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Secular trends in mortality from common cancers in the United States by educational attainment, 1993-2001.
J Natl Cancer Inst 2008; 100(14):1003-12JNCI

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.

Authors+Show Affiliations

Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18612132

Citation

Kinsey, Tracy, et al. "Secular Trends in Mortality From Common Cancers in the United States By Educational Attainment, 1993-2001." Journal of the National Cancer Institute, vol. 100, no. 14, 2008, pp. 1003-12.
Kinsey T, Jemal A, Liff J, et al. Secular trends in mortality from common cancers in the United States by educational attainment, 1993-2001. J Natl Cancer Inst. 2008;100(14):1003-12.
Kinsey, T., Jemal, A., Liff, J., Ward, E., & Thun, M. (2008). Secular trends in mortality from common cancers in the United States by educational attainment, 1993-2001. Journal of the National Cancer Institute, 100(14), pp. 1003-12. doi:10.1093/jnci/djn207.
Kinsey T, et al. Secular Trends in Mortality From Common Cancers in the United States By Educational Attainment, 1993-2001. J Natl Cancer Inst. 2008 Jul 16;100(14):1003-12. PubMed PMID: 18612132.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Secular trends in mortality from common cancers in the United States by educational attainment, 1993-2001. AU - Kinsey,Tracy, AU - Jemal,Ahmedin, AU - Liff,Jonathan, AU - Ward,Elizabeth, AU - Thun,Michael, Y1 - 2008/07/08/ PY - 2008/7/10/pubmed PY - 2008/8/15/medline PY - 2008/7/10/entrez SP - 1003 EP - 12 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 100 IS - 14 N2 - 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. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/18612132/Secular_trends_in_mortality_from_common_cancers_in_the_United_States_by_educational_attainment_1993_2001_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djn207 DB - PRIME DP - Unbound Medicine ER -