Higher Risk for Colorectal Cancer Seen Among the Poor
A disproportionately high incidence of colorectal cancers in the US occurs among people with a relatively low socioeconomic status. To investigate why this happens, researchers led by Chyke A. Doubeni, MD, MPH, from the University of Pennsylvania Perelman School of Medicine, used records of participants enrolled in the National Institutes of Health-AARP Diet and Health Study. Participants were enrolled in 1995/96 and followed until 2006. Out of more than 500,000 participants, 7676 developed cancer of the colon/rectum.
The investigators found that health behaviors among the participants belonging to the lower socioeconomic status accounted for the increased risk for colorectal cancer. Among these behaviors, having poor dietary habits was found to have the biggest impact. Other factors which were observed to affect the incidence of cancer included physical inactivity, smoking, and unhealthy weight.
The socioeconomic status of the participants was evaluated in 2 ways: by “neighborhood socioeconomic status,” as revealed by census data and by self-reported educational level (less than high school versus high school and more than high school). They found an overall observation that the combination of health behaviors and body mass index (BMI) explained about 44% of the association between risk for colorectal cancer and education and 36% of the association between the risk and neighborhood socioeconomic status. This demonstrated that about 1/3 to ½ of colorectal cancers that occur in either low income or less educated Americans may be attributed to obesity and unhealthy lifestyles.
Experts therefore believe that public health practitioners should implement more effective strategies to improve nutrition and physical activity in the United States to curb the rising incidence of obesity, particularly in disadvantaged communities and for those with less education.
Mulcahy, N. Why Poor People Have a Higher Risk for Colorectal Cancer. Medscape.