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Wednesday, 09 July 2008 07:04

Better education in U.S. means less risk from four common cancers

According to American Cancer Society and Emory University scientists, the better educated you are in America the less chance you have at getting breast, colorectal, lung, and prostate cancer. Go for it: Graduate from college school and live longer!

Lead researcher in the American Cancer Society study is Ahmedin Jemal, the director of the ACS’s Occurrence Office.

The study found that the deaths from these cancers dropped quite a bit from 1993 to 2001. However, they discovered that men and women with college degrees have the biggest drop of these cancers.

In fact, they state in the abstract to their paper, “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.”

The team of researchers calculated death rates based on age for the four cancers (lung, breast, prostate, and colon-and-rectum [colorectal]) by level of education among non-Hispanic white and non-Hispanic black men and women.

Each participant was between the ages of 25 and 64 years. Data, taken from 1993 to 2001, was from the majority of deaths recorded by the National Center for Health Statistics. In addition, education level and population data were taken from the U.S. Bureau of Census’ Current Population Survey.

Dr. Ahmedin Jemal stated, "Everybody has not been benefiting from advances in prevention and treatment of cancer. The decrease in cancer deaths is mostly confined to the most educated men and women. For those less educated men and women, those rates are either stable or for some cancers has been increasing.” [U.S. News and World Report: “College-Educated Fare Better When Cancer Strikes”]

The authors of the paper stated, “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% …, 4.8% …, 3.0% …, and 2.6% … annually, respectively.” [U.S. News and World Report]

They added, “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; …). 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; …) and for colon cancer in black men (2.7% per year; …) and were stable for the remaining race/sex/site strata….” [U.S. News and World Report]

Additional specifics found in the study are found on page two.

The researchers found a large decline in the rate of mortality from prostate, lung, and colorectal cancer, for black and white men with sixteen or more years of education; that is a high school education plus at least a degree from a four-year college or university.

The study also found that death rates decreased among black and white women with sixteen years of education or more for colorectal, breast, and lung cancer. The decline in lung cancer death rates, however, was not found among black women.

In addition, the researchers found that for women with less than twelve years of education, only white women showed a significant decrease in deaths from breast cancer.

Finally, the study discovered that deaths from lung cancer among less educated white women increased and deaths from colon cancer among less educated black men increased.

Jemal stated some conclusions based on the study results, "Less educated people have more risk factors for cancer like smoking and obesity. They receive less medical services for prevention, early detection and treatment. Less access to care is a major barrier." [U.S. News and World Report]

He also noted that education continues to be a strong indicator for socioeconomic status. Jemal commented that people who have attained less education also tend to have less money and are less likely to go to a doctor when needing medical advice.

Jemal added, "In addition, they are less likely to navigate the health care system effectively. So, they are at a disadvantage." [U.S. News and World Report]

To help people with less education Jemal believes there needs to be more emphasis placed on access to care and prevention.

The paper that notes these conclusions is called “Secular Trends in Mortality From Common Cancers in the United States by Educational Attainment, 1993–2001.” It was published online on July 8, 2008 in the Journal of the National Cancer Institute.

The authors of the study are Tracy Kinsey, Ahmedin Jemal, Jonathan Liff, Elizabeth Ward, and Michael Thun. They are affiliated to the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (Kinsey and Liff); and the Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA (Jemal, Ward, and Thun).


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