Colorectal Cancer Deaths Tied to Socioeconomic Factors

Colorectal cancer deaths may be tied to socioeconomic status, education level and other factors

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Colon and rectal cancer rates have been rising among young adults, a recent study found. And new research found that colorectal cancer deaths may be tied to social and economic inequality.

In the beginning of November, a study published in JAMA Surgery found that rates of colon and rectal cancer have been rising by about 2 percent a year among patients between ages 20 and 34 since the mid-1970s.

And a new study has found that many deaths from colorectal cancer in US patients ages 25 to 64 may be tied to social and economic factors. Education level may also play a key role.

Ahmedin Jemal, PhD, of the American Cancer Society’s Surveillance and Health Services Research program in Atlanta, led the new study.

Dr. Jemal and team studied data representing the entire United Sates from the National Vital Statistics System of the National Center for Health Statistics.

The study authors found that rates of death from colorectal cancer were higher in states where people had the least education.

For instance, the authors found that whites in New Mexico with the least education had a three times greater risk of colorectal cancer death than those who had achieved the highest education levels. The lowest level of education was defined as 12 years or less. The highest level was 16 years or more.

Dr. Jemal and colleagues calculated that, if all the patients in their study had experienced the lowest death rate of the most educated whites, half of all the colorectal cancer deaths that occurred from 2008 to 2010 could have been avoided. That lowest death rate was 7,690 deaths per year.

“We found that the least educated persons in the United States have a disproportionately higher burden of [colorectal cancer] death rate, regardless of race or state of residence,” the authors wrote.

Historically, whites with higher socioeconomic status in northern states had a higher colorectal cancer death rate. Over the past few decades, though, that changed. Now, blacks with the lowest socioeconomic status in southern states may have higher death rates, Dr. Jemal and team noted.

The authors noted that southern states had more preventable colorectal cancer deaths than northern and western states. For instance, if all racial, ethnic, socioeconomic and other inequalities were eliminated in Mississippi, 69 percent of the state's deaths from colorectal cancer could be avoided, the authors estimated. That same figure in Vermont was 23 percent.

Dr. Jemal and team said the reasons behind the inequalities were varied and complex. Differences in income, education, insurance status and location all appeared to contribute. These factors may tie into access to screening and treatment services that could prevent or treat colorectal cancer, the authors noted.

Healthy behaviors were also tied to socioeconomic status, the authors found. Those in the higher-income, higher-education groups were less likely to be obese, smoke cigarettes and eat red meat. They were more likely to exercise and take anti-inflammatory medication. The opposite was true among those who had lower income and less education.

“The majority of premature deaths from [colorectal cancer] in southern states and half the deaths nationwide are potentially avertable through the elimination of racial/ethnic, socioeconomic, and geographic inequalities,” Dr. Jemal and colleagues wrote.

The study authors noted that inequalities might be reduced through increased access to preventive care services, such as colorectal cancer screening.

“In an effort to increase screening nationwide, several organizations, including the American Cancer Society and the Centers for Disease Control and Prevention, are supporting an initiative to increase [colorectal cancer] screening rates to 80 percent by 2018, largely by focusing on patients and clinicians in community health centers and other safety-net providers,” Dr. Jemal and team wrote.

This study was published Nov. 10 in the Journal of Clinical Oncology.

The authors disclosed no funding sources. They listed conflicts of interest on the journal website.

Review Date: 
November 10, 2014
Last Updated:
November 13, 2014