Background Socioeconomic-correlates of cancer of the large bowel differ in various countries and calendar periods and may differ for the colon and rectum. Thus, the relationship between education and social class and risk of cancers of the colon and rectum was considered. Methods Combination of two hospital-based case-control studies conducted in six Italian centres between 1985 and 1996. Cases were 3533 patients aged <79, with histologically confirmed cancer of the colon (n =2180) or rectum (n = 1353), and controls were 7062 patients admitted to hospital for a wide spectrum of acute, non-neoplastic, non-digestive tract diseases. Results Compared to individuals with <7 years of education the multivariate odds ratios (OR) of colon cancer for those with greater than or equal to 16 years were 2.45 (95% confidence interval [CI] : 1.87-3.23) in men and 1.29 (95% CI : 0.88-1.90) in women, with significant trends in risk. No significant association emerged between education and risk of rectal cancer, with OR of 1.18 (95% CI : 0.83-1.70) and 1.01 (95% CI : 0.61-1.67) respectively for men and women in the highest educational category compared to the lowest. Social class was also related to colon cancer risk: the OR were 2.30 (95% CI : 1.82-2.90) in men and 1.33 (95% CI : 1.03-1.73) in women in the highest versus the lowest social class. No association was found between social class and rectal cancer risk, with OR of 1.18 for either men or women in the highest as compared to the lowest social class. No significant heterogeneity was found for the association between education and colon cancer risk in either sex across strata of age at diagnosis, coffee, alcohol and vegetable intake, family history of the disease, and in anatomical subsites within the colon. Conclusions This study, based on a uniquely large dataset, indicates that there are different social class correlates for colon and rectal cancer. Consequently the two sites should not be combined in studies considering lifestyle factors in the aetiology of these neoplasms.

Education, socioeconomic status and risk of cancer of the colon and rectum / A. Tavani, F. Fioretti, S. Franceschi, S. Gallus, E.V.L. Negri, M. Montella, E. Conti, C.V.B. LA VECCHIA. - In: INTERNATIONAL JOURNAL OF EPIDEMIOLOGY. - ISSN 0300-5771. - 28:3(1999 Jun), pp. 380-385.

Education, socioeconomic status and risk of cancer of the colon and rectum

E.V.L. Negri;C.V.B. LA VECCHIA
Ultimo
1999-06

Abstract

Background Socioeconomic-correlates of cancer of the large bowel differ in various countries and calendar periods and may differ for the colon and rectum. Thus, the relationship between education and social class and risk of cancers of the colon and rectum was considered. Methods Combination of two hospital-based case-control studies conducted in six Italian centres between 1985 and 1996. Cases were 3533 patients aged <79, with histologically confirmed cancer of the colon (n =2180) or rectum (n = 1353), and controls were 7062 patients admitted to hospital for a wide spectrum of acute, non-neoplastic, non-digestive tract diseases. Results Compared to individuals with <7 years of education the multivariate odds ratios (OR) of colon cancer for those with greater than or equal to 16 years were 2.45 (95% confidence interval [CI] : 1.87-3.23) in men and 1.29 (95% CI : 0.88-1.90) in women, with significant trends in risk. No significant association emerged between education and risk of rectal cancer, with OR of 1.18 (95% CI : 0.83-1.70) and 1.01 (95% CI : 0.61-1.67) respectively for men and women in the highest educational category compared to the lowest. Social class was also related to colon cancer risk: the OR were 2.30 (95% CI : 1.82-2.90) in men and 1.33 (95% CI : 1.03-1.73) in women in the highest versus the lowest social class. No association was found between social class and rectal cancer risk, with OR of 1.18 for either men or women in the highest as compared to the lowest social class. No significant heterogeneity was found for the association between education and colon cancer risk in either sex across strata of age at diagnosis, coffee, alcohol and vegetable intake, family history of the disease, and in anatomical subsites within the colon. Conclusions This study, based on a uniquely large dataset, indicates that there are different social class correlates for colon and rectal cancer. Consequently the two sites should not be combined in studies considering lifestyle factors in the aetiology of these neoplasms.
case-control studies; colorectal cancer; education; risk factors; socioeconomic status
Settore MED/01 - Statistica Medica
Article (author)
File in questo prodotto:
File Dimensione Formato  
280380.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 216.97 kB
Formato Adobe PDF
216.97 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/520190
Citazioni
  • ???jsp.display-item.citation.pmc??? 7
  • Scopus 34
  • ???jsp.display-item.citation.isi??? 26
social impact