Abstract
B66
Background: Cancer death rates from the four most common cancer sites have declined continuously in the U.S. since the early 1990’s, except for lung cancer in women. The extent to which this trend varies by individual-level socioeconomic status has not been examined. Methods: We calculated annual age-standardized death rates by level of education for cancer of the lung, breast, prostate, and colon and rectum among 25-64 year old non-Hispanic white and black men and women from 1993 through 2001 using mortality data from the National Center for Health Statistics, education level recorded on the death certificate, and population data from the United States Bureau of Census Current Population Survey. We estimated the annual percent change in the age-standardized death rates over this time interval using a log-linear regression model. All tests were two sided (P, 0.05). Results: In the highest educated persons (16 or more years of education), death rates from 1993 through 2001 decreased for each of the four major cancers except for lung cancer in black women. In contrast, in least educated persons (<12 years of education), rates increased for lung cancer in white women and for colon cancer in black men and were stable (no decline) for the remaining race-, sex-, and cancer-specific groups except for breast cancer in white women. The slope of the decrease in the death rates from each of the four major cancers generally became steeper with higher educational attainment within each race and sex group. For example, the breast cancer death rate in white women decreased by 1.4% per year in persons with <12 years of education vs. 4.3% in persons with 16 or more years of education. Conclusion: The recent declines in death rates from major cancers in the U.S. have not yet benefited individuals with the least education. Socioeconomic disparities will continue to increase unless advances in prevention, early detection, and treatment reach all segments of the population.
First AACR International Conference on the Science of Cancer Health Disparities-- Nov 27-30, 2007; Atlanta, GA