Socioeconomic status and the risk of colorectal cancer: an analysis of more than a half million adults in the National Institutes of Health-AARP Diet and Health Study.
Socioeconomic status and the risk of colorectal cancer: an analysis of more than a half million adults in the National Institutes of Health-AARP Diet and Health Study.
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作者：
Doubeni CA;Laiyemo AO;Major JM;Schootman M;Lian M;Park Y;Graubard BI;Hollenbeck AR;Sinha R
美国之前没有前瞻性研究调查过低社会经济地位（SES）男性和女性结直肠癌（CRC）发病率是否过高。这项研究考察了个体和地区层面的 SES 与 CRC 发病率之间的关系，总体上以及按肿瘤位置划分。数据来自正在进行的前瞻性 NIH-AARP 饮食与健康研究，研究对象为 1995-1996 年基线时居住在美国 6 个州和 2 个大都市区的人员（50-71 岁）。截至 2006 年 12 月，从肿瘤登记处确定了事件 CRC。SES 通过自我报告的教育和人口普查区的社会经济剥夺来衡量。基线和后续调查问卷收集了有关个体层面 CRC 危险因素的详细信息，包括家族史和健康行为。在分析的 506,488 名参与者中，7,676 人被诊断患有原发性侵袭性结直肠腺癌：46.6% 位于右结肠，26.7% 位于左结肠，25.9% 位于直肠。即使在考虑了其他风险因素后，相对于各自最高 SES 群体而言，教育水平较低或居住在低 SES 社区的人群中 CRC 的总体发病率显着较高。这些关联在直肠中比在左或右结肠中更强。在右结肠中，考虑协变量后，任一 SES 测量值均没有显着的 SES 差异。即使在考虑了其他风险因素后，通过个人教育或社区措施评估的社会经济地位也与结直肠癌的风险相关。 SES 和 CRC 之间的关系在直肠中最强，在右结肠中最弱。
No previous prospective US study has examined if the incidence of colorectal cancer (CRC) is disproportionately high in low socioeconomic status (SES) populations of both men and women. This study examined the relationship between both individual and area-level SES and CRC incidence, overall and by tumor location. Data were obtained from the ongoing prospective NIH-AARP Diet and Health Study of persons (50–71 years old) who resided in 6 US states and 2 metropolitan areas at baseline in 1995–1996. Incident CRCs were ascertained from tumor registries through December 2006. SES was measured by self-reported education and census-tract socioeconomic deprivation. Baseline and follow-up questionnaires collected detailed information on individual-level CRC risk factors including family history and health behaviors. Among 506,488 participants analyzed, 7,676 were diagnosed with primary invasive colorectal adenocarcinomas: 46.6% in the right colon, 26.7% in the left colon and 25.9% in the rectum. The overall incidence of CRC was significantly higher among people who had low-educational level or lived in low-SES neighborhoods, relative to respective highest-SES groups, even after accounting for other risk factors. These associations were stronger in the rectum than in left or right colon. In the right colon, there were no significant SES differences by either SES measure after accounting for covariates. SES, assessed by either individual-level education or neighborhood measures, was associated with risk of CRC even after accounting for other risk factors. The relationship between SES and CRC was strongest in the rectum and weakest in the right colon.
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影响因子：
12.7
作者：
Doubeni, Chyke A.;Schootman, Mario;Schatzkin, Arthur
通讯作者：
Schatzkin, Arthur
影响因子：
2.3
作者：
Krieger, N;Quesenberry, C;Ward, F
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影响因子：
8.4
作者：
Deng, Guoren;Kakar, Sanjay;Kim, Young S.
通讯作者：
Kim, Young S.
影响因子：
3.3
作者：
Siegel, Rebecca L.;Jemal, Ahmedin;Ward, Elizabeth M.
通讯作者：
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影响因子：
5
作者：
Schatzkin, A;Subar, AF;Kipnis, V
通讯作者：
Kipnis, V