T); Jemal, Ahmedin (A); Liff, Jonathan (J); Ward, Elizabeth (E); Thun, Michael (M);

Affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.

Journal and publication information

Publication Type: Journal Article

Journal: Journal of the National Cancer Institute (J Natl Cancer Inst), published in United States. (Language: eng)

Reference: 2008-Jul; vol 100 (issue 14) : pp 1003-12

Dates: Created 2008/07/16; Completed 2008/08/14;

PMID: 18612132, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult African Americans - statistics & numerical data Breast Neoplasms - ethnology; mortality Colorectal Neoplasms - ethnology; mortality Confounding Factors (Epidemiology) Educational Status European Continental Ancestry Group - statistics & numerical data Female Humans

Linear Models Lung Neoplasms - ethnology; mortality Male Middle Aged Mortality - trends Prostatic Neoplasms - ethnology; mortality Research Design Sex Distribution United States - epidemiology

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