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Education Linked to Cancer Death Rates
Date:9/12/2007

Socioeconomic status and access to health care may explain the connection

WEDNESDAY, Sept. 12 (HealthDay News) -- If you have a college degree, you have up to a 76 percent reduced risk of dying from cancer, a new study found.

Higher education lowers the risk for black and white women and men, according to the report in the Sept. 11 online edition of the Journal of the National Cancer Institute.

"Cancer mortality varies a great deal for all cancers by individual level of education," said study co-author Elizabeth Ward, the American Cancer Society's director of cancer surveillance. "If we could get everyone's cancer mortality to the level we see among the best educated, it would make a huge impact on cancer in the United States."

Education is tied to socioeconomic status and access to medical care, Ward noted. The new study finding makes it clear that many of the factors that influence cancer mortality are preventable, she said.

"They are preventable by social policies -- things we can change, such as smoking prevention, access to cancer screening and opportunities to good nutrition and physical activity," Ward said.

In the study, Ward and her colleagues used data from death certificates and the U.S. Census Bureau to look at the associations between education level and death rates from lung, breast, prostate and colorectal cancer. The researchers collected data on 137,708 cancer deaths from 2001 involving black and white men and women between the ages of 25 and 64.

The researchers found that more education was associated with lower death rates from cancer among all race and gender groups. The greatest difference was found between people with 12 or fewer years of education and those with more than 12 years of schooling, Ward's team found.

Compared with those with the lowest levels of education, those with the highest levels of education cut their risk of dying from cancer. For the highest educated white men, the risk was cut by 48 percent, for white women it was cut by 76 percent as it was for black men, and the most educated black women had a 43 percent lower risk of dying from cancer, the researchers reported.

This difference in cancer deaths is most likely due to a relationship between education and other factors directly associated with risks of developing and dying from cancer, such as smoking, cancer screening, and access to health care, the researchers speculated.

Although cancer death rates were higher among blacks than whites with the same level of education, they were almost the same for black and white men with zero to eight years of education, the researchers said.

"The difference between blacks and whites is most certainly due to socioeconomic conditions and access to care," Ward said.

Sholom Wacholder, an epidemiologist with the National Cancer Institute and author of an accompanying editorial in the journal, thinks the study findings account for some -- but not all -- cancer disparity rates between blacks and whites.

"I asked myself if I could use this data to figure out the difference between blacks and whites in cancer mortality," said Wacholder. "And the answer is that it is probably not possible."

The problem is that there are too many unanswered questions, Wacholder said. "We can't answer the question whether additional education by itself is the explanation or whether people with access to education have lower cancer mortality beyond the effect of education," he said.

More information

For more on cancer, visit the American Cancer Society.



SOURCES: Elizabeth Ward, Ph.D., director, cancer surveillance, American Cancer Society, Atlanta; Sholom Wacholder, Ph.D., National Cancer Institute, Bethesda, Md.; Sept. 11, 2007, Journal of the National Cancer Institute, online


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